RA患者血清FFA、hs-CRP及TNF-α的水平变化与胰岛素抵抗的关系

摘要

Objective To investigate the serum levels of free fatty acid (FFA ) ,hs- CRP, TNF-α explore its relationship with insulin resistance in patients with rheumatoid arthritis (RA). Methods The free fatty acid(FFA) , fasting insulin(fINS) , fasting plasma ghicose(fPS) ,serum high-sensitivity G-reactive protein(hs-CRP) , tumor necrosis factor-α (TNF-α) and the lipid profile were measured in 92 patients with rheumatoid arthritis and SO normal controls. Insulin resistance was evaluated using insulin sensitivity index (ISI ) and homeostasis model assessment -insulin resistance index( HOMA-IR). This study evaluated the relationship among the serum levels of FFA, hs-CRP, TNF-α as well as the insulin resistance in 53 adult patients with stationary phase RA and also in 38patients with active phase RA. The relationship between FFA level and insulin resistance in RA patients was analyzed. Results The serum levels of FFA,hs-CRP, TNF-α, Homa-IR,TG and LP(α) were significantly higher in RA patients with active phase and stationary phase compared to the health contFols(P<0.05 orP <0. 01). In the active phase group, the serum levels of FFA, hs-CRP, TNF-αa, fINS ,Homa-IR,TG and LP(α) were higher than those in the stationary phase group (P<0.05 orP<0.01). In all patients , FFA was positively correlated with ha-GRP,TNF-α fINS, Homn-IR, TG and LP(α). While negatively correlated with ISI(P < 0.01). Conclusion The serum level of FFA is significantly higher in patients with rheumatoid arthritis and serum FFA level is closely correlated with insulin resistance.%目的:研究类风湿性关节炎(RA) 患者血清游离脂肪酸(FFA)、高敏C-反应蛋白(hs- CRP)和肿瘤坏死因子(TNF-α)水平的变化及其与胰岛素抵抗的关系.方法:测定92例RA患者(稳定期53例,活动期39例)及50例正常人血清FFA、空腹胰岛素(fINS)、空腹血糖(fPS),同时检测hs-CRP 、TNF-α、血脂等指标,并计算胰岛素敏感指数(ISI)、稳态模型胰岛素抵抗指数(Homa-IR),分析FFA水平的变化与胰岛素抵抗的关系.结果:非活动期和活动期RA患者,FFA、hs-CRP、TNF-α、Homa-IR、TG和LP(α)水平均较正常对照组显著升高(P<0.05或P<0.01),且活动期RA组FFA、hs-CRP、TNF-α、fINS、Homa-IR、TG和LP(α)水平较非活动期RA患者明显升高(P<0.05或P<0.01);直线相关分析显示,血清FFA水平与hs-CRP、TNF-α、fINS、Homa-IR、TG和LP(α)呈正相关(P<0.01),与ISI呈负相关(P<0.01).结论:RA患者血清FFA水平明显升高,且与hs-CRP、TNF-α及胰岛素抵抗密切相关.