Gülkesen Arif, Akgöl Gürkan, Tuncer Türkan, Kal Gül Ayden, Telo Selda, Poyraz Ahmet Kürşad, Kaya Arzu
Department of Physical Medicine and Rehabilitation, Medical Faculty of Fırat University, Elazığ, Turkey.
Department of Physical Medicine and Rehabilitation, Siirt State Hospital, Siirt, Turkey.
Arch Rheumatol. 2016 Apr 14;31(4):333-339. doi: 10.5606/ArchRheumatol.2016.5893. eCollection 2016 Dec.
This study aims to determine serum leptin and neopterin levels in patients with rheumatoid arthritis (RA) and investigate the relationship between clinical and laboratory parameters of disease activity and radiographic progression.
The study included 33 RA patients (9 males, 24 females; mean age 52.5±12.3 years; range 29 to 75 years) and age- and sex-matched 24 healthy controls (11 males, 13 females, mean age 42.5±14.8; range 18 to 75). RA patients were divided into three groups based on Disease Activity Scores in 28 joints (DAS28) as low disease activity, moderate disease activity, and high disease activity groups. Of the patients, 13 (39.4%) had low disease activity (DAS28=2.6-3.2), 12 (36.4%) had moderate disease activity (DAS28=3.2-5.1), and eight (24.2%) had high disease activity (DAS28≥5.1).
Mean serum leptin and neopterin levels in the RA group were 23.98±18.88 ng/mL and 1.88±1.84 nmol/L, respectively. Mean serum leptin and neopterin levels in the control group were 19.40±13:42 ng/mL and 1.13±0.55 nmol/L, respectively. There was no statistically significant difference in the levels of serum leptin (p=0.674) and neopterin (p=0.078) between RA patients and control group. Serum leptin (p=0.574) and neopterin (p=0.921) levels in RA patients and control group showed no correlation with body mass index levels. Besides, there was no correlation between age and plasma leptin and neopterin levels and rheumatoid factor positivity, anti-cyclic citrullinated peptide antibodies, disease duration, erythrocyte sedimentation rate, and C-reactive protein levels in RA group. In RA patients, there was no correlation between serum leptin and neopterin levels and clinical and laboratory parameters indicating the disease activity. In RA patients, there was also no correlation between radiographic joint damage and serum leptin and neopterin levels. A positive correlation was shown in RA patients between disease duration and modified Larsen score (p=0.01).
In our study, no correlation was detected between serum leptin and neopterin levels and disease activity parameters in RA patients. Therefore, leptin and neopterin levels may not be considered as beneficial inflammation parameters to be used in the diagnosis of RA and disease activation tracking.
本研究旨在测定类风湿关节炎（RA）患者的血清瘦素和新蝶呤水平，并探讨疾病活动的临床和实验室参数与影像学进展之间的关系。
本研究纳入了33例RA患者（9例男性，24例女性；平均年龄52.5±12.3岁；范围29至75岁）以及年龄和性别匹配的24例健康对照者（11例男性，13例女性，平均年龄42.5±14.8岁；范围18至75岁）。根据28个关节的疾病活动评分（DAS28），将RA患者分为三组，即低疾病活动组、中度疾病活动组和高疾病活动组。其中，13例（39.4%）患者疾病活动度低（DAS28 = 2.6 - 3.2），12例（36.4%）患者疾病活动度中等（DAS28 = 3.2 - 5.1），8例（24.2%）患者疾病活动度高（DAS28≥5.1）。
RA组患者血清瘦素和新蝶呤的平均水平分别为23.98±18.88 ng/mL和1.88±1.84 nmol/L。对照组血清瘦素和新蝶呤的平均水平分别为19.40±13.42 ng/mL和1.13±0.55 nmol/L。RA患者与对照组之间血清瘦素水平（p = 0.674）和新蝶呤水平（p = 0.078）无统计学显著差异。RA患者和对照组的血清瘦素水平（p = 0.574）和新蝶呤水平（p = 0.921）与体重指数水平均无相关性。此外，RA组中年龄与血浆瘦素和新蝶呤水平、类风湿因子阳性、抗环瓜氨酸肽抗体、病程、红细胞沉降率及C反应蛋白水平均无相关性。在RA患者中，血清瘦素和新蝶呤水平与指示疾病活动的临床和实验室参数之间无相关性。在RA患者中，影像学关节损伤与血清瘦素和新蝶呤水平之间也无相关性。RA患者的病程与改良Larsen评分之间呈正相关（p = 0.01）。
在我们的研究中，未检测到RA患者血清瘦素和新蝶呤水平与疾病活动参数之间存在相关性。因此，瘦素和新蝶呤水平可能不被视为用于RA诊断和疾病活动追踪的有益炎症参数。
