Department of Clinical Biochemistry and.
The Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Denmark.
Clin Chem. 2019 May;65(5):644-652. doi: 10.1373/clinchem.2018.299636. Epub 2019 Feb 11.
HDL is quantitatively the most important lipoprotein in most species and mechanistic evidence points toward a role for HDL in normal immune function. We tested the hypothesis that concentrations of HDL cholesterol are associated with risk of autoimmune disease.
From 2 studies of the general population-the Copenhagen General Population Study and the Copenhagen City Heart study-we included 107954 and 9387 individuals with baseline measurements of HDL cholesterol. These were followed with the national Danish Patient Registry from baseline in 2003-2015 or 1991-1994 through 2017, during which time 4078 and 1101 individuals developed autoimmune disease in the 2 studies.
In the Copenhagen General Population Study, compared to individuals with HDL cholesterol ≥2.0 mmol/L (77 mg/dL), the multifactorially adjusted hazard ratios for any autoimmune disease were 1.06 (95% CI, 0.94-1.19) for individuals with HDL cholesterol of 1.5-1.99 mmol/L (58-77 mg/dL), 1.18 (95% CI, 1.04-1.35) for individuals with HDL cholesterol of 1.0-1.49 mmol/L (39-58 mg/dL), and 1.84 (95% CI, 1.52-2.22) for individuals with HDL cholesterol <1.0 mmol/L (39 mg/dL) ( for trend <0.001). These results were similar when excluding events within 5 years of baseline, in women and men separately, for events at baseline, irrespective of low-grade inflammation or triglyceride concentrations, for the apolipoprotein A1 part of HDL, and for more restrictive end point definitions. Finally, the Copenhagen City Heart Study provided independent confirmation.
Low HDL cholesterol level is associated with high risk of autoimmune disease in individuals from the general population. Our observational findings cannot determine causality.
在大多数物种中，高密度脂蛋白（HDL）是数量最多的脂蛋白，并且有机制证据表明 HDL 与正常免疫功能有关。我们检验了这样一个假设，即高密度脂蛋白胆固醇的浓度与自身免疫性疾病的风险有关。
我们从两项普通人群研究（哥本哈根普通人群研究和哥本哈根城市心脏研究）中选取了 107954 名和 9387 名个体，他们的基线高密度脂蛋白胆固醇测量值均在 2003-2015 年或 1991-1994 年到 2017 年期间的丹麦国家患者登记处随访。在此期间，两项研究中分别有 4078 名和 1101 名个体患上了自身免疫性疾病。
在哥本哈根普通人群研究中，与高密度脂蛋白胆固醇≥2.0 mmol/L（77 mg/dL）的个体相比，任何自身免疫性疾病的多因素调整风险比为：高密度脂蛋白胆固醇为 1.5-1.99 mmol/L（58-77 mg/dL）的个体为 1.06（95%CI，0.94-1.19），高密度脂蛋白胆固醇为 1.0-1.49 mmol/L（39-58 mg/dL）的个体为 1.18（95%CI，1.04-1.35），高密度脂蛋白胆固醇<1.0 mmol/L（39 mg/dL）的个体为 1.84（95%CI，1.52-2.22）（趋势 P<0.001）。当排除基线后 5 年内的事件、按性别分别排除事件、排除基线时的事件、不论低度炎症或甘油三酯浓度如何、排除高密度脂蛋白的载脂蛋白 A1 部分、以及采用更严格的终点定义时，这些结果仍然相似。最后，哥本哈根城市心脏研究提供了独立的确认。
普通人群中，低水平的高密度脂蛋白胆固醇与自身免疫性疾病的高风险相关。我们的观察性发现不能确定因果关系。
