类风湿性关节炎患者血清脂质水平与疾病活动度的关系
Relationship between Serum Lipid Level and Disease Activity in Patients with Rheumatoid Arthritis
DOI: 10.12677/ACM.2021.112079, PDF,   
作者: 赵 旋, 郭欣欣:青岛大学附属医院风湿免疫科,山东 青岛;青岛大学医学部,山东 青岛;刘莹爽:聊城市传染病医院消化内科,山东 聊城
关键词: 类风湿性关节炎血清脂质炎症疾病活动度Rheumatoid Arthritis Serum Lipids Inflammation Disease Activity
摘要: 目的:分析类风湿性关节炎(Rheumatoid arthritis, RA)患者血清脂质水平,进一步探讨RA患者血清脂质水平与疾病活动度的关系。方法:回顾性纳入2014年6月至2019年10月于青岛大学附属医院风湿免疫科住院的RA患者(RA组)及本院同期健康体检者(对照组),排除肿瘤、急慢性感染、其他自身免疫性疾病及严重肝肾功不全者,收集所有研究对象的人口学资料及临床资料,运用SPSS26.0软件进行统计分析。结果:与年龄、性别相匹配的健康人群相比,RA患者血清脂质水平(包括甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)及低密度脂蛋白胆固醇(LDL-C))明显降低(P < 0.05),C反应蛋白(CRP)、红细胞沉降率(ESR)及DAS28 (ESR)均与TC (r = −0.146, −0.164及−0.146, P < 0.05)、HDL-C (r = −0.311, −0.330及−0.309, P < 0.05)呈负相关,与TC/HDL-C呈正相关(r = 0.230, 0.231及0.208, P < 0.05),DAS28 (CRP)与HDL-C呈负相关(r = −0.281, P < 0.001),与TC/HDL-C呈正相关(r = 0.205, P = 0.001);类风湿因子(RF)与HDL-C呈负相关(r = −0.155, P = 0.016),与LDL-C、TC/HDL-C呈正相关(r = 0.141, P = 0.028; r = 0.207, P = 0.001),抗环瓜氨酸肽抗体(ACPA)与血脂无明显相关性;RA患者合并症数量与HDL-C呈负相关(r = −0.198, P = 0.002),与TC/HDL-C呈正相关(r = 0.208, P = 0.001)。结论:RA患者血清脂质水平异常,部分血清脂质指标变化与疾病活动度密切相关。
Abstract: 目的:分析类风湿性关节炎(Rheumatoid arthritis, RA)患者血清脂质水平,进一步探讨RA患者血清脂质水平与疾病活动度的关系。方法:回顾性纳入2014年6月至2019年10月于青岛大学附属医院风湿免疫科住院的RA患者(RA组)及本院同期健康体检者(对照组),排除肿瘤、急慢性感染、其他自身免疫性疾病及严重肝肾功不全者,收集所有研究对象的人口学资料及临床资料,运用SPSS26.0软件进行统计分析。结果:与年龄、性别相匹配的健康人群相比,RA患者血清脂质水平(包括甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)及低密度脂蛋白胆固醇(LDL-C))明显降低(P < 0.05),C反应蛋白(CRP)、红细胞沉降率(ESR)及DAS28 (ESR)均与TC (r = −0.146, −0.164及−0.146, P < 0.05)、HDL-C (r = −0.311, −0.330及−0.309, P < 0.05)呈负相关,与TC/HDL-C呈正相关(r = 0.230, 0.231及0.208, P < 0.05),DAS28 (CRP)与HDL-C呈负相关(r = −0.281, P < 0.001),与TC/HDL-C呈正相关(r = 0.205, P = 0.001);类风湿因子(RF)与HDL-C呈负相关(r = −0.155, P = 0.016),与LDL-C、TC/HDL-C呈正相关(r = 0.141, P = 0.028; r = 0.207, P = 0.001),抗环瓜氨酸肽抗体(ACPA)与血脂无明显相关性;RA患者合并症数量与HDL-C呈负相关(r = −0.198, P = 0.002),与TC/HDL-C呈正相关(r = 0.208, P = 0.001)。结论:RA患者血清脂质水平异常,部分血清脂质指标变化与疾病活动度密切相关。
文章引用:赵旋, 刘莹爽, 郭欣欣. 类风湿性关节炎患者血清脂质水平与疾病活动度的关系[J]. 临床医学进展, 2021, 11(2): 547-552. https://doi.org/10.12677/ACM.2021.112079

参考文献

[1] Smolen, J.S., Aletaha, D. and McInnes, I.B. (2016) Rheumatoid Arthritis. Lancet, 388, 2023-2038.
