类风湿性关节炎患者血浆中胶质细胞衍生神经营养因子的水平及其与lexithymia的关系。

IF 1.4 Q3 RHEUMATOLOGY
Reumatologia Pub Date : 2024-01-01 Epub Date: 2024-04-30 DOI:10.5114/reum/187110
Yevhenii Shalkovskyi, Mykola Stanislavchuk
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引用次数: 0

摘要

导言:胶质细胞源性神经营养因子(GDNF)在类风湿性关节炎(RA)的发病机制和临床表现中起着重要作用。无嗜睡症与严重的临床病程和较差的预后有关,而之前尚未研究过 RA 患者无嗜睡症与 GDNF 之间的关系。本研究的目的是根据有无lexithymia调查RA患者血浆中的GDNF水平,并评估GDNF水平与临床表现和生活质量的关系:对15名男性和73名女性RA患者进行了检查,使用了疾病活动评分(DAS28)和红细胞沉降率(ESR)指数、简单疾病活动指数(SDAI)、类风湿性关节炎临床疾病活动指数(CDAI)、视觉模拟量表(根据患者评估--VAS-P 和医生评估--VAS-D)、健康评估问卷(HAQ)、多伦多 Alexithymia 量表(TAS-20)、残疾评级指数(DRI)和 SF-36 指数。通过酶联免疫吸附试验(ELISA)测定血浆中胶质细胞衍生神经营养因子的水平:结果:40%的RA患者患有失神症。受检患者的神经胶质细胞衍生神经营养因子水平为 3.73 ±2.59 pg/ml,有反射障碍的患者为 4.08 ±2.87 pg/ml,无反射障碍的患者为 3.48 ±2.37 pg/ml(P = 0.295)。与无lexithymia患者相比,有lexithymia患者的红细胞沉降率(ESR)和指数评分更高--ESR:34.29 ±14.22 vs. 22.73 ±12.03 mm/h (p = 0.017),DAS28:6.53 ±0.66 vs. 6.09 ±0.55 (p = 0.017),VAS-D:7.19 ±0.81 vs. 6.53 ±0.83 (p = 0.020),HAQ:1.78 ±0.58 vs. 1.51 ±0.54 (p = 0.040)。此外,他们的 SF-36 指标也较差--身体功能:39.52 ±13.78 vs. 51.00 ±14.90 (p = 0.019),身体状况导致的角色功能:30.95 ±20.77 vs. 51.00 ±0.83 (p = 0.020):30.95 ±20.77 vs. 46.67 ±24.76 (p = 0.041),健康的身体部分:31.47 ±11.44 vs. 41.61 ±15.88 (p = 0.028)。根据 VAS-P(rS = 0.338,p = 0.044)和 VAS-D(rS = 0.446,p = 0.006),GDNF 水平和疼痛严重程度之间存在相关性:40%的类风湿关节炎患者存在亚历山大症。类风湿关节炎患者的 GDNF 水平明显高于无反射症状的患者。在患有失认症的类风湿关节炎患者中,血浆中的 GDNF 水平与类风湿关节炎的活动性、功能丧失和生活质量下降有关。RA患者的失认症是RA临床表现和改变GDNF病理生理作用的一个重要因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Level of glial cell derived neurotrophic factor in the blood plasma of rheumatoid arthritis patients and its relationship with alexithymia.

Introduction: Glial cell derived neurotrophic factor (GDNF) has an important role in the pathogenetic mechanisms and clinical manifestations of rheumatoid arthritis (RA). Alexithymia is associated with a severe clinical course and worse prognosis, while the relationship between alexithymia and GDNF in RA patients has not been investigated before. The aims of the study were to investigate the GDNF level in blood plasma in RA patients depending on the presence of alexithymia and to evaluate the relationship of GDNF level with clinical manifestation and quality of life.

Material and methods: Fifteen men and 73 women with RA were examined using the Disease Activity Score with 28-joint count (DAS28) with erythrocyte sedimentation rate (ESR) index, the Simple Disease Activity Index (SDAI), the Rheumatoid Arthritis Clinical Disease Activity Index (CDAI), the Visual Analogue Scale (according to the assessment of the patient - VAS-P and the assessment of the doctor - VAS-D), the Health Assessment Questionnaire (HAQ), the Toronto Alexithymia Scale (TAS-20), the Disability Rating Index (DRI) and SF-36 indexes. Glial cell derived neurotrophic factor level in the blood plasma was determined by enzyme-linked immunosorbent assay (ELISA).

Results: Forty percent of RA patients had alexithymia. Glial cell derived neurotrophic factor level in the examined patients was 3.73 ±2.59 pg/ml, in patients with alexithymia 4.08 ±2.87 pg/ml, without alexithymia 3.48 ±2.37 pg/ml (p = 0.295). Patients with alexithymia had a higher erythrocyte sedimentation rate (ESR) and index scores than patients without alexithymia - ESR: 34.29 ±14.22 vs. 22.73 ±12.03 mm/h (p = 0.017), DAS28: 6.53 ±0.66 vs. 6.09 ±0.55 (p = 0.017), VAS-D: 7.19 ±0.81 vs. 6.53 ±0.83 (p = 0.020), HAQ: 1.78 ±0.58 vs. 1.51 ±0.54 (p = 0.040). Also they had worse SF-36 indicators - physical functioning: 39.52 ±13.78 vs. 51.00 ±14.90 (p = 0.019), role functioning due to physical condition: 30.95 ±20.77 vs. 46.67 ±24.76 (p = 0.041), physical component of health: 31.47 ±11.44 vs. 41.61 ±15.88 (p = 0.028). In patients with alexithymia, a correlation was found between the GDNF level and severity of pain according to VAS-P: rS = 0.338, p = 0.044, and VAS-D: rS = 0.446, p = 0.006.

Conclusions: Alexithymia was found in 40% of RA patients. Rheumatoid arthritis patients with alexithymia had a nonsignificantly higher GDNF level compared to patients without alexithymia. In RA patients with alexithymia, an association of GDNF level in the blood plasma with RA activity, loss of functional capacity and reduced quality of life was established. Alexithymia in RA patients is an important factor in the clinical manifestation of RA and modification of the pathophysiological role of GDNF.

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来源期刊
Reumatologia
Reumatologia Medicine-Rheumatology
CiteScore
2.70
自引率
0.00%
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10 weeks
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