Fang Chenglong, Luo Tingting, Chen Xiaoqing, Lin Ling
Department of Rheumatology, Second Affiliated Hospital, Fujian Medical University, Quanzhou 362000, China.
Department of Ultrasonic Cardiogram, Second Affiliated Hospital, Fujian Medical University, Quanzhou 362000, China.
Xi Bao Yu Fen Zi Mian Yi Xue Za Zhi. 2018 Jun;34(6):541-545.
Objective To detect the level of serum proprotein convertase subtilisin/kexin type 9 (PCSK9) in patients with systemic lupus erythematosus (SLE) and investigate the correlation between PCSK9 level and disease parameters. Methods Forty-seven SLE patients and 30 age, sex-matched healthy controls (HCs) were included in our research. Traditional cardiovascular disease (CVD) risk factors were compared between the two groups. The level of serum PCSK9 was examined by ELISA. Carotid intima-media thickness (cIMT) was measured by carotid ultrasound. According to the measured value of cIMT, SLE patients were divided into SLE-AS (cIMT≥1.0 mm) and SLE-NonAS (cIMT<1.0 mm) subgroups. Atherogenic factors and PCSK9 levels were compared between the two subgroups. Univariate correlational analysis of PCSK9 levels and disease parameters was conducted in the SLE patients. Results No difference was found in the total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), ApoA1, ApoB, triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), fasting blood-glucose (FBG), body mass index (BMI) or uric acid (UA) between the SLE patients and HCs. However, the higher ratio of cIMT thickening and the elevation of serum PCSK9 levels were observed in the SLE patients as compared with the HCs. No significant difference in the traditional risk factors for CVD was found, but significant difference in the level of C-reactive protein (CRP) existed between the SLE-AS subgroup and SLE-NonAS subgroup. The level of serum PCSK9 in the SLE-AS subgroup was significantly higher than that in the SLE-NonAS subgroup. PCSK9 concentrations were positively correlated with CRP levels, but not correlated obviously with the age, SLEDAI, lipids parameters (TC, LDL-C, ApoA1, ApoB, TG, HDL-C), BMI or UA levels. This tendency seemed to be more significant in the female patients. Conclusion Elevated level of serum PCSK9 can be observed in SLE patients, especially in those with thickening of cIMT. PCSK9 may be associated with atherogenic inflammation in SLE.
目的 检测系统性红斑狼疮（SLE）患者血清前蛋白转化酶枯草溶菌素9型（PCSK9）水平，探讨PCSK9水平与疾病参数之间的相关性。方法 本研究纳入47例SLE患者和30例年龄、性别相匹配的健康对照者（HCs）。比较两组患者传统心血管疾病（CVD）危险因素。采用酶联免疫吸附测定法（ELISA）检测血清PCSK9水平。通过颈动脉超声测量颈动脉内膜中层厚度（cIMT）。根据cIMT测量值，将SLE患者分为SLE-AS组（cIMT≥1.0 mm）和SLE-NonAS组（cIMT<1.0 mm）。比较两组间致动脉粥样硬化因素及PCSK9水平。对SLE患者PCSK9水平与疾病参数进行单变量相关性分析。结果 SLE患者与HCs在总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、载脂蛋白A1（ApoA1）、载脂蛋白B（ApoB）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）、空腹血糖（FBG）、体重指数（BMI）或尿酸（UA）方面无差异。然而与HCs相比，SLE患者cIMT增厚比例更高，血清PCSK9水平升高。两组间CVD传统危险因素无显著差异，但SLE-AS组与SLE-NonAS组间C反应蛋白（CRP）水平存在显著差异。SLE-AS组血清PCSK9水平显著高于SLE-NonAS组。PCSK9浓度与CRP水平呈正相关，但与年龄、SLE疾病活动指数（SLEDAI）、血脂参数（TC、LDL-C、ApoA1、ApoB、TG、HDL-C）、BMI或UA水平无明显相关性。这种趋势在女性患者中似乎更显著。结论 SLE患者血清PCSK9水平升高，尤其是cIMT增厚者。PCSK9可能与SLE中的动脉粥样硬化性炎症相关。
