Department of Clinical Laboratory, The First Affiliated Hospital of Nanchang University, Nanchang, China.
Department of Clinical Laboratory, The Second Affiliated Hospital of Nanchang University, Nanchang, China.
Scand J Clin Lab Invest. 2020 Sep;80(5):375-380. doi: 10.1080/00365513.2020.1747109. Epub 2020 Apr 11.
Dyslipidaemia is common in patients with rheumatoid arthritis (RA) appearing both early and advanced stages of the disease. A retrospective study was designed to explore the clinical significance of high density lipoprotein (HDL) in Chinese patients with RA. Serum levels of total cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL) and low density lipoprotein (LDL) were compared between RA patients complicated with osteoporosis (OP) and without OP, using logistic regression and ROC curve to analyse the association of HDL with OP. C reactive protein (CRP), erythrocyte sedimentation rate(ESR), rheumatoid factor(RF), anti-cyclic citrulline polypeptide antibody (anti-CCP), 28 joints disease activity(DAS28) as well as organ involvement rates were then analysed between RA patients with different HDL levels. Serum levels of HDL were 1.2 ± 0.3 mmol/L in RA patients complicated with OP, significantly higher than those without OP; HDL was a risk factor for RA patients with OP, OR (95% CI) being 10.2 (4.5-23.0) after adjusting for gender, age and body mass index(BMI). RA patients with HDL ≤ 1.04 mmol/L had significantly higher levels of CRP, ESR, DAS28 and cardiovascular disease