文章摘要
NLRP3炎症小体与类风湿关节炎患者疾病活动度和骨代谢指标的关系及其诊断价值分析
The relationship between NLRP 3 inflammasome and disease activity and bone metabolism indexes of rheumatoid arthritis patients and its diagnostic value analysis
投稿时间:2024-02-26  修订日期:2024-02-26
DOI:
中文关键词: NLRP3炎症小体  类风湿关节炎  疾病活动度  骨代谢
英文关键词: NLRP 3 inflammasome  Rheumatoid arthritis  Disease activity  Bone metabolism
基金项目:山西省留学人员科技活动择优资助项目(编号:20200037)
作者单位邮编
王志云* 山西医科大学第一临床医学院 WANG Zhi-yun
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中文摘要:
      目的:研究核苷酸结合寡聚化结构域样受体热蛋白结构域相关蛋白3(NLRP3)炎症小体与类风湿关节炎(RA)患者疾病活动度和骨代谢指标的关系及其诊断价值。方法:选取2021年5月至2022年9月山西医科大学第一医院收治的RA患者300例,根据28个关节疾病活动度(DAS28)评分将患者分为低度组(n=62)、中度组(n=104)、重度组(n=134)。检测并对比各组NLRP3、凋亡相关斑点样蛋白(ASC),半胱天冬酶-1(caspase-1) mRNA表达水平以及骨代谢指标。Pearson相关性分析NLRP3炎症小体指标与DAS28评分和骨代谢指标的相关性,受试者工作特征(ROC)曲线分析NLRP3,ASC,caspase-1对RA疾病活动严重程度的诊断价值。结果:重度组和中度组的血清NLRP3、ASC及Caspase-1mRNA高于低度组,且重度组高于中度组(P<0.05)。中度组和低度组的血清骨钙素(BGP)、甲状旁腺激素(PTH)及β-胶原特殊序列(β-CTx)水平明显低于重度组,且低度组又低于中度组(P<0.05)。中度组和低度组的血清25 -(OH)维生素D3[25-(OH)D3]及Ⅰ型前胶原N-末端前肽(PINP)水平明显高于重度组,且低度组又高于中度组(P<0.05)。Pearson相关性分析发现,RA患者血清NLRP3炎症小体指标与DAS28评分、BGP、PTH及β-CTx均呈正相关,而与25-(OH)D3及PINP均呈负相关(均P<0.05)。ROC分析显示:NLRP3、NLRP3、ASC单独及联合应用对RA疾病活动严重程度的曲线下面积分别为0.770、0.733、0.739、0.828。结论:NLRP3炎症小体与RA患者与疾病活动度关系紧密,血清NLRP3炎症小体指标与DAS28评分、BGP、PTH及β-CTx均呈正相关,而与25-(OH)D3及PINP均呈负相关。NLRP3、ASC及Caspase-1水平联合检测对RA疾病活动严重程度具有较高的诊断价值。
英文摘要:
      Objective: To study the relationship between nucleotide-binding oligomerization domain-like receptors family pyrin domain containing 3(NLRP3) inflammasome and disease activity and bone metabolism indexes of rheumatoid arthritis (RA) patients and its diagnostic value. Methods: 300 RA patients admitted to the First Hospital of Shanxi Medical University from May 2021 to September 2022 were selected, and the patients were divided into low-degree group(n=62), moderate group(n=104),severe group(n=134) according to the 28 joint disease range of motion (DAS28) score. NLRP3, apoptosis-related spot-like protein (ASC), caspase-1 (caspase-1) mRNA expression level, bone metabolism indexes of each group were detected and compared.The correlation of NLRP3 inflammasome index and DAS 28 score and bone metabolism indexes was analyed by Pearson correlation, and the diagnostic value of NLRP3, ASC, and caspase-1 for the severity of disease activity of RA was analyzed by receiver operating characteristic (ROC) curve. Results: The serum NLRP 3, ASC and Caspase-1 mRNA were higher in the severe and moderate groups than the low-degree group, and severe group was higher than the moderate group (P <0.05). Serum Bone gla protein ( BGP), parathyroid hormone (PTH) and β-collagen special sequence ( β -CTx) levels in the moderate group and low-degree group were significantly lower than the severe group, and low-degree group was lower than the moderate group (P <0.05). Serum 25- (OH) Vitamin D3 [25- (OH) D3] and type I procollagen propeptide (PINP) levels were significantly higher in the moderate group and low-degree grade group than the severe group, and low-degree grade group was higher than the moderate group (P <0.05). The Pearson correlation analysis showed that, the serum NLRP 3 inflammasome index was positively associated with DAS 28 score, BGP, PTH and β-CTx, but negatively associated with 25- (OH) D3 and PINP (all P <0.05).ROC analysis showed that the area under the curve of NLRP3, NLRP3, ASC alone and in combination for the severity of disease activity of RAwas 0. 770, 0.733, 0.739, and 0.828, respectively. Conclusion: The NLRP3 inflammasome is closely related to disease activity in RA patients, the serum NLRP 3 inflammasome index is positively correlated with DAS 28 score, BGP, PTH and β -CTx, but negatively correlated with 25- (OH) D3 and PINP.The combined detection of NLRP 3, ASC and Caspase-1 levels has the higher diagnostic value for the severity of disease activity of RA.
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