[Google Scholar] [CrossRef
[2] 王茜, 孙明姝, 刘莹爽, 等. 类风湿关节炎患者主动脉钙化积分研究[J]. 中华风湿病学杂志, 2019(5): 289-294.
[3] Scott, D.L., Wolfe, F. and Huizinga, T.W. (2010) Rheumatoid Arthritis. Lancet, 376, 1094-1108.
[Google Scholar] [CrossRef
[4] Lassere, M.N., Rappo, J., Portek, I.J., et al. (2013) How Many Life Years Are Lost in Patients with Rheumatoid Arthritis? Secular Cause-Specific and All-Cause Mortality in Rheumatoid Arthritis, and Their Predictors in a Long-Term Australian Cohort Study. Internal Medicine Journal, 43, 66-72.
[Google Scholar] [CrossRef] [PubMed]
[5] Van Raemdonck, K., Umar, S., Szekanecz, Z., et al. (2018) Impact of Obesity on Autoimmune Arthritis and Its Cardiovascular Complications. Autoimmunity Reviews, 17, 821-835.
[Google Scholar] [CrossRef] [PubMed]
[6] Choy, E. and Sattar, N. (2009) Interpreting Lipid Levels in the Context of High-Grade Inflammatory States with a Focus on Rheumatoid Arthritis: A Challenge to Conventional Cardiovascular Risk Actions. Annals of the Rheumatic Diseases, 68, 460-469.
[Google Scholar] [CrossRef] [PubMed]
[7] Myasoedova, E., Crowson, C.S., Nicola, P.J., et al. (2011) The Influence of Rheumatoid Arthritis Disease Characteristics on Heart Failure. The Journal of Rheumatology, 38, 1601-1606.
[Google Scholar] [CrossRef] [PubMed]
[8] Kinosian, B., Glick, H. and Garland, G. (1994) Cholesterol and Coronary Heart Disease: Predicting Risks by Levels and Ratios. Annals of Internal Medicine, 121, 641-647.
[Google Scholar] [CrossRef] [PubMed]
[9] Yang, D., Liu, X. and Xiang, M. (2011) The Correlation between Lipids Ratio and Degree of Coronary Artery Stenosis. High Blood Pressure & Cardiovascular Prevention, 18, 53-56.
[Google Scholar] [CrossRef] [PubMed]
[10] McGrath, C.M. and Young, S.P. (2015) Lipid and Metabolic Changes in Rheumatoid Arthritis. Current Rheumatology Reports, 17, Article No. 57.
[Google Scholar] [CrossRef] [PubMed]
[11] Plutzky, J. and Liao, K.P. (2018) Lipids in RA: Is Less Not Necessarily More? Current Rheumatology Reports, 20, Article No.8.
[Google Scholar] [CrossRef] [PubMed]
[12] Navarro-Millan, I., Charles-Schoeman, C., Yang, S., et al. (2013) Changes in Lipoproteins Associated with Methotrexate or Combination Therapy in Early Rheumatoid Arthritis: Results from the Treatment of Early Rheumatoid Arthritis trial. Arthritis & Rheumatology, 65, 1430-1438.
[Google Scholar] [CrossRef] [PubMed]
[13] Vander, C.B., Peene, I., Cantaert, T., et al. (2005) Anti-Citrullinated Protein/Peptide Antibodies (ACPA) in Rheumatoid Arthritis: Specificity and Relation with Rheumatoid Factor. Autoimmunity Reviews, 4, 468-474.
[Google Scholar] [CrossRef] [PubMed]
[14] Amezaga, U.M. and Suarez-Almazor, M.E. (2012) Lipid Paradox in Rheumatoid Arthritis: Changes with Rheumatoid Arthritis Therapies. Current Rheumatology Reports, 14, 428-437.
[Google Scholar] [CrossRef] [PubMed]