脂肪细胞因子、C 反应蛋白与肌萎缩侧索硬化症——来自德国人群肌萎缩侧索硬化症注册登记研究的结果。
Adipokines, C-reactive protein and Amyotrophic Lateral Sclerosis - results from a population- based ALS registry in Germany.
机构信息
Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany.
Department of Neurology, Ulm University, Ulm, Germany.
出版信息
Sci Rep. 2017 Jun 29;7(1):4374. doi: 10.1038/s41598-017-04706-5.
To investigate the associations of leptin, adiponectin and high-sensitive (hs) C-reactive protein (CRP) with risk and prognosis of amyotrophic lateral sclerosis (ALS). Data from a population-based case-control study in Southern Germany (10/2010-6/2014) of 289 ALS patients (mean age of 65.7 (SD 10.5) years, 59.5% men) and 506 controls were included. During median follow-up of 14.5 months of 279 ALS patients 104 (53.9% men, 68.9 (10.3) years) died. Serum samples were measured for leptin, adiponectin and hs-CRP. Conditional logistic regression was used to estimate ALS risk. Survival models were used to appraise the prognostic value. ALS patients were characterized by lower levels of school education, BMI and smoking prevalence. Adjusted for covariates, leptin was inversely associated with ALS risk (top vs. bottom quartile: OR 0.49; 95% CI 0.29-0.80), while for adiponectin a positive association was found (OR 2.89; 95% CI 1.78-4.68). Among ALS patients increasing leptin concentrations were associated with longer survival (p for trend 0.002), while for adiponectin no association was found (p for trend 0.55). For hs-CRP no association was found. Leptin and adiponectin, two key hormones regulating energy metabolism, were strongly and independently related with ALS risk. Leptin levels were further negatively related with overall survival of ALS patients.
目的
探讨瘦素、脂联素和高敏 C 反应蛋白（hs-CRP）与肌萎缩侧索硬化（ALS）风险和预后的相关性。
资料来源
该研究为德国南部一项基于人群的病例对照研究，纳入了 289 例 ALS 患者（平均年龄 65.7 岁±10.5 岁，59.5%为男性）和 506 例对照（中位随访时间 14.5 个月，279 例 ALS 患者中有 104 例死亡）。
方法
在中位随访 14.5 个月时，279 例 ALS 患者中有 104 例（53.9%为男性，68.9 岁±10.3 岁）死亡。测量血清瘦素、脂联素和 hs-CRP 水平。采用条件 logistic 回归分析估计 ALS 风险，采用生存模型评估预后价值。
结果
与对照组相比，ALS 患者受教育程度较低、BMI 较低、吸烟率较低。在校正了协变量后，瘦素与 ALS 风险呈负相关（最高 vs. 最低四分位数：OR 0.49；95%CI 0.29-0.80），而脂联素与 ALS 风险呈正相关（OR 2.89；95%CI 1.78-4.68）。在 ALS 患者中，瘦素浓度升高与生存时间延长相关（趋势检验 p 值=0.002），而脂联素与生存时间无相关性（趋势检验 p 值=0.55）。hs-CRP 与 ALS 风险或预后均无相关性。
结论
瘦素和脂联素是调节能量代谢的两个关键激素，与 ALS 风险有很强的相关性，且独立相关。瘦素水平与 ALS 患者的总生存率呈负相关。
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