高密度脂蛋白胆固醇外排能力与银屑病关节炎患者的疾病活动度相关。
HDL cholesterol efflux capacity is related to disease activity in psoriatic arthritis patients.
机构信息
Servicio de Reumatología, Hospital Universitario de Canarias, La Laguna, Spain.
Departamento de Farmacología, Facultad de Medicina, Universidad de La Laguna, La Laguna, Spain.
出版信息
Clin Rheumatol. 2020 Jun;39(6):1871-1880. doi: 10.1007/s10067-020-04961-4. Epub 2020 Jan 28.
OBJECTIVE
Cholesterol efflux capacity (CEC) is the ability of high-density lipoprotein (HDL) cholesterol to accept cholesterol from macrophages. CEC is linked to cardiovascular events in the general population, and it has been shown to be disrupted in inflammatory states. The aim of this study was to establish whether CEC is impaired in PsA patients and if this could be explained by disease-related features like disease activity.
METHODS
Case-control study that encompassed 105 individuals: 52 PsA patients and 53 controls. CEC, using an in vitro assay, and lipoprotein serum concentrations were assessed in patients and controls. Disease activity in patients with PsA was measured using the Disease Activity Index for Psoriatic Arthritis (DAPSA). Multivariate analysis was performed to study the differences between CEC in patients and controls, and the relation of CEC with PsA activity-related data and lipid profile.
RESULTS
Total cholesterol, apolipoprotein A1, and LDL cholesterol serum levels were downregulated in PsA patients. CEC did not differ between controls and patients (17 ± 10 vs. 18 ± 2%, p = 0.15) after adjusting for traditional cardiovascular risk factors or other variations in the lipid profile related to the disease. Traditional cardiovascular risk factors, both in patients and controls, were not related to CEC. After multivariate regression analysis, the DAPSA score was inversely and independently associated with CEC (beta coefficient - 0.75 [95%CI - 1.39-- 0.11] %, p = 0.023).
CONCLUSION
CEC is inversely associated with disease activity in PSA patients, reinforcing the role of disease activity as a key factor in the development of accelerated atherosclerosis in these patients.Key Points• Cholesterol efflux capacity is linked to cardiovascular events in the general population.• In patients with psoriatic arthritis, cholesterol efflux capacity is inversely associated with disease activity (beta coefficient - 0.75[95% CI - 1.39-- 0.11] %, p = 0.023).• This finding reinforces the role of disease activity as a key factor in increasing cardiovascular risk in psoriatic arthritis patients.
目的
胆固醇外排能力（CEC）是指高密度脂蛋白（HDL）胆固醇从巨噬细胞中摄取胆固醇的能力。CEC 与普通人群中的心血管事件有关，并且已经证明其在炎症状态下受到破坏。本研究旨在确定 CEC 是否在 PsA 患者中受损，如果是，这是否可以用疾病相关特征（如疾病活动度）来解释。
方法
这项病例对照研究纳入了 105 名个体：52 名 PsA 患者和 53 名对照者。采用体外检测法评估患者和对照组的 CEC 和脂蛋白血清浓度。使用关节炎银屑病疾病活动指数（DAPSA）评估 PsA 患者的疾病活动度。进行多变量分析以研究患者和对照组之间的 CEC 差异，以及 CEC 与 PsA 活动相关数据和血脂谱的关系。
结果
总胆固醇、载脂蛋白 A1 和 LDL 胆固醇血清水平在 PsA 患者中下调。在调整了传统心血管危险因素或与疾病相关的血脂谱其他变化后，CEC 在对照组和患者之间没有差异（17±10%与 18±2%，p=0.15）。传统心血管危险因素在患者和对照组中均与 CEC 无关。多元回归分析后，DAPSA 评分与 CEC 呈负相关且独立相关（β系数-0.75[95%CI-1.39--0.11]%，p=0.023）。
结论
CEC 与 PSA 患者的疾病活动度呈负相关，这进一步证实了疾病活动度是这些患者加速动脉粥样硬化发展的关键因素。
关键点
CEC 与普通人群中的心血管事件有关。
在患有银屑病关节炎的患者中，胆固醇外排能力与疾病活动度呈负相关（β系数-0.75[95%CI-1.39--0.11]%，p=0.023）。
这一发现进一步证实了疾病活动度是增加银屑病关节炎患者心血管风险的关键因素。
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