外周血脂联素在类风湿关节炎疾病骨与关节损伤中的临床意义

陈栖栖1，田娟2 ，王甲甲1，路涛1 ，周婷1，周乔1 ，龙丽1 ，周彬1

（1.四川省医学科学院·四川省人民医院风湿免疫科，四川 成都，610072；2.川北医学院，四川 南充，637000）

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摘要：

目的 探讨类风湿关节炎（RA）患者外周血脂联素（AD）水平的变化及其与RA患者骨与关节损伤之间的相关性。方法 观察38例RA患者和34例健康对照组的年龄和身体质量指数（BMI），所有RA患者摄双手X 线检查并进行Sharp评分。详细记录RA患者的各项临床及实验室指标，包括病程、关节肿胀数、关节压痛数、C-反应蛋白（CRP）、血沉（ESR）、类风湿因子（RF）、抗环瓜氨酸肽抗体（抗CCP）、自评分、28个关节的疾病活动度评分（DAS28 评分）；采用酶联免疫吸附试验（ELISA）检测38例RA患者和34例正常人外周血AD水平并进行对比分析。结果 RA患者血清中AD水平高于对照组（[17.5±7.5）μg/mL vs.（13.6±5.5）μg/mL，P=0.015]；AD水平与年龄呈正相关（r=0.327，P=0.045）；与病程、BMI、关节肿胀数、关节压痛数、血沉、 CRP、RF、抗CCP、自评分、DAS28 评分均无相关性（P>0.05）；血清AD水平与双手X片关节骨侵蚀评分、双手X片关节间隙狭窄评分和双手X片Sharp评分均无相关性。结论 RA患者血清中AD水平较正常人明显增高，提示血清AD水平可以做为RA患者的生物标志物，RA患者血清AD水平与疾病活动度无关，与骨和关节的损伤也无相关性。

关键词：类风湿关节炎；脂联素；骨保护素

中图分类号：R593.22文献标志码：A文章编号：2096-1413(2017)18-0001-03

Clinical significance of serum adiponectin on bone and joint damage in patients with rheumatoid arthritis
CHEN Qi-qi 1, TIAN Juan 2, WANG Jia-jia 1, LU Tao 1, ZHOU Ting 1, ZHOU Qiao 1, LONG Li 1, ZHOU Bin 1
(1. Department of Rheumatology, Medical Sciences Academy of Sichuan & Sichuan Provincial People``s Hospital, Chengdu 610072; 2. North Sichuan Medical College, Nanchong 637000, China)

ABSTRACT: Objective To examine the plasma of adiponectin (AD) levels in patients with rheumatoid arthritis (RA) and investigate the relationship between AD and bone and joint damage. Methods Thirty eight patients with RA and 34 healthy individuals were recruited into this research. Radiographs of two hands in all the patients with RA were evaluated according to the Sharp``s method. Detailed clinical and laboratory indicators of RA patients were recorded, including course of disease, joint swelling, joint tenderness, C-reactive protein (CRP), ESR, rheumatoid factor (RF), anti-cyclic citrullinated peptide antibody (anti-CCP), self-score and 28 joint diseases activity score (DAS28 score). The levels of serum AD in 38 patients with RA and 34 healthy individuals were detected with enzyme-linked immunosorbent assay (ELISA), and the data of the two groups were compared. Results The level of serum AD in RA patients was significantly higher than that in healthy individuals [(17.5±7.5) μg/mL vs. (13.6±5.5) μg/mL, P=0.015]. The serum AD level was positively related with age (r=0.327, P=0.045), and they were uncorrelated with the course of disease, BMI, number of swollen joints, joint tenderness, ESR, CRP, RF, anti-CCP and DAS28 scores (P>0.05). The serum AD level has no correlation with both hands X-ray joint bone erosion score, both hands X-ray joint space narrowing score and both hands X-slice Sharp score. Conclusion Serum AD levels in RA patients are significantly higher than those in the normal people, it indicated that serum AD levels may be served as a biomarker in RA patients. Serum AD levels in patients with RA has nothing to do with disease activity, and has no correlation with bone and joint damage.
KEYWORDS: rheumatoid arthritis; adiponectin; osteoprotegerin

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