Dara Rodríguez-González, María García-González, Fuensanta Gómez-Bernal, Juan C Quevedo-Abeledo, Agustín F González-Rivero, Elena González-López, J Gonzalo Ocejo-Vinyals, Miguel Á González-Gay, Iván Ferraz-Amaro
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引用次数: 0
Abstract
Objective: The complement system has been associated with the etiopathogenesis of rheumatoid arthritis (RA). Insulin resistance (IR) and metabolic syndrome (MetS) are prevalent among patients with RA. The aim of this study was to explore the relationship between a comprehensive evaluation of the complement system and IR, as well as MetS, in patients with RA.
Methods: A total of 339 nondiabetic patients with RA were recruited. Functional assays of the 3 complement pathways were assessed. Additionally, serum levels of the following individual components of the complement system were measured: C1q (classical); lectin (lectin); C2, C4, and C4b (classical lectin); factor D and properdin (alternative); C3 and C3a (common); C5, C5a, and C9 (terminal); as well as the factor I and C1 inhibitor regulators. IR and β cell function indices were calculated using the homeostatic model assessment. Criteria for MetS were applied. Multivariable linear regression analysis was performed to investigate the association between the complement system and IR in patients with RA.
Results: Many elements of the upstream and common complement pathways, but not the functional tests of the 3 routes, correlated positively with higher levels of IR and β cell function. However, after multivariable adjustment for factors associated with IR, these relationships were lost. Conversely, the presence of MetS in patients with RA maintained a relationship with higher levels of C1q, C4, C3, properdin, and factor I after adjusting for confounders.
Conclusion: There is a positive correlation between the complement system and MetS among nondiabetic patients with RA. This association is independent of traditional IR factors.
目的：补体系统与类风湿性关节炎（RA）的发病机制有关：补体系统与类风湿性关节炎（RA）的发病机制有关。胰岛素抵抗（IR）和代谢综合征在 RA 患者中十分普遍。本研究的目的是探讨对 RA 患者补体系统的综合评估与 IR 以及代谢综合征之间的关系。方法：招募了 339 名非糖尿病的 RA 患者，评估了三种补体途径的功能测定。此外，还测量了血清中补体系统各成分的水平：C1q（经典）、凝集素（凝集素）、C2、C4 和 C4b（经典选择素）、因子 D 和 properdin（替代）、C3 和 C3a（常见）、C5、C5a 和 C9（末端）以及调节因子 I 和 C1 抑制剂。红外和β细胞功能指数是通过平衡模型评估（HOMA）计算得出的。采用代谢综合征标准。对RA患者的补体系统与IR之间的关系进行了多变量线性回归分析：结果：上游和共同补体途径的许多元素与较高水平的IR和β细胞功能呈正相关，但三种途径的功能测试并不相关。然而，在对与IR相关的因素进行多变量调整后，这些关系消失了。相反，在对混杂因素进行调整后，RA 患者中代谢综合征的存在与较高水平的 C1q、C4、C3、properdin 和因子 I 保持着一定的关系：结论：在非糖尿病的 RA 患者中，补体系统与代谢综合征之间存在正相关。结论：在非糖尿病的 RA 患者中，补体系统与代谢综合征之间存在正相关，这种关联与传统的红外因素无关。
期刊介绍：
The Journal of Rheumatology is a monthly international serial edited by Earl D. Silverman. The Journal features research articles on clinical subjects from scientists working in rheumatology and related fields, as well as proceedings of meetings as supplements to regular issues. Highlights of our 41 years serving Rheumatology include: groundbreaking and provocative editorials such as "Inverting the Pyramid," renowned Pediatric Rheumatology, proceedings of OMERACT and the Canadian Rheumatology Association, Cochrane Musculoskeletal Reviews, and supplements on emerging therapies.
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