Muhammad Sajjad, Chaudhry Shafqat R, Yearwood Thomas L, Krauss Joachim K, Kinfe Thomas M
Department of Neurosurgery, Rheinische Friedrich Wilhelms University Hospital, Bonn, Germany.
Comprehensive Pain and Rehabilitation, Pascagoula, MS, USA.
Neuromodulation. 2018 Jan;21(1):31-37. doi: 10.1111/ner.12708. Epub 2017 Oct 24.
In our previous study, anti-inflammatory IL-10 serum levels were significantly elevated after burst spinal cord stimulation (SCS) in back pain patients and correlated with pain intensity. This current study extended cytokine analysis including metabolic-associated adipokine/cytokine serum assessment in chronic back pain patients with co-existing metabolic disorders such as diabetes, hypertension, and cardiovascular diseases.
At baseline and after three months of burst SCS treatment, leptin (LP), adiponectin (AN), and ghrelin (GH) were recorded in non-/pre-obese chronic back pain patients with co-existing metabolic disorders and compared to age-/gender-matched healthy controls (HC).
Mean BMI was 22 ± 0.81 kg/m in 12 (five male/seven female) participants with diabetes in 6/12 (50%), hypertension in 9 (75%), and CVD in five patients (42%). Pre- and post-SCS LP levels were significantly higher compared to healthy controls: pre-SCS, 30567 (12,996-58,821) vs. HC, 7952 (4932-12,583) pg/mL, p = 0.029; post-SCS, 18,890 (7140-44,719) vs. HC, 7952 (4932-12,583) pg/mL, p = 0.035. Pre- and post-SCS changes of GH (p = 0.18) and AN (p = 0.8) did not differ significantly. GH serum levels correlated with AN (Spearman r = 0.5; p = 0.012; 95 CI 0.11 to -0.76) and AN levels were significantly correlated with higher age (Pearson correlation r = 0.8; p = 0.002; 95 CI 0.41-0.94) at baseline.
This study determined serum changes of metabolic-associated cytokines/adipokines in non-obese chronic back pain patients responsive to burst SCS suggesting that neuroinflammation assessment may consider pain-associated mood, cognition, sleep, and metabolic state.
在我们之前的研究中，背痛患者在爆发性脊髓刺激（SCS）后抗炎性白细胞介素-10血清水平显著升高，且与疼痛强度相关。本研究扩展了细胞因子分析，包括对合并糖尿病、高血压和心血管疾病等代谢紊乱的慢性背痛患者进行代谢相关脂肪因子/细胞因子血清评估。
在基线期和爆发性SCS治疗三个月后，记录合并代谢紊乱的非肥胖/肥胖前期慢性背痛患者的瘦素（LP）、脂联素（AN）和胃饥饿素（GH）水平，并与年龄和性别匹配的健康对照（HC）进行比较。
12名参与者（5名男性/7名女性）的平均体重指数为22±0.81kg/m²，其中6/12（50%）患有糖尿病，9名（75%）患有高血压，5名患者（42%）患有心血管疾病。与健康对照相比，SCS前后的LP水平显著更高：SCS前，30567（12996-58821）pg/mL，而HC为7952（4932-12583）pg/mL，p=0.029；SCS后，18890（7140-44719）pg/mL，而HC为7952（4932-12583）pg/mL，p=0.035。GH（p=0.18）和AN（p=0.8）在SCS前后的变化无显著差异。基线时，GH血清水平与AN相关（斯皮尔曼r=0.5；p=0.012；95%置信区间0.11至-0.76），且AN水平与较高年龄显著相关（皮尔逊相关r=0.8；p=0.002；95%置信区间0.41-0.94）。
本研究确定了对爆发性SCS有反应的非肥胖慢性背痛患者代谢相关细胞因子/脂肪因子的血清变化，提示神经炎症评估可能需要考虑疼痛相关的情绪、认知、睡眠和代谢状态。
