内脂素水平与类风湿关节炎患者动脉粥样硬化相关性研究  

Study on the correlation of visfatin level and atheros clerosis in patients with rheumatoid arthritis

作　　者：曾婷[1] 陆静忠 施丹[1] 顾科峰[1] 宋超英[1] 

机构地区：[1]上海交通大学医学院附属新华医院崇明分院血液风湿科,202150

出　　处：《中华风湿病学杂志》2016年第4期257-260,共4页Chinese Journal of Rheumatology

基　　金：上海市崇明县青年科技启明星项目（CQYL2014-02）

摘　　要：目的研究RA患者血清内脂素水平变化，探讨其与RA发生动脉粥样硬化的相关性。方法50例RA患者根据颈动脉内膜中层厚度（IMT），分为有斑块组33例和无斑块组17例，同时分别测定其血脂、胰岛素抵抗指数（HOMA-IR）、RF、抗CCP抗体、内脂素等指标水平，以50名健康体检者为健康对照组。分析RA患者内脂素水平与动脉粥样硬化的关系。统计学方法采用t检验、方差分析、Spearman相关分析、多元逐步回归分析。结果RA有斑块组血清内脂素水平明显高于无斑块组[（47±22）μg，L与（34±19）μg／L，t=4．361，P〈0．01]，RA患者血清内脂索水平和HOMA-IR（r=0．567，P=0．001）、RF（r=0．502，P=0．003）、抗CCP抗体（r=0．420，P=0．038）、颈动脉IMT（r=0．596，P=0．001）呈正相关。HDL-C（OR=I．009，P=0．020）、HOMA-IR（OR=1．450，P=0．006）、抗CCP抗体（OR=1．005，P=0．014）和内脂索（OR=0．971，P=0．008）为影响颈动脉IMT的独立相关因素。结论RA患者血清内脂索水平与动脉粥样硬化密切相关。Objective To study the visfatin level changes in patients with rheumatoid arthritis （RA）, and to study the correlation of visfatin level and atherosclerosis in RA. Methods Fifty cases of patients were divided to the plaque group （33 cases） and plaque-free group （17 cases） according to the carotid intima media thickness checked by carotid ultrasonography. In addition, their blood lipid level, homeostasis model asses- sment of insulin resistance （HOMA-IR）, rheumatoid factors （RFs）, anti-CCP, visfatin etc. were measured. Fifty healthy people were set as the control group. The correlation between the visfatin level of RA patients and atherosclerosis was analyzed. The statistical analysis was carried out with independent t-test,analysis of variance, Spearman correlation analysis and multiple stepwise regression. Results The serum visfatin level of RA plaques group was obviously higher than that of the plaque-free group [（47±22） μg/L vs （34±19） μg/L, t=4.361, P〈0.01]. The serum visfatin level of RA patients was positively correlated to HOMA-IR （r=0.567, P=0.001）, RF （r=0.502, P=0.003）, anti-cyclic peptide containing citrulline, （anti-CCP） （r=0.420, P=0.038） and carotid artery IMT （r=0.596, P=0.001）. High-density lipoprotein-C （OR=1.009, P=0.020）, HOMA-IR （OR=1.450, P=0.006）, anti-CCP （OR=1.005, P=0.014） and visfatin （OR=0.971, P=0.008） were independent relevant factors affecting carotid artery IMT. Conclusion The serum visfatin level of RA patients is closely related to atherosclerosis.

关 键 词：关节炎 类风湿 动脉硬化 内脂素 

分 类 号：R593.22[医药卫生—内科学]