Changes And Significance Of Serum Leptin Levels In Patients With Active Axial Spondylitis Treated With RhTNFR-Fc Therapy

Objective: To investigate the changes of serum leptin(LP)and related clinical indexes in patients with active axial axonal arthritis(ax SpA)treated with recombinant human type II tumor necrosis factor receptor-antibody fusion protein(rhTNFR-Fc,Etanercept)the role and significance in the pathogenesis of ax SpA.Methods:Twenty-four patients with active ax SpA were enrolled according to the inclusion criteria.They were randomly divided into two groups,A and B.In the first 12 weeks,A and B groups were given traditional medicine for benefiting the competition.After 12 weeks,group A(n=12)Treated according to the original protocol,Group B(n=12)discontinued rhTNFR-Fc and maintained traditional medicine treatment.Serum leptin levels were measured at baseline(week 0)and at 6,12,18,and 24 weeks after treatment in ax SpA patients by enzyme-linked immunosorbent assay(ELISA).SPSS statistical software was used to analyze the changes of serum leptin levels and the correlation with clinical indicators.rhTNFR-FcResults:(1)The level of leptin at week 0(μg/L)was 8.25±3.35,and that of the normal group was 4.64±2.80.The level of leptin in ax SpA patients was higher than that in healthy controls at baseline level.The baseline level of leptin in ax SpA patients was different from that in healthy controls(p<0.05).(2)Serum leptin levels(μg/L)in patients with ax SpA at 6 weeks,12 weeks,18weeks(A),18 weeks(B),24 weeks(A),and 24 weeks(B)were 6.63±2.27,5.94±2.06,4.65±1.55,7.22±2.69,4.47±2.04,7.94±1.83,Serum leptin levels were different at 0 and 12 weeks(P=0.013),0 and 24 weeks(P=0.001)in group A(P<0.05),and at 0 and 12 weeks(P=0.011)in group B(P<0.05),serum leptin showed a gradual decline from 0-12 weeks,and group A 12-continued after using the original protocol.After 24 weeks,the gradual decline trend continued.After stopping the use of rhTNFR-Fc,serum leptin in group B gradually increased from 12 weeks to 24 weeks.There were differences between groups A and B at 18 weeks and 24 weeks(P<0.05)..(3)clinical indicators(ASDAS,BASDAI,BASFI,CRP,ESR):gradual decline from 0-12 weeks,group A gradually decreased from 12-24 weeks,group B gradually recovered from 12weeks to 24 weeks.Compared with the previous follow-up point,there was no statistical significance between 12 weeks and 24 weeks in group A,and there were differences between 0 weeks and 12 weeks,0 weeks and 24 weeks(P<0.05).In group B,there was a difference between week 0 and week 12(P<0.05);there was a difference between week 12 and week 24 in ASDAS and ESR;there was a statistical difference between week 0 and week 24 in ASDAS and BASDAI(P<0.05)..The clinical indicators of ASDAS,CRP and ESR showed statistical difference between groups A and B at 18 weeks(P<0.05),while ASDAS and ESR showed statistical difference between groups A and B at24 weeks(P<0.05).(4)serum leptin level was 0 Weeks were correlated with rhTNFR-Fc ASDAS,BASDAI,BASFI,CRP,ESR,and correlated with ASDAS,BASDAI,and ESR at 6 weeks,and correlated with ASDAS BASDAI、ESRand CRP at 12weeks.Conclusions: 1.rhTNFR-Fc can effectively control the inflammatory state of active ax SpA patients compared with traditional drugs.2.Ax SpA patients in the active stage show a high leptin level,which can be decreased after treatment,which is related to clinical indicators,and leptin may be used as an indicator of disease activity evaluation.