Changes And Significance Of Serum Monosaccharide Levels In Children With Systemic Lupus Erythematosus

Objective To detect the changes of serum degraded monosaccharides and free monosaccharides in children with systemic lupus erythematosus(SLE)and to explore their clinical significance.Method Forty-five children with systemic lupus erythematosus(SLE)(≤ 18 years old)who were hospitalized in the Department of Pediatric Rheumatology,affiliated Hospital of Qingdao University from January 2019 to March 2022 were selected as subjects,and50 children of the same age who underwent physical examination in our hospital in the same period were selected as normal control group.All the children in SLE group were diagnosed for the first time.According to the SLE disease activity index(SLEDAI-2K)score,they were divided into mild activity SLE group(SLEDAI ≤ 6),moderate activity SLE group(SLEDAI 7-12)and severe activity SLE group(SLEDAI > 12).All children with SLE were followed up for clinical treatment,and blood samples were drawn again for examination at 3 months and 6 months after discharge.Among them,34 children completed two blood sampling tests during the follow-up.Degradation of serum monosaccharides(mannose,glucosamine,galactosamine,N-acetylglucosamine,galactose by high performance liquid chromatography technology and serum free monosaccharides(mannose,glucose)were quantitatively analyzed.The difference of serum monosaccharide concentration between SLE group and normal control group was compared by Studentt test;Pearson and speraman correlation analysis method was used to compare serum monosaccharide level with SLEDAI score,lymphocyte subsets(CD3+ T lymphocyte count,CD4+ T lymphocyte count,CD4+T lymphocyte/CD8+T lymphocyte ratio,CD56+T lymphocyte count,CD19+B lymphocyte count),immunoglobulin(Ig A,Ig E,Ig G,Ig M)levels and other indicators are correlated One-way analysis of variance was used for parameter comparison among multiple groups,and LSD-t test was used for pairwise comparison.Results1.Changes of serum monosaccharide level and serum free glucose / mannose(g / M)ratio in SLE group: compared with normal control group,the levels of degraded monosaccharides(mannose,glucosamine,galactosamine,N-acetylglucosamine and galactose)in SLE group were higher than those in normal control group(P < 0.05);The levels of serum free monosaccharide(glucose and mannose)in SLE group were also higher than those in normal control group(P < 0.05),while the ratio of serum free glucose/ mannose(g / M)in SLE group was lower than that in normal control group(P < 0.05).2.The results of correlation analysis between serum monosaccharide level and serum free glucose / mannose(g / M)ratio and SLEDAI score and immunological indexes in SLE group: the levels of serum degraded mannose and degraded glucosamine were positively correlated with SLEDAI 2K score,CD19 + B lymphocyte count and immunoglobulin G level;The level of serum degraded galactosamine was positively correlated with the count of CD19 + B lymphocytes and the level of immunoglobulin A;The level of serum degraded N-acetylglucosamine was positively correlated with SLEDAI score;The level of serum degraded galactose was positively correlated with SLEDAI score,CD19 + B lymphocyte count,immunoglobulin G level and complement C4 level.Serum free mannose level was positively correlated with CD19 + B lymphocyte count,immunoglobulin G and complement C4 level;Serum free glucose / mannose(g / M)ratio was negatively correlated with CD19 + B lymphocyte count and immunoglobulin G level.3.Changes of monosaccharide level and serum free glucose / mannose(g / M)ratio in children with SLE with different disease activity: the level of serum degradable monosaccharide(mannose,glucose and galactose)in severe active SLE group was higher than that in moderate active SLE group and mild active SLE group(P < 0.05),and the level of serum degradable monosaccharide(mannose,glucose and galactose)in moderate active SLE group was higher than that in mild active SLE group(P < 0.05).The ratio of serum free glucose / mannose(g / M)in severe active SLE group was lower than that in moderate active SLE group and mild active SLE group(P < 0.05),and the ratio of serum free glucose / mannose(g / M)in moderate active SLE group was lower than that in mild active SLE group(P < 0.05).4.Dynamic changes of serum monosaccharide level and serum free glucose / mannose(g/ M)ratio in children with SLE: the level of serum degradable monosaccharide(mannose,glucosamine,galactosamine,N-acetylglucosamine and galactose)in children with SLE was significantly lower than that at discharge and 3 months of follow-up(P < 0.05),and the ratio of serum free monosaccharide g / M was significantly higher than that at discharge and 3 months of follow-up(P < 0.05).Conclusion1.The average of serum degradable monosaccharide(mannose,glucosamine,galactosamine,N-acetylglucosamine,galactose)and serum free monosaccharide(glucose,mannose)monosaccharide water in children with SLE increased significantly,while the ratio of serum free glucose / mannose(g / M)decreased.2.the serum monosaccharide level was positively correlated with SLEDAI score,B cell count and immunoglobulin g/a level,while the serum free glucose / mannose(g/m)ratio was negatively correlated with B cell count and immunoglobulin G level.It is suggested that there is a certain correlation between serum monosaccharide level and immune dysfunction in children with SLE.3.The increase of serum degradable monosaccharides(mannose,N-acetylglucosamine,galactose)and the decrease of serum free glucose / mannose(g / M)ratio in children with SLE are closely related to disease activity.The more serious the disease is,the more obvious the change is.It is suggested that the unique "sugar fingerprint" characteristics of SLE children may be of great value in the evaluation of disease condition.