Sadanand Shajit, Paul Binoy J, Thachil Emil J, Meletath Rejadheesh
Department of Internal Medicine, Government Medical College, Calicut, India.
Department of Rheumatology, KMCT Medical College, Calicut, India.
Eur J Rheumatol. 2016 Dec;3(4):161-164. doi: 10.5152/eurjrheum.2016.16041. Epub 2016 Dec 1.
Antiphospholipid antibody syndrome (APS) is one of the most common acquired thrombophilic disorders resulting in arterial and venous thromboses. APS is a major cause for cerebrovascular accidents or stokes, myocardial infarction, venous thromboembolism and recurrent abortions/pregnancy losses especially in young patients. APS patients have an increased risk of atherosclerotic cardiovascular events. There are only two studies on lipid abnormalities in APS patients. None of them have studied the relationship between individual laboratory tests for APS and lipid profile abnormalities. Here we describe the significance of the relationship between various APS tests and lipid profile abnormalities in a subset of APS patients who presented with arterial thrombosis in a tertiary care hospital.
The study was conducted at Government Medical College, which is a tertiary care referral hospital. All patients who presented to the medicine department with APS during a two-year period were studied. A patient was considered to be positive for anticardiolipin (aCL) antibody or anti-β2 glycoprotein (anti-β2G) if the titer was more than 15 IU/mL, and a high titer was considered to be more than 40 IU/mL for Immunoglobulin (lg) IgG and IgM isotypes. The fasting lipid profile was measured in all patients, and lipid profile abnormalities were defined with cutoffs of low-density lipoprotein (LDL) levels of >150 mg/dL, triglyceride (TG) levels of >150 mg/dL, and high-density lipoprotein (HDL) levels of <40 mg/dL. The relationship between lipid abnormalities and individual tests for APS, aCL IgG and IgM and anti-β2G IgG and IgM, were determined by statistical analysis.
The study population included 77 APS patients, with 53% of patients between 20 and 40 years. The commonest abnormality in the lipid profile test was elevated TG levels of >150 mg/dL in 51.9% of the patients, followed by low HDL levels (<40 mg/dL) in 38.9% of the patients and high LDL levels (>150 mg/dL) in 40.2% of the patients. There was a statistically significant relationship between anti-β2G IgG levels and HDL and LDL levels, but not TG levels. Only LDL levels had a statistically significant relationship with aCL IgM levels. None of the lipid abnormalities had any statistically significant relationship with aCL IgG levels.
This study highlights the importance of testing lipid profile abnormalities in APS patients and the existence of a statistically significant relationship between antiphospholipid antibody tests and lipid profile abnormalities.
抗磷脂抗体综合征（APS）是最常见的获得性易栓症之一，可导致动静脉血栓形成。APS是脑血管意外或中风、心肌梗死、静脉血栓栓塞以及反复流产/妊娠丢失的主要原因，尤其是在年轻患者中。APS患者发生动脉粥样硬化性心血管事件的风险增加。关于APS患者脂质异常的研究仅有两项。它们均未研究APS的单项实验室检查与血脂异常之间的关系。在此，我们描述了在一家三级医疗医院中出现动脉血栓形成的部分APS患者中，各种APS检查与血脂异常之间关系的重要性。
本研究在政府医学院进行，该学院是一家三级医疗转诊医院。对在两年期间到内科就诊的所有APS患者进行了研究。如果抗心磷脂（aCL）抗体或抗β2糖蛋白（抗β2G）的滴度超过15 IU/mL，则患者被认为呈阳性；对于免疫球蛋白（Ig）IgG和IgM亚型，高滴度被认为超过40 IU/mL。对所有患者进行空腹血脂检测，并将血脂异常定义为低密度脂蛋白（LDL）水平>150 mg/dL、甘油三酯（TG）水平>150 mg/dL以及高密度脂蛋白（HDL）水平<40 mg/dL。通过统计分析确定血脂异常与APS的单项检查、aCL IgG和IgM以及抗β2G IgG和IgM之间的关系。
研究人群包括77例APS患者，53%的患者年龄在20至40岁之间。血脂检测中最常见的异常是51.9%的患者TG水平升高>150 mg/dL，其次是38.9%的患者HDL水平低（<40 mg/dL），40.2%的患者LDL水平高（>150 mg/dL）。抗β2G IgG水平与HDL和LDL水平之间存在统计学显著关系，但与TG水平无关。只有LDL水平与aCL IgM水平存在统计学显著关系。血脂异常与aCL IgG水平均无统计学显著关系。
本研究强调了检测APS患者血脂异常的重要性，以及抗磷脂抗体检查与血脂异常之间存在统计学显著关系。
