The Correlation Of Serum Resistin Level With Insulin Resistance In Patients With Systemic Lupus Erythematosus

Objective To detect the serum levels of resistin in systemic lupus erythematosus (SLE) patients, and analyze the corrlation between resistin and clinical and biochemical data, further explore the corrlation between resistin and insulin resistance(IR).Method61SLE patients and24healthy, age and sex matched controls were studied. All qualified patients fulfilled the1997revised American College of Rheumatology criteria. Patients’disease activity was assessed at time of enrollment in the study using the SLE Disease Activity Index(SLEDAI). In all the participants, height, weight, waist, hips and other clinical data and fasting blood glucose and insulin were measured to calculate insulin resistance index(HOMA-IR). Serum resistin was measured by enzyme-linked immunosorbent assay(ELISA). Resistin levels, Clinical and biochemical data were compared between SLE group and healthy control group. Besides, we divided the SLE patients into primary treatment group and treatment group, the dose of prednisone>7.5mg/d group and the doses of prednisone≤7.5mg/d group, remission group and active group, the obese group and non-obese group, IR group and no-IR group. Serum resistin levels and other clinical and biochemical data were compared between these SLE groups. Linear correlation analysis and multiple regression analysis were used to investigate the related factors to resistin in SLE.Results1. SLE patients had significantly higher TG and lower HDL than healthy controls, which suggest that SLE patients have abnormal lipid metabolism.2. Compared with control subjects, SLE patients showed significantly higher FINS, HOMA-IR and lower ISI, it’s suggested that SLE patients have IR.3. There is no significant difference of serum resistin between SLE group and the controls, but the level of serum resistin in primary treatment group is significantly higher than that in treatment group and healthy control group, and activity group showed higher resistin than remission group. The resistin level in SLE patients who had prednisone>7.5mg/d is lower than the patients who had no treatment, while there’s no significant difference of serum resistin between the SLE patients with no treatment and prednisone≤7.5mg/d, suggesting that the resistin level in SLE patient with higher doses of daily prednisone treatment can effectively lower than those with lower doses of daily prednisone treatment. In SLE patients, resistin levels were positively correlated with CRP and SLEDAI, and negatively correlated with WHR, WBC, LDL and the dose of prednisone. While, resistin levels were not correlated with age, BMI, BF%, TG, FINS, ISI, HOMA-IR in SLE patients. The resullt of multiple regression analysis is that WHR, CRP and SLEDAI is independent factors to serum resistin levels in SLE paients.4. Compared with the treatment group, SLE patients with no treatment have lower systolic pressures, BMI, WHR, BF%and TC. SLE patient with treatment are easier to have abnormal lipid metabolism, obese and hypertension. Compared with non-obese group, obese group showed significantly higher FINS and HOMA-IR, and lower ISI, suggest that IR more common in obese patients. In IR group, WHR, FBG and FINS were significantly higher than that in no-IR group, meanwhile, ISI was significantly lower in IR group. These suggested that IR was more common in the patients with abdominal obesity. SLE patients with the doses of prednisone prednisone>7.5mg/d have higher systolic pressures, BMI, BF%, TC and HDL than ones with doses of prednisone≤7.5mg/d. These suggest SLE patients with higher doses of prednisone are easier to have abnormal lipid metabolism, obese and hypertension.Conclusion1. SLE patients have a higher risk of abnormal lipid metabolism and insulin resistance.2. There’s no difference on serum resistin levels between SLE patients and controls. In SLE patients, resistin levels had no correlated to FINS and HOMA-IR. These suggest resisitin may not take part in the pathology of IR inSLE.3. In SLE patients, resistin levels in primary treatment group were higher than those in non-primary treatment group, CRP and SLEDAI is independent factors to serum resistin levels in SLE paients. These suggest resisitin may take part in the inflammation and immune response of SLE.