Clinical Significance of Dense Fine Speckled Pattern: Association with Inflammatory State
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배경: 29개의 항핵항체 형광양상 중 dense fine speckled (DFS) 양상의 임상적 의미는 불분명하다. DFS 양상은 건강한 정상인뿐만 아니라 다양한 환자에게서 검출되며, 염증성 미세환경의 지표가 될 수 있다고 보고되었다. 본 연구에서는 DFS 양상과 염증 표지자 및 다양한 질환과의 연관성을 분석하였다. 방법: 2019년부터 2022년 사이의 기간에 일개 3차 병원의 건강검진 또는 외래에서 ANA 검사가 의뢰된 862명(DFS 양성 436명, DFS 음성 426명)의 의료 정보를 수집하였다. 염증 표지자와 DFS 양성 사이의 연관성을 평가했고 로지스틱 회귀 모델을 사용하여 교란 변수를 조정한 오즈비(odds ratio)를 추정하였다. 결과: DFS 양성과 C-반응성 단백질(CRP), 백혈구 수, 호중구 비율과 같은 염증 표지자 사이에 유의한 연관성이 관찰되었다. 그러나 알레르기 비염만 DFS 양성과 유의한 연관을 보인 반면, 다른 염증성 질환들은 DFS 음성과 유의한 연관성을 보였다. 항 Ro/SSA 항체 및 항 La/SSB 항체와 DFS 양성과의 유의한 관련성은 주목할만했다. 결론: CRP, 백혈구 수, 호중구 비율과 같은 염증 표지자가 DFS 양성과 유의하게 관련이 있었지만, 염증 상태와 DFS 양성 사이의 연관성이 있다고 결론을 도출하기에는 부족했다.
Abstract
Background: The clinical significance of the nuclear dense fine speckled (DFS) pattern is unclear among 29 antinuclear antibody (ANA) patterns. DFS pattern has been reported in healthy individuals and in various patients, and is proposed to be an indicator of a proinflammatory microenvironment. We analyzed the association of DFS pattern with inflammatory markers and various diseases. Methods: Medical information was collected for 862 subjects (436 DFS-positive and 426 DFS-negative subjects) who were tested for ANA in regular health checkups or at the outpatient clinic at a tertiary hospital between 2019 and 2022. Statistical analyses were performed to assess the association between inflammatory markers and DFS positivity, and logistic regression models were used to estimate the odds ratios (ORs) adjusted for confounding factors. Results: A significant association was observed between the DFS positivity and inflammatory markers such as C-reactive protein (CRP) levels, white blood cell (WBC) counts, and proportions of neutrophils. However, only allergic rhinitis showed a significant association with DFS positivity, whereas other inflammatory-based diseases were significantly associated with negative DFS patterns. The significant relation of anti-Ro/SSA and anti-La/SSB antibodies with DFS positivity was remarkable. Conclusions: Although inflammatory markers such as CRP levels, WBC counts, and proportions of neutrophils were significantly associated with DFS positivity, the link between inflammatory states and DFS positivity remains controversial.
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