摘要
目的探究类风湿关节炎(RA)患者血清脂肪酸结合蛋白4(FABP4)、卵泡抑素样蛋白1(FSTL1)表达及其临床意义。方法选取2020年6月至2024年6月期间于本院收治的106例RA患者作为研究对象。依据28项疾病活动度(DAS28)评分的差异,将其划分为活动期组(56例)与缓解期组(50例)。同期在本院选取干燥综合征患者106例为干燥综合征组,选取体检且身体健康的106例志愿者组成对照组。运用酶联免疫吸附测定(ELISA)法对所有研究对象的血清FABP4、FSTL1、抗环瓜氨酸肽抗体(CCP)水平予以检测。借助Spearman相关性分析方法,深入探究RA患者血清FABP4、FSTL1水平与DAS28评分之间的关联。另外,通过绘制受试者工作特征(ROC)曲线,剖析血清FABP4、FSTL1水平对于RA患者活动期的诊断价值。多因素Logistic回归分析影响RA患者活动期发生的因素。结果与对照组相比,RA组和干燥综合征组患者血清中FABP4、FSTL1、CCP水平显著升高;与干燥综合征组相比,RA组患者血清中FABP4、FSTL1、CCP水平显著升高(P<0.05)。与FABP4、FSTL1、CCP单独检测相比,FABP4、FSTL1联合检测对RA和干燥综合征发生的诊断价值较高(P<0.05)。与缓解期组相比,活动期组血清FABP4、FSTL1、DAS28评分水平显著升高(P<0.05)。Spearman相关性分析显示,RA患者血清FABP4(r S=0.639,P<0.001)、FSTL1(r S=0.592,P<0.001)水平与DAS28评分均呈正相关。血清FABP4、FSTL1联合检测的AUC显著高于FABP4(Z=2.082,P=0.037)、FSTL1(Z=2.585,P=0.010)水平对RA患者活动期诊断的AUC。活动期组类风湿因子(RF)、C反应蛋白(CRP)、红细胞沉降率(ESR)水平显著高于缓解组(P<0.05)。多因素Logistic回归分析显示,血清FABP4(OR=4.241)、FSTL1(OR=3.521)、RF(OR=1.645)、CRP(OR=1.895)、ESR(OR=3.045)水平是RA活动期发生的影响因素(P<0.05)。结论RA患者血清中FABP4、FSTL1水平呈高表达,二者可以作为诊断RA活动期的生物学指标。
Objective To investigate the expression and clinical significance of serum fatty acid binding protein 4(FABP4)and follistatin-like protein 1(FSTL1)in patients with rheumatoid arthritis(RA).Methods 106 patients with RA who were admitted to our hospital from June,2020 to June,2024 were selected as research objects.According to the difference of 28 disease activity(DAS28)scores,these patients were divided into an active group(56 cases)and a remission group(50 cases).During the same period,106 patients with Sjogren’s syndrome were selected as sjogren’s syndrome group.In addition,106 healthy volunteers who participated in physical examination in our hospital during the same period were selected to form the control group.Serum FABP4,FSTL1 and anti-cyclic citrullinated peptide antibody(CCP)levels of all subjects were detected by enzyme-linked immunosorbent assay(ELISA).Spearman correlation analysis was applied to evaluate the correlation between serum FABP4,FSTL1 and DAS28 scores in RA patients.In addition,the diagnostic value of serum FABP4 and FSTL1 levels in the active stage of RA patients was analyzed by drawing receiver operating characteristic(ROC)curve.Multivariate logistic regression was performed to identify potential factors that affected the occurrence of active phase in RA patients.Results Compared with the control group,the serum levels of FABP4,FSTL1 and CCP in RA group and Sjogren’s syndrome group were significantly increased(P<0.05).Compared with Sjogren’s syndrome group,serum FABP4,FSTL1 and CCP levels in RA group were significantly increased(P<0.05).Compared with FABP4,FSTL1 and CCP alone,the combined detection of FABP4 and FSTL1 had higher diagnostic value for RA and Sjogren’s syndrome(P<0.05).Compared with remission phase group,active phase group had significantly higher serum FABP4,FSTL1,and DAS28 score(P<0.05).Spearman correlation analysis showed that serum FABP4(r S=0.639,P<0.001)and FSTL1(r S=0.592,P<0.001)in RA patients were positively correlated with DAS28 score.The AUC of combined detection of serum FABP4 and FSTL1 was conspicuously higher than that of FABP4(Z=2.082,P=0.037)and FSTL1(Z=2.585,P=0.010)for diagnosing active RA patients.The active phase group showed significantly higher rheumatoid factor(RF),C-reactive protein(CRP),and erythrocyte sedimentation rate(ESR)compared to remission phase group(P<0.05).Multivariate logistic regression showed that serum FABP4(OR=4.241),FSTL1(OR=3.521),RF(OR=1.645),CRP(OR=1.895),and ESR(O R=3.045)were influencing factors of RA activity(P<0.05).Conclusion FABP4 and FSTL1 are highly expressed in the serum of RA patients.Both can serve as potential biological indicators for diagnosing RA activity.
作者
张笑栩
丁秀芳
赵薇
ZHANG Xiaoxu;DING Xiufang;ZHAO Wei(Department of Intrarenal Gastroenterology(Rheumatic Immunology Group),Beijing Longfu Hospital,Beijing 100010,China;Institute of Geriatric Health,Beijing Longfu Hospital,Beijing 100010,China;Department of Health Care,Beijing Tongren Hospital Affiliated to Capital Medical University,Beijing 100005,China)
出处
《标记免疫分析与临床》
2025年第7期1368-1374,共7页
Labeled Immunoassays and Clinical Medicine
基金
首都卫生发展科研专项项目(编号:首发2020-2-7014)。
作者简介
张笑栩(1988—),女,博士研究生,主治医师,研究方向:风湿免疫病中西医结合诊治。Tel:18301198621,E-mail:tvjk02@163.com;通信作者:赵薇(1981—),女,硕士研究生,主治医师,研究方向:老年心血管疾病的临床诊治。Tel:15810758597,E-mail:xzjrbh@163.com。
