Oklahoma Medical Research Foundation, Oklahoma City, OK, USA.
Arthritis Care Res (Hoboken). 2012 Jul;64(7):993-1000. doi: 10.1002/acr.21646.
The purpose of this study was to explore whether nontraditional risk factors, such as apolipoprotein C-III (Apo C-III) and its corresponding Apo B lipoprotein (Lp) subclasses, contribute to the risk of cardiovascular disease in rheumatoid arthritis (RA) patients.
Apolipoprotein and lipoproteins were measured in 152 RA patients by immunoturbidimetric procedures, electroimmunoassay, and immunoprecipitation. Patients had a coronary artery calcium (CAC) score assessed at baseline and at year 3. Differences in the CAC scores between baseline and year 3 were calculated and dichotomized at 0, where patients with a difference score >0 were denoted as progressors and the rest were denoted as nonprogressors. Differences between means were tested with a 2-sided independent Student's t-test with Satterthwaite's adjustment. Proportion differences were tested with a chi-square test. Multiple logistic regression was performed to assess the relationship between apolipoprotein and lipoprotein levels and the dichotomized CAC score.
Progressors accounted for almost 60% of the cohort. Progressors had significantly higher levels of triglycerides, very low-density lipoprotein (VLDL) cholesterol, total cholesterol/high-density lipoprotein (HDL), triglycerides/HDL, Apo B, LpA-II:B:C:D:E, LpB:C, Apo B/Apo A-I, Apo C-III, and Apo C-III-heparin precipitate than the nonprogressors. After adjusting for age, sex, statin use (yes/no), and hypertension (yes/no), significant risk factors of progressors were total cholesterol, triglycerides, VLDL cholesterol, LDL cholesterol, Apo B, LpB:C, Apo C-III, and Apo B/Apo A-I.
Apo C-III-containing Apo B lipoprotein subclasses were found to be significantly elevated in progressors compared to nonprogressors. Many of these same lipoproteins were found to be associated with an increase in CAC scores among progressors. These lipoproteins may be considered new risk factors for progression of atherosclerosis in RA patients.
本研究旨在探讨载脂蛋白 C-III（Apo C-III）及其相应的载脂蛋白 B 脂蛋白（Lp）亚类等非传统危险因素是否与类风湿关节炎（RA）患者的心血管疾病风险相关。
采用免疫比浊法、电泳免疫法和免疫沉淀法检测 152 例 RA 患者的载脂蛋白和脂蛋白。患者在基线和第 3 年时进行冠状动脉钙评分（CAC）评估。计算基线和第 3 年 CAC 评分的差值，并将差值>0 的患者分为进展者，其余患者为非进展者。采用双侧独立 Student's t 检验，并用 Satterthwaite 校正法比较均值差异。采用卡方检验比较比例差异。采用多因素 logistic 回归分析评估载脂蛋白和脂蛋白水平与 CAC 评分二分变量之间的关系。
进展者占队列的近 60%。进展者的甘油三酯、极低密度脂蛋白（VLDL）胆固醇、总胆固醇/高密度脂蛋白（HDL）、甘油三酯/HDL、载脂蛋白 B、LpA-II:B:C:D:E、LpB:C、载脂蛋白 B/载脂蛋白 A-I、Apo C-III 和 Apo C-III-肝素沉淀均显著高于非进展者。在校正年龄、性别、他汀类药物使用（是/否）和高血压（是/否）后，进展者的显著危险因素为总胆固醇、甘油三酯、VLDL 胆固醇、LDL 胆固醇、载脂蛋白 B、LpB:C、Apo C-III 和 Apo B/Apo A-I。
与非进展者相比，进展者的载脂蛋白 C-III 载脂蛋白 B 脂蛋白亚类明显升高。其中许多脂蛋白与进展者 CAC 评分升高相关。这些脂蛋白可能被视为 RA 患者动脉粥样硬化进展的新危险因素。
