类风湿关节炎患者血清生长分化因子-15水平：与疾病活动度及亚临床动脉粥样硬化的关系
Serum GDF-15 level in rheumatoid arthritis: relationship with disease activity and subclinical atherosclerosis.
作者信息
Tanrıkulu Osman, Sarıyıldız Mustafa Akif, Batmaz İbrahim, Yazmalar Levent, Polat Nihat, Kaplan İbrahim, Çevik Remzi
出版信息
Acta Reumatol Port. 2017 Jan-Mar;42(1):66-72.
OBJECTIVES
Growth differentiation factor (GDF)-15 was originally identified as a factor secreted by activated macrophages, and plays an important role in cell growth and differentiation. GDF-15 plays an important role in cell growth, signal transduction, and apoptosis regulation. The aim of this study was to evaluate the serum GDF-15 levels and their relationship with disease-related characteristics in patients with rheumatoid arthritis (RA).
MATERIALS AND METHODS
Forty-six patients diagnosed with RA and 36 demographically matched healthy control subjects participated in this study. GDF-15 levels were measured in blood samples from patients and controls. The disease activity score-28 (DAS28) was used to evaluate the disease activity of RA. The quality of life was evaluated using the disease-specific rheumatoid arthritis quality of life (RAQoL) scale. The health assessment questionnaire (HAQ) was used to evaluate the functional status. The degree of joint damage was assessed according to Larsen's method. Atherosclerosis was assessed by a cardiologist with the help of echocardiography according to the carotid intima media thickness (CIMT) method; vascular stiffness was assessed by using the flow mediated dilatation (FMD) method.
RESULTS
Serum GDF-15 levels were significantly higher in RA patients when compared to the control subjects (p< 0.05). RA patients were divided into two groups according to the disease activity; while 26 subjects (57%) were in the active group, 20 patients were in the non-active group (43%). Serum GDF-15 levels were significantly higher in the group that was considered to have an active disease. According to Pearson's correlation, serum GDF-15 levels were positively correlated with erythrocyte sedimentation rate (ESR) levels, morning stiffness, DAS28 score, tender joint count, and CIMT (p<0.05).
CONCLUSION
GDF-15 may play a role in the pathway of disease activity, joint involvement, and atherosclerosis in patients with rheumatoid arthritis.
目的
生长分化因子（GDF）-15最初被鉴定为活化巨噬细胞分泌的一种因子，在细胞生长和分化中起重要作用。GDF-15在细胞生长、信号转导和细胞凋亡调控中发挥重要作用。本研究旨在评估类风湿关节炎（RA）患者血清GDF-15水平及其与疾病相关特征的关系。
材料与方法
46例诊断为RA的患者和36例人口统计学匹配的健康对照者参与了本研究。检测患者和对照者血样中的GDF-15水平。采用疾病活动评分-28（DAS28）评估RA的疾病活动度。使用疾病特异性类风湿关节炎生活质量（RAQoL）量表评估生活质量。采用健康评估问卷（HAQ）评估功能状态。根据Larsen法评估关节损伤程度。由心脏病专家借助超声心动图根据颈动脉内膜中层厚度（CIMT）法评估动脉粥样硬化；采用血流介导的血管扩张（FMD）法评估血管僵硬度。
结果
与对照者相比，RA患者血清GDF-15水平显著升高（p<0.05）。根据疾病活动度将RA患者分为两组；26例受试者（57%）为活动组，20例患者为非活动组（43%）。在被认为患有活动性疾病的组中，血清GDF-15水平显著更高。根据Pearson相关性分析，血清GDF-15水平与红细胞沉降率（ESR）水平、晨僵、DAS28评分、压痛关节数和CIMT呈正相关（p<0.05）。
结论
GDF-15可能在类风湿关节炎患者的疾病活动、关节受累和动脉粥样硬化途径中发挥作用。
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