Cardiovascular Disease Research Institute, The Third People's Hospital of Chengdu, The Second Affiliated Chengdu Clinical College of Chongqing Medical University, Chengdu, Sichuan, China.
J Eur Acad Dermatol Venereol. 2013 Feb;27(2):175-9. doi: 10.1111/j.1468-3083.2011.04437.x. Epub 2012 Jan 9.
Altered lipid levels may occur in autoimmune diseases, such as systemic lupus erythematosus and rheumatoid arthritis. However, serum lipid profiles in patients with dermatomyositis (DM) have not been investigated. Our aim was to identify lipid profiles in untreated DM patients, and to assess the relationship of the inflammatory condition of DM with lipid profiles.
This work was designed and conducted as a case-control study. Forty-one DM patients and 41 age- and gender-matched healthy controls were included. None of the patients had received corticosteroids or disease-modifying antirheumatic drugs prior to the study. Triglyceride (TG), total cholesterol (TC), low-density lipoprotein-cholesterol (LDL-C) and high-density lipoprotein-cholesterol (HDL-C), C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were assessed using standard techniques.
Twenty-nine patients (70.7%) had an increase level of TG, and 41.5% had a decrease level of HDL-C. The levels of HDL-C in DM were significantly lower than in controls (P < 0.01). The levels of TG, Non- HDL-cholesterol and very LDL-cholesterol (VLDL-C) were significantly higher than in controls (P < 0.001, P < 0.001 and P < 0.05 respectively). The ratios of VLDL-C/LDL-C, TC/HDL-C and LDL-C/HDL-C were significantly higher than in controls (P < 0.001). Spearman's correlation test demonstrated that serum CRP levels correlated negatively with HDL-C in DM(r = -0.420, P = 0.006).
Dyslipoproteinemia is a common feature in patients with DM that is characterized by an increase in TG and a decrease in HDL-C, suggesting a high risk of atherosclerosis. Inflammation might partly account for the changes of serum lipid profiles in DM.
自身免疫性疾病（如系统性红斑狼疮和类风湿关节炎）可能会出现脂质水平改变。然而，皮肌炎（DM）患者的血清脂质谱尚未得到研究。我们的目的是确定未经治疗的 DM 患者的脂质谱，并评估 DM 的炎症状态与脂质谱的关系。
本研究设计为病例对照研究。纳入 41 例 DM 患者和 41 名年龄和性别匹配的健康对照者。在研究之前，所有患者均未接受皮质类固醇或改善病情的抗风湿药物治疗。使用标准技术评估甘油三酯（TG）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）和高密度脂蛋白胆固醇（HDL-C）、C 反应蛋白（CRP）和红细胞沉降率（ESR）。
29 例（70.7%）患者 TG 水平升高，41.5%患者 HDL-C 水平降低。DM 患者的 HDL-C 水平明显低于对照组（P<0.01）。TG、非 HDL-胆固醇和极 LDL-胆固醇（VLDL-C）水平明显高于对照组（P<0.001、P<0.001 和 P<0.05）。VLDL-C/LDL-C、TC/HDL-C 和 LDL-C/HDL-C 比值明显高于对照组（P<0.001）。Spearman 相关检验显示，DM 患者血清 CRP 水平与 HDL-C 呈负相关（r=-0.420，P=0.006）。
DM 患者存在血脂异常，表现为 TG 升高和 HDL-C 降低，提示动脉粥样硬化风险较高。炎症可能部分解释了 DM 患者血清脂质谱的变化。
