Study On Lymphocyte Subsets And Related Immune Indexes In Peripheral Blood Of Patients With Systemic Lupus Erythematosus With Different Body Mass Indexes

Purpose:To compare the clinical features,inflammatory indicators,blood lipids,autoantibodies,peripheral blood lymphocytes,CD4~+T cell subsets,cytokine levels and differences among patients with systemic lupus erythematosus(SLE)with different body mass indexes.Method:97 patients with systemic lupus erythematosus hospitalized in the Second Hospital of Shanxi Medical University from January 2018 to February 2021 were selected.The general data(gender,age,height,weight,course of disease),clinical features(rash,arthritis,serositis,etc.),laboratory indicators(inflammatory indicators,blood lipids,autoantibodies,peripheral blood lymphocytes,CD4~+T cell subsets,cytokines,etc.)of SLE patients were collected.Laboratory indexes were obtained from rheumatology laboratory and laboratory of the Second Hospital of Shanxi Medical University.BMI was calculated and divided into low weight group(BMI<18.5kg/m~2),normal weight group(18.5kg/m~2≤BMI<24kg/m~2)and overweight or obese group(BMI≥24kg/m~2)according to BMI.The differences of clinical characteristics and laboratory indexes among different weight groups were analyzed.Results:Among 97 SLE patients,18(18.6%)were in low weight group,26(26.8%)were overweight or obese,and 53(54.6%)were in normal weight.The levels of complement C3(P=0.027)and C4(P=0.019)in SLE patients with overweight or obesity were higher than those in normal weight group.The incidence of hypertension in overweight or obese group was higher than that in normal weight group and low weight group,and the difference was statistically significant.Serum triglyceride(TG)levels in overweight or obese SLE patients were lower than those in other two groups,but total cholesterol(Chol)and low-density lipoprotein(LDL)levels were slightly higher,with no significant difference.The positive rates of anti-Sm antibody,anti-SSA antibody,anti-histone antibody and anti-phospholipid antibody in serum of SLE patients in overweight or obese group were higher than those in low weight group and normal weight group,while the positive rates of anti-ds DNA antibody and anti-β2 glycoprotein antibody were lower than those in normal weight group,while the positive rates of anti-nucleosome antibody in low weight group were higher than those in other two groups.The number of CD4~+T cells in peripheral blood of SLE patients in overweight or obese group was less than that in normal weight group(P=0.034).The level of Th17 cells in SLE patients with low body weight was lower than that in normal body weight group(P=0.012).Compared with normal weight group,Treg cell level of SLE patients in low weight group/overweight or obese group decreased significantly(P=0.035/P=0.043).The levels of B cells and NK cells in peripheral blood of SLE patients in overweight or obese group were higher than those in other two groups,while those in low weight group were lower than those in normal weight group,but there was no statistical difference.The levels of Th1 cells in overweight or obese patients were higher than those in normal weight group,while the levels of Th2 and Th17 cells were lower than those in normal weight group,but there was no statistical difference.The levels of Th1 and Th2 cells in low body weight group were lower than those in other two groups,but there was no significant difference.In overweight or obese group,IL-2 and TNF-αwere slightly higher than those in normal weight group,while IL-4,IL-6,IL-10,IL-17 and IFN-γwere slightly lower than those in normal weight group.IL-2,IL-4 and IL-10 in low body weight group were slightly lower than those in normal body weight group,while IL-6,IL-17,IFN-γand TNF-αwere higher than those in normal body weight group,but there was no statistical difference.Conclusion:The level of Treg cells in peripheral blood of SLE patients is lower than that of normal weight group regardless of overweight or underweight,suggesting that there may be immune tolerance deficiency in low weight group and overweight or obese group.Compared with normal weight group,Th17 cells in peripheral blood of SLE patients in low weight group decreased significantly.Complement C3 and C4 levels in overweight or obese SLE patients were higher than those in normal weight group.Overweight or obese SLE patients have higher incidence of hypertension.