The Level And Clinical Significance Of Serum Sclerotin In Patients With Systemic Autoimmune Diseases Treated With Glucocorticoids

Objectives: To explore the expression and clinical significance of sclerotin in the serum of patients with systemic autoimmune diseases treated with glucocorticoids.Methods: The serum of 43 patients with systemic autoimmune diseases were collected before and after glucocorticoid treatment(pre and post glucocorticoid group),other serum samples were from 56 patients with systemic autoimmune diseases(long-term group)who have been using glucocorticoid for a long time,and 30 healthy people(healthy control group).Enzyme-linked immunosorbent assay was used to detect the concentration of serum sclerotin and serum bone turnover markers,and clinical data of patients were collected for statistical analysis.Results: 1,The serum sclerotin level of patients in the long-term group was significantly higher than that in the healthy group([7.96(5.63,10.87)] ng/ml than [4.21(3.63,5.12)]ng/ml,p<0.001).2,The level of N-terminal pre-peptide of type Ⅰ procollagen in the long-term group was significantly lower than that in the healthy group([4.79(3.37,7.19)]ng/ml vs [13.47(11.21,16.30)]ng/ml,p<0.001);The serum osteocalcin level and the C-terminal peptide level of type Ⅰ collagen in the long-term group were significantly higher than those in the healthy group([2.91(2.02,4.41)]ng/ml vs [0.59(0.46,0.74)]ng/ml,p<0.001,[781.60(695.00,899.69)]pg/ml vs [254.55(206.48,292.67)]pg/ml,p<0.001).3,In the long-term group,the level of sclerotin was positively correlated with the Cterminal peptide of type Ⅰ collagen(r=0.481,p<0.001)and osteocalcin(r=0.282,p=0.017);In this group,there was no significant correlation between the level of sclerotin and the N-terminal pre-peptide of type Ⅰ procollagen(r=0.105,p=0.442).4,In the long-term group,the serum sclerotin level was positively correlated with white blood cell count(r=0.653,p<0.001),IgM(r=0.504,p<0.001),complement C3(r=0.440,p=0.001),complement C4(r=0.310,p=0.023),low density lipoprotein cholesterol(r=0.294,p=0.045),CD3-CD16+CD56+(r=0.359,p=0.011),and negatively correlated with IgG(r=-0.332,p=0.012),but not significantly correlated with other indicators.5,Compared with 43 patients before and after hormone treatment,there was no significant difference in the concentration of sclerotin(110.77 ± 52.59pg/ml vs 99.87 ±53.06pg/ml,p=0.290),osteocalcin(2.3438ng/ml vs 2.5547ng/ml,p=0.440),N-terminal peptide of type Ⅰ procollagen(7.3953ng/ml vs 4.6989ng/ml,p=0.088)and C-terminal peptide of type Ⅰ collagen(841.2698pg/ml vs 791.5478pg/ml,p=0.904).6,The serum sclerotin level of patients in the group before hormone treatment was negatively correlated with red blood cell count(r=-0.305,p=0.049),platelet count(r=-0.334,p=0.029),C-reactive protein(r=-0.326,p=0.035),complement C3(r=-0.312,p=0.047),complement C4(r=-0.359,p=0.023),CD3-CD16+CD56+(r=-0.458,p=0.021),and there was no significant correlation with other indicators.7,The N-terminal pre-peptide of type Ⅰ procollagen in the group before treatment with GC was significantly lower than that in the healthy group([9.55(7.40,13.84)] ng/ml vs[13.47(11.21,16.30)]ng/ml,p<0.001),and the serum osteocalcin concentration([2.34(1.75,3.87)]ng/ml vs [0.59(0.46,0.74)]ng/ml,p<0.001)and the serum C-terminal peptide concentration of type Ⅰ collagen([841.26(390.46,1008.67)]pg/ml vs [254.55(206.48292.67)]pg/ml,p<0.001)in the group before treatment with GC were significantly higher than those in the healthy group.Conclusions: The level of serum sclerotin increased in patients with systemic autoimmune diseases who use hormones for a long time.It is significantly correlated with inflammation index,complement,immunoglobulin,CD3-CD16+CD56+,LDL-C,suggesting that the increase of sclerotin may participate in the formation of glucocorticoid-induced osteoporosis.