Department of Rheumatology, Faculty of Medicine, Firat University, Elazig, Turkey.
Clin Rheumatol. 2011 Jun;30(6):757-63. doi: 10.1007/s10067-010-1649-2. Epub 2010 Dec 17.
Chronic inflammatory rheumatic diseases lead to increased prevalence of atherosclerosis. However, this early and accelerated atherosclerosis cannot be explained by traditional cardiovascular risk factors alone. The permanent overexpression of cellular adhesion molecules and pro-inflammatory cytokines in chronic inflammatory conditions may participate in accelerated atherosclerosis. Visfatin, a novel adipocytokine, has a potential insulin-like action and pro-inflammatory effects. Therefore, the aim of the study was to determine serum visfatin level and its association with common carotid intima-media thickness (IMT), which is a predictor of atherosclerosis, in patients with rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), systemic sclerosis (SSc), and Behçet's disease (BD). The study involved 29 RA, 26 SLE, 25 SSc, 30 BD patients, and 29 healthy controls (HC). Serum levels of TNF-α, IL-6, and visfatin were analyzed using enzyme-linked immunosorbent assay method and homeostasis model assessment for insulin resistance (HOMA-IR) indexes, and IMTs were determined. Serum visfatin level was higher in the RA group than all the other groups. In addition, visfatin level was higher in the active BD subgroup than the inactive BD subgroup. In the study groups, visfatin levels were not correlated with HOMA-IR indexes and IMTs. Whereas visfatin serum concentration was not associated with insulin resistance and carotid atherosclerosis in selected rheumatic diseases, it was higher in the RA and active BD groups, but not in the SLE and SSc groups. Visfatin levels may be associated with Th1/Th2 balance. Further studies are needed for more precise elucidation of the pro-inflammatory activities of visfatin.
慢性炎症性风湿性疾病导致动脉粥样硬化的患病率增加。然而，这种早期和加速的动脉粥样硬化不能仅用传统的心血管危险因素来解释。在慢性炎症状态下，细胞黏附分子和促炎细胞因子的持续过度表达可能参与了加速的动脉粥样硬化。内脏脂肪素是一种新型脂肪细胞因子，具有潜在的胰岛素样作用和促炎作用。因此，本研究旨在确定类风湿关节炎（RA）、系统性红斑狼疮（SLE）、系统性硬皮病（SSc）和贝赫切特病（BD）患者血清内脏脂肪素水平及其与颈总动脉内膜中层厚度（IMT）的关系，IMT 是动脉粥样硬化的预测指标。该研究纳入了 29 例 RA 患者、26 例 SLE 患者、25 例 SSc 患者、30 例 BD 患者和 29 名健康对照者（HC）。采用酶联免疫吸附试验法检测 TNF-α、IL-6 和内脏脂肪素水平，并检测胰岛素抵抗的稳态模型评估（HOMA-IR）指数和 IMT。RA 组血清内脏脂肪素水平高于其他各组。此外，活动期 BD 亚组的内脏脂肪素水平高于非活动期 BD 亚组。在研究组中，内脏脂肪素水平与 HOMA-IR 指数和 IMT 均无相关性。虽然内脏脂肪素血清浓度与所选风湿性疾病的胰岛素抵抗和颈动脉粥样硬化无关，但在 RA 和活动期 BD 组中较高，而在 SLE 和 SSc 组中则较低。内脏脂肪素水平可能与 Th1/Th2 平衡有关。需要进一步的研究来更精确地阐明内脏脂肪素的促炎活性。
