Rheumatology Division, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo-SP, Brazil.
Clin Exp Rheumatol. 2012 Nov-Dec;30(6):871-8. Epub 2012 Dec 17.
This study was undertaken to evaluate a possible association of adipocytokines with metabolic syndrome (MetS), inflammation and other cardiovascular risk factors in primary antiphospholipid syndrome (PAPS).
Fifty-six PAPS patients and 72 controls were included. Adiponectin, leptin, visfatin, resistin, plasminogen activator inhibitor-1 (PAI-1), lipoprotein (a), glucose, ESR, CRP, uric acid and lipid profiles were measured. The presence of MetS was determined as defined by the International Diabetes Federation (IDF), and insulin resistance was rated using the homeostasis model assessment (HOMA) index.
Concentrations of leptin were higher [21.5 (12.9-45.7) ng/mL] in PAPS patients than in the controls [12.1 (6.9-26.8) ng/mL), p=0.001]. In PAPS patients, leptin and PAI-1 levels were positively correlated with BMI (r=0.61 and 0.29), HOMA-IR (r=0.71 and 0.28) and CRP (r=0.32 and 0.36). Adiponectin levels were negatively correlated with BMI (r=-0.28), triglycerides (r=-0.43) and HOMA-IR (r=-0.36) and positively correlated with HDL-c (r=0.37) and anti-β2GPI IgG (r=0.31). The presence of MetS in PAPS patients was associated with higher levels of leptin (p=0.002) and PAI-1 (p=0.03) levels and lower levels of adiponectin (p=0.042). Variables that independently influenced the adiponectin concentration were the triglyceride levels (p<0.001), VLDL-c (P=0.002) and anti-β2GPI IgG (p=0.042); the leptin levels were BMI (p<0.001), glucose (p=0.046), HOMA-IR (p<0.001) and ESR (p=0.006); and the PAI-1 levels were CRP (p=0.013) and MetS (p=0.048).
This study provides evidence that adipocytokines may be involved in low-grade inflammation, insulin resistance and MetS in PAPS patients.
本研究旨在评估脂肪细胞因子与代谢综合征（MetS）、炎症和原发性抗磷脂综合征（PAPS）中其他心血管危险因素的相关性。
纳入 56 例 PAPS 患者和 72 名对照者。检测脂联素、瘦素、内脂素、抵抗素、纤溶酶原激活物抑制剂-1（PAI-1）、脂蛋白（a）、血糖、红细胞沉降率（ESR）、C 反应蛋白（CRP）、尿酸和血脂谱。根据国际糖尿病联合会（IDF）定义的标准确定 MetS 的存在，使用稳态模型评估（HOMA）指数评估胰岛素抵抗。
与对照组[12.1（6.9-26.8）ng/mL]相比，PAPS 患者的瘦素浓度较高[21.5（12.9-45.7）ng/mL]，p=0.001]。在 PAPS 患者中，瘦素和 PAI-1 水平与 BMI（r=0.61 和 0.29）、HOMA-IR（r=0.71 和 0.28）和 CRP（r=0.32 和 0.36）呈正相关。脂联素水平与 BMI（r=-0.28）、甘油三酯（r=-0.43）和 HOMA-IR（r=-0.36）呈负相关，与 HDL-c（r=0.37）和抗-β2GPI IgG（r=0.31）呈正相关。PAPS 患者 MetS 的存在与更高水平的瘦素（p=0.002）和 PAI-1（p=0.03）以及更低水平的脂联素（p=0.042）相关。独立影响脂联素浓度的变量是甘油三酯水平（p<0.001）、VLDL-c（P=0.002）和抗-β2GPI IgG（p=0.042）；瘦素水平为 BMI（p<0.001）、血糖（p=0.046）、HOMA-IR（p<0.001）和 ESR（p=0.006）；PAI-1 水平为 CRP（p=0.013）和 MetS（p=0.048）。
本研究表明，脂肪细胞因子可能参与 PAPS 患者的低度炎症、胰岛素抵抗和 MetS。
