Iannello Silvia, Cavaleri Antonina, Milazzo Paolina, Cantarella Santi, Belfiore Francesco
Department of Internal Medicine, University of Catania Medical School, Garibaldi Hospital, Catania, Italy.
MedGenMed. 2003 Aug 7;5(3):20.
The authors recently reported the occurrence of low fasting serum triglyceride (TG) and high free fatty acid (FFA) levels in idiopathic pulmonary fibrosis. TG estimation in diverse groups of patients with autoimmune disease or hyperactive immune response confirmed the occurrence of a similar decrease of TG. In some patients, serum FFA level was also evaluated. TG value in lean and obese patients was compared with that in lean (n = 108) and obese (n = 208) control subjects without autoimmune disease. In patients affected by autoimmune chronic thyroiditis with enhanced concentration of antithyroglobulin antibodies and without thyroidal failure (n = 24), lean and obese patients had reduced TG (-69/%, P < .01 and -52%, P < .0001, respectively). Both lean and obese patients affected by chronic active B or C hepatitis (n = 26), with autoantibodies and without signs of hepatic insufficiency or cirrhosis, presented reduced TG (-57%, P < .01 and -61%, P < .001, respectively). A marked TG decrease (-73%, P < .001) was observed in the lean patients affected by lupus-like syndrome (n = 7). The lean and obese patients with systemic lupus erythematosus or rheumatoid arthritis (n = 11) showed TG decrease (-66%, P < .01 and -55%, P < .05, respectively). In patients affected by anamnestic allergy or atopic dermatitis/asthma (n = 66), both lean and obese, TGs were reduced (-67%, P < .0001 and -62%, P < .001, respectively). In isolated cases of diverse autoimmune diseases (scleroderma, APECED [autoimmune polyendocrinopathy, candidiasis, and ectodermal dystrophy], urticaria or urticarial vasculitis, Reiter or Sjogren syndromes, ulcerative colitis or Crohn's disease, multiple sclerosis or Guillain-Barré syndrome) (n = 14), decreased TG was also observed both in the lean and obese subjects (-59%, P < .01 and -57%, P < .01, respectively). Concerning FFA (n = 69), value in lean patients (n = 22) vs that in lean controls (n = 18) was increased (520 +/- 31 vs 299 +/- 30 mcEq/L, +74%, P < .001), whereas value in obese patients (n = 18) vs that in obese control subjects (n = 11) was decreased (542 +/- 34 vs 774 +/- 62, -30%, P < .01). This opposite behavior of FFA in lean and obese patients needs to be confirmed. Data in this study seem to indicate that low TG value may be a precocious marker of autoimmunity or immune system hyperreactivity.
作者最近报道，特发性肺纤维化患者存在空腹血清甘油三酯（TG）水平低和游离脂肪酸（FFA）水平高的情况。对患有自身免疫性疾病或免疫反应亢进的不同患者群体进行TG评估，证实了TG出现类似程度的降低。在一些患者中，还评估了血清FFA水平。将 lean 和肥胖患者的TG值与无自身免疫性疾病的 lean（n = 108）和肥胖（n = 208）对照受试者的TG值进行比较。在抗甲状腺球蛋白抗体浓度升高且无甲状腺功能减退的自身免疫性慢性甲状腺炎患者（n = 24）中，lean 和肥胖患者的TG均降低（分别降低-69%，P <.01和-52%，P <.0001）。患有慢性活动性B或C型肝炎（n = 26）、有自身抗体且无肝功能不全或肝硬化迹象的 lean 和肥胖患者，TG均降低（分别降低-57%，P <.01和-61%，P <.001）。在患有狼疮样综合征的 lean 患者（n = 7）中观察到TG显著降低（-73%，P <.001）。患有系统性红斑狼疮或类风湿关节炎的 lean 和肥胖患者（n = 11）的TG降低（分别降低-66%，P <.01和-55%，P <.05）。在患有记忆性过敏或特应性皮炎/哮喘的患者（n = 66）中，无论 lean 还是肥胖患者，TG均降低（分别降低-67%，P <.0001和-62%，P <.001）。在多种自身免疫性疾病（硬皮病、自身免疫性多内分泌腺病-念珠菌病-外胚层营养不良综合征、荨麻疹或荨麻疹性血管炎、赖特综合征或干燥综合征、溃疡性结肠炎或克罗恩病、多发性硬化症或吉兰-巴雷综合征）的个别病例（n = 14）中，lean 和肥胖受试者的TG也均降低（分别降低-59%，P <.01和-57%，P <.01）。关于FFA（n = 69），lean 患者（n = 22）与 lean 对照受试者（n = 18）相比，其值升高（520±31对299±30 mEq/L，升高74%，P <.001），而肥胖患者（n = 18）与肥胖对照受试者（n = 11）相比，其值降低（542±34对774±62，降低30%，P <.01）。FFA在 lean 和肥胖患者中的这种相反表现有待证实。本研究中的数据似乎表明，低TG值可能是自身免疫或免疫系统反应亢进的早期标志物。
