CAJ | 학술논문

目的检测原发性痛风性关节炎(GA)患者和健康对照组外周血血浆睾酮水平及单个核细胞(PBMCs)雄激素受体(AR)表达水平差异,探讨雄激素及其受体系统在GA代谢与免疫炎症调节中可能的作用.方法化学发光法检测GA组(其中急性期119例,非急性期60例)和健康对照组(47名)血浆睾酮水平；实时荧光定量聚合酶链反应(RT-qPCR)检测原发性急性痛风性关节炎(AGA)组(41例)和健康对照组(35名)PBMCs AR转录水平；蛋白印迹法检测GA和健康对照组组各6例PBMCs AR蛋白水平；详细收集所有研究者的临床及实验室指标.组间分析采用单因素方差分析、秩和检验或t检验,相关分析采用Spearman相关分析.结果血浆睾酮水平在痛风急性期[(3.7±1.4) ng/ml]及非急性期[(4.9±2.0) ng/ml]均显著低于健康对照组[(6.1±1.5)ng/ml,P均＜0.01],而在痛风急性期显著低于非急性期(P＜0.01).PBMCs AR转录水平及蛋白水平在痛风组均显著低于健康对照组(P均＜0.01)；痛风患者AR转录水平与血尿酸呈负相关(P＜0.01),与其他临床及实验室指标之间无相关性(P均＞0.05)；非急性期GA组血浆睾酮水平与极低密度脂蛋白胆固醇、血糖呈负相关(P均＜0.05),与高密度脂蛋白胆固醇呈正相关(P＜0.05).结论雄激素及其受体系统在原发性GA患者的异常表达可能在痛风的发生发展中发挥重要作用.加强雄激素及其受体系统在痛风发病中的研究,有望为痛风的治疗寻找新的靶点.
목적 검측원발성통풍성관절염(GA)환자화건강대조조외주혈혈장고동수평급단개핵세포(PBMCs)웅격소수체(AR)표체수평차이,탐토웅격소급기수체계통재GA대사여면역염증조절중가능적작용.방법 화학발광법검측GA조(기중급성기119례,비급성기60례)화건강대조조(47명)혈장고동수평；실시형광정량취합매련반응(RT-qPCR)검측원발성급성통풍성관절염(AGA)조(41례)화건강대조조(35명)PBMCs AR전록수평；단백인적법검측GA화건강대조조조각6례PBMCs AR단백수평；상세수집소유연구자적림상급실험실지표.조간분석채용단인소방차분석、질화검험혹t검험,상관분석채용Spearman상관분석.결과 혈장고동수평재통풍급성기[(3.7±1.4) ng/ml]급비급성기[(4.9±2.0) ng/ml]균현저저우건강대조조[(6.1±1.5)ng/ml,P균＜0.01],이재통풍급성기현저저우비급성기(P＜0.01).PBMCs AR전록수평급단백수평재통풍조균현저저우건강대조조(P균＜0.01)；통풍환자AR전록수평여혈뇨산정부상관(P＜0.01),여기타림상급실험실지표지간무상관성(P균＞0.05)；비급성기GA조혈장고동수평여겁저밀도지단백담고순、혈당정부상관(P균＜0.05),여고밀도지단백담고순정정상관(P＜0.05).결론 웅격소급기수체계통재원발성GA환자적이상표체가능재통풍적발생발전중발휘중요작용.가강웅격소급기수체계통재통풍발병중적연구,유망위통풍적치료심조신적파점.
Objective To measure the level of androgen receptor (AR) mRNA in peripheral blood monocytes (PBMCs) and serum testosterone level of patients with gouty arthritis (GA) and healthy controls (HC),and to explore the role of testosterone and AR in the pathogenesis of GA.Methods Chemilluminescence was used to detect the level of serum testosterone in GA [including 119 acute GA (AGA) and 60 nonacute GA (NAGA) patients] and 47 HC group.Real-time quantitative polymerase chain reaction (RT-qPCR)was used to measure AR mRNA in PBMCs from 41 GA and 35 HC.Western blotting was used to measure PBMCs AR in GA and HC for each 6 cases.One-way ANOVA,t test and Spearman's correlation were adopted for statistical analysis.Results Serum testosterone was significantly reduced in AGA and NAGA group compared to that in HC group [(6.1±1.5) ng/ml,P＜0.01,respectively],and the expression was lower in the AGA [(3.7±1.4) ng/ml] group [(4.9±2.0) ng/ml] than that in the NAGA group (P＜0.01).The level of AR mRNA and protein was much lower in the GA group than that in the HC group (P＜0.01,respectively).Negative correlations was detected between AR mRNA and uric acid in GA patients.There was negative correlation between serum testosterone and VLDL,GLU; meanwhile,positive correlation was found between serum testosterone and HDL (P＜0.05,respectively) in NAGA patients.There were no correlations between testosterone and other laboratory data.There was no correlation between AR and other laboratory data in GA patients and healthy controls (P＞0.05,respectively).Conclusion Altered expression of testosterone and its receptor may be involved in the pathogenesis of gouty inflammation.Further study will be needed to shed light on the exact role of androgen and AR in gout.