Quintanilla María Amparo, Andrés Mariano, Pascual Eliseo, Pallarés Vicente, Fácila Lorenzo, Morillas Pedro
Cardiology Service, General University Hospital of Elche, Camí de l'Almazara 11, 03203, Elche (Alicante), Spain.
Rheumatology Unit, General University Hospital of Alicante, Alicante, Spain.
Rheumatol Int. 2017 Jun;37(6):941-948. doi: 10.1007/s00296-017-3683-8. Epub 2017 Mar 14.
In inflammatory disease, the levels of high-density lipoprotein cholesterol (HDL-C) decrease, and the composition of HLD-C changes. Data from the "non-inflammatory" general population indicate the presence of the same phenomenon, albeit to a smaller extent. Levels of uricaemia contribute to the overall inflammatory state of patients. The aim of this study was to analyse the association between inflammatory state, levels of uricaemia, and levels of HLD-C in a hypertensive Spanish population aged 65 or older. This was a retrospective analysis of the FAPRES database. We compared lipid levels [HDL-C, low-density lipoprotein cholesterol (LDL-C), total cholesterol, and triglycerides] in terciles of patients according to their leukocyte counts and uricaemia. When we observed statistically significant differences at a 95% confidence level, we constructed a multivariable linear regression model to adjust for possible confounders. We analysed 860 patients (52.7% women) with a mean age of 72.9 years (±5.8). Participants in the highest tercile for leukocytes or uricaemia presented with significantly lower levels of HDL-C and higher levels of triglycerides, but there was no difference in total cholesterol or LDL-C. The multivariable analysis confirmed an independent and inverse association between HDL-C and both leukocytes (β = -0.001, p = 0.025) and uricaemia (β = -1.054, p = 0037) as well as an independent, direct association between triglycerides and both leukocytes (β = 0.004, p = 0.049), and uricaemia (β = 8.411, p = 0.003). In hypertensive adults aged 65 or older, inflammatory state, and uricaemia independently operate to decrease HDL-C-these findings confirm those described in studies in people with inflammatory disease. This phenomenon could help to define a proatherogenic profile in people without inflammatory disease.
在炎症性疾病中，高密度脂蛋白胆固醇（HDL-C）水平降低，且HDL-C的组成发生变化。来自“非炎症性”普通人群的数据表明存在同样的现象，尽管程度较轻。血尿酸水平会影响患者的整体炎症状态。本研究的目的是分析65岁及以上西班牙高血压人群的炎症状态、血尿酸水平与HDL-C水平之间的关联。这是对FAPRES数据库的一项回顾性分析。我们根据患者的白细胞计数和血尿酸水平，将其分为三个三分位数组，比较了各组的血脂水平[HDL-C、低密度脂蛋白胆固醇（LDL-C）、总胆固醇和甘油三酯]。当我们在95%置信水平观察到统计学上的显著差异时，构建了多变量线性回归模型以调整可能的混杂因素。我们分析了860名患者（52.7%为女性），平均年龄为72.9岁（±5.8）。白细胞或血尿酸处于最高三分位数组的参与者，其HDL-C水平显著较低，甘油三酯水平较高，但总胆固醇或LDL-C无差异。多变量分析证实，HDL-C与白细胞（β = -0.001，p = 0.025）和血尿酸（β = -1.054，p = 0.037）之间存在独立的负相关，甘油三酯与白细胞（β = 0.004，p = 0.049）和血尿酸（β = 8.411，p = 0.003）之间存在独立的正相关。在65岁及以上的高血压成年人中，炎症状态和血尿酸水平独立作用导致HDL-C降低——这些发现证实了炎症性疾病患者研究中所描述的情况。这一现象可能有助于确定无炎症性疾病人群的促动脉粥样硬化特征。
