系统性硬化症中的胰岛素抵抗:解读其与严重临床表现型的关联
Eugenio Capparelli1,2, Luca Clerici3,4, Giusy Cinzia Moltisanti3,4
1Rheumatology Unit, ASST Ovest Milanese, Legnano Hospital, 20025 Milan, Italy.
Journal of clinical medicine
|January 28, 2026
概括
系统性硬化 (SSc) 中的胰岛素抵抗 (IR) 与间歇性肺病 (ILD) 和数字有关. 更高的BMI和ILD独立地预测SSc患者的IR,突出显示了这种类风湿性疾病中的代谢问题.
科学领域:
- 类风湿病学 类风湿病学
- 内分泌学 在内分泌学.
- 肺部病理学 肺部病理学
背景情况:
- 胰岛素耐药性 (IR) 是一种已知的类风湿性疾病中的代谢问题,但其对全身性硬化症 (SSc) 的影响还未得到充分研究.
- 关于SSc患者中IR的临床特征和预测因素的数据有限.
研究的目的:
- 调查系统性硬化症患者队列中胰岛素抵抗的流行率和临床特征.
- 确定与SSc.中胰岛素抵抗相关的独立预测因子.
主要方法:
- 一项涉及178名SSc患者的横截面研究,根据IR状态分层,使用验证的HOMA-IR值.
- 数据收集包括人口统计,临床,实验室,肺功能,毛细管镜和治疗参数.
- 使用多变量逻辑回归来确定IR的独立预测因子.
主要成果:
- 患有IR的患者 (n=76) 患有扩散性SSc,间歇性肺病 (ILD),抗Scl70抗体,肌肉骨症状和数字的患病率较高.
- 在IR组中观察到更高的体重指数 (BMI),禁食葡萄糖,胰岛素,HOMA-IR,HbA1c,脂质不良症和肝肥胖症.
- 多变量分析确定BMI (OR 1.09;p=0.038) 和ILD (OR 3.03;p=0.034) 作为IR的独立预测因素.
结论:
- 在SSc中胰岛素抵抗与特定的临床表现有关,包括ILD,数字和肌肉骨参与.
- 反Scl70自身抗体的存在也与SSc患者的IR有关.
- 体重指数和ILD是系统性硬化症中IR的显著独立预测因素.
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