Miranda-Bautista José, de Gracia-Fernández Celia, López-Ibáñez María, Barrientos María, Gallo-Moltó Alejandra, González-Arias Marina, González-Gil Casilda, Díaz-Redondo Alicia, Marín-Jiménez Ignacio, Menchén Luis
Sección de Gastroenterología, Servicio de Aparato Digestivo, Hospital General Universitario "Gregorio Marañón" - Instituto de Investigación Sanitaria Gregorio Marañón, C/Dr. Esquerdo 46, 28007, Madrid, Spain.
Dig Dis Sci. 2015 Jul;60(7):2130-5. doi: 10.1007/s10620-015-3577-0. Epub 2015 Feb 14.
Previous studies analyzing lipid profile in small cohorts of patients with rheumatic and inflammatory bowel diseases (IBD) treated with TNFα blockers showed conflicting results. We aim to evaluate the effect of anti-TNFα monoclonal antibodies, infliximab and adalimumab, on lipid profile in IBD patients followed up to 3 years.
Clinical charts of 128 consecutive IBD patients, who received at least three doses of infliximab or two doses of adalimumab, and with a clinical follow-up of at least 1 year, were retrospectively reviewed. Lipid profiles (total, HDL and LDL cholesterol, and triglycerides) before beginning the treatment and after 1 and 3 years of follow-up were collected. Multiple linear regression analysis was performed considering total cholesterol difference at basal time, 1 and 3 years as a dependent variable.
There was not a statistically significant difference between pre- and post-treatment lipid profiles. However, the subgroup with normal-range total cholesterol level before anti-TNFα treatment (n = 82) showed a significant increase in total cholesterol after 1 and 3 years, and a significant increase in LDL cholesterol after 3 years. The subgroup with basal normal-range triglycerides showed a significant increase after 1 and 3 years of follow-up. Atherogenic index resulted significantly increased after 3 years of anti-TNFα treatment. Multivariate analysis showed no influence of age, gender, type of IBD, body mass index, or the presence of two or more cardiovascular risk factors.
No significant changes in lipid profile of IBD patients on anti-TNFα therapy were observed after 1 and 3 years of treatment.
先前对接受肿瘤坏死因子α（TNFα）阻滞剂治疗的小样本风湿性疾病和炎症性肠病（IBD）患者的血脂情况进行分析的研究结果相互矛盾。我们旨在评估抗TNFα单克隆抗体英夫利昔单抗和阿达木单抗对随访3年的IBD患者血脂情况的影响。
回顾性分析128例连续的IBD患者的临床病历，这些患者接受了至少三剂英夫利昔单抗或两剂阿达木单抗治疗，且临床随访至少1年。收集治疗开始前以及随访1年和3年后的血脂情况（总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇和甘油三酯）。以基础时间、1年和3年时的总胆固醇差异作为因变量进行多元线性回归分析。
治疗前后血脂情况无统计学显著差异。然而，抗TNFα治疗前总胆固醇水平在正常范围的亚组（n = 82）在1年和3年后总胆固醇显著升高，3年后低密度脂蛋白胆固醇显著升高。基础甘油三酯在正常范围的亚组在随访1年和3年后显著升高。抗TNFα治疗3年后致动脉粥样硬化指数显著升高。多变量分析显示年龄、性别、IBD类型、体重指数或存在两种或更多心血管危险因素均无影响。
IBD患者接受抗TNFα治疗1年和3年后，未观察到血脂情况有显著变化。
