Gheita Tamer Atef, Kenawy Sanaa Abdel Baky, El Sisi Rehab Wafik, Gheita Heba Atef, Khalil Hossam
Department of Rheumatology, Faculty of Medicine, Cairo University , Cairo , Egypt.
Mod Rheumatol. 2014 Jul;24(4):612-7. doi: 10.3109/14397595.2013.851639. Epub 2013 Nov 7.
Glucose-6-phosphate dehydrogenase (G6PD) is an important site of metabolic control in the pentose phosphate pathway. The purpose of this study was to investigate the enzyme activity of G6PD in Rheumatoid Arthritis (RA) and Sjögren's Syndrome (SS) patients not known to be deficient in this enzyme. It was also within the scope of the aim to find the relation of G6PD to the presence of metabolic syndrome (MetS) in these patients.
Erythrocyte G6PD activity was evaluated in 40 RA patients, 30 SS patients and in 30 age- and sex-matched control. The clinical characteristics, disease activity score (DAS28), SS disease activity (SSDAI) and damage (SSDDI) indices and presence of MetS of the included patients were analyzed in relation to the enzyme level.
The G6PD activity in RA patients (7.72 ± 3.57 U/g Hb) was significantly reduced compared to that in the SS patients (11.55 ± 3.14 U/g Hb) and control (13.23 ± 3.34 U/g Hb) especially those with MetS (4.61 ± 1.84 U/g Hb) (p < 0.001). There was a significant negative correlation of the G6PD activity with the disease duration and DAS28 (p < 0.001).
The results of this study, suggest that G6PD not only does not protect against MetS in RA, but may even be considered a risk factor for the development of this disorder. The identification of regulatory tools for G6PD activity may prove promising for treating the associated metabolic disorders and chronic inflammation in RA.
葡萄糖-6-磷酸脱氢酶(G6PD)是磷酸戊糖途径中代谢控制的重要位点。本研究旨在调查类风湿关节炎(RA)和干燥综合征(SS)患者中G6PD的酶活性,这些患者不存在该酶缺乏情况。本研究的目的还包括探寻这些患者中G6PD与代谢综合征(MetS)存在情况之间的关系。
对40例RA患者、30例SS患者以及30例年龄和性别匹配的对照者的红细胞G6PD活性进行评估。分析纳入患者的临床特征、疾病活动评分(DAS28)、SS疾病活动(SSDAI)和损伤(SSDDI)指数以及MetS的存在情况与酶水平的关系。
与SS患者(11.55±3.14 U/g Hb)和对照组(13.23±3.34 U/g Hb)相比,尤其是与合并MetS的患者(4.61±1.84 U/g Hb)相比,RA患者的G6PD活性(7.72±3.57 U/g Hb)显著降低(p<0.001)。G6PD活性与疾病持续时间和DAS28呈显著负相关(p<0.001)。
本研究结果表明,G6PD不仅不能预防RA患者发生MetS,甚至可能被视为该疾病发生的一个危险因素。确定G6PD活性的调节工具可能对治疗RA相关的代谢紊乱和慢性炎症具有前景。