Departments of Rheumatology and Rehabilitation, Mansoura University Hospital, Mansoura, Egypt.
Rheumatol Int. 2012 Mar;32(3):683-90. doi: 10.1007/s00296-010-1698-5. Epub 2010 Dec 8.
Reports suggest leptin, which was initially described as a hormone that regulates food intake and energy balance, has an intimate relationship, and interacts with the immune system. Leptin consumption in the synovial cavity in patients with rheumatoid arthritis (RA) reported to have protective effect against erosion. To determine the difference in serum leptin and synovial/serum leptin ratio between RA and control and to assess whether these parameters correlate with systemic inflammation in RA. Also, the hypothesis that synovial/serum leptin ratio could be linked to joint erosion in RA was evaluated. The study subjects consisted of 40 consecutive patients with RA, 30 patients of them had knee effusion, and 30 controls. Ten of these controls had acute knee injury and their synovial fluid was obtained for comparison of synovial/serum leptin ratio with patients with RA. The mean serum leptin in patients with RA was significantly higher than controls. Also, the synovial leptin and synovial/serum leptin ratio in the RA patients with effusion was significantly higher than in the 10 control subjects with traumatic effusion. Serum leptin in the 30 RA patients with effusion was higher than the matched synovial leptin. In RA patients with effusion, synovial/serum leptin ratio was also significantly higher in RA patients with erosion than RA patients without erosion. Serum leptin level and synovial/serum leptin ratio are significantly correlated with the RA duration, DAS28, ESR, CRP, TNF-α, and IL-6. Finally, in regression analysis, only the synovial/serum leptin ratio was positively associated with erosion in patients with RA. In RA, there is a significant increase in circulating leptin levels and synovial/serum leptin ratio compared to non-RA controls. Serum leptin and synovial/serum leptin ratio are significantly in erosive RA than non-erosive RA. Both parameters are correlated with disease duration and parameters of RA activity. In regression analysis, only the synovial/serum leptin ratio was positively associated with erosion in patients with RA. These results indicate that local consumption of leptin in the joint cavity has a protective role against the destructive course of RA.
报告表明，瘦素最初被描述为一种调节食物摄入和能量平衡的激素，它与免疫系统有着密切的关系，并与之相互作用。有报道称，类风湿关节炎 (RA) 患者滑液中的瘦素具有抗侵蚀作用。本研究旨在确定 RA 患者血清瘦素和滑膜/血清瘦素比值与对照组之间的差异，并评估这些参数是否与 RA 的全身炎症相关。此外，还评估了滑膜/血清瘦素比值与 RA 关节侵蚀相关的假设。研究对象包括 40 例连续的 RA 患者，其中 30 例有膝关节积液，30 例为对照组。其中 10 例对照组为急性膝关节损伤，获得他们的滑膜液来比较 RA 患者滑膜/血清瘦素比值。RA 患者的血清瘦素水平明显高于对照组。此外，RA 伴积液患者的滑膜瘦素和滑膜/血清瘦素比值明显高于 10 例创伤性积液的对照组。30 例有积液的 RA 患者的血清瘦素高于匹配的滑膜瘦素。在有积液的 RA 患者中，侵蚀性 RA 患者的滑膜/血清瘦素比值也明显高于非侵蚀性 RA 患者。血清瘦素水平和滑膜/血清瘦素比值与 RA 病程、DAS28、ESR、CRP、TNF-α和 IL-6 显著相关。最后，在回归分析中，只有滑膜/血清瘦素比值与 RA 患者的侵蚀呈正相关。RA 患者与非 RA 对照组相比，循环瘦素水平和滑膜/血清瘦素比值显著升高。侵蚀性 RA 患者的血清瘦素和滑膜/血清瘦素比值明显高于非侵蚀性 RA 患者。这两个参数均与疾病病程和 RA 活动参数相关。在回归分析中，只有滑膜/血清瘦素比值与 RA 患者的侵蚀呈正相关。这些结果表明，关节腔局部消耗瘦素对 RA 的破坏性病程具有保护作用。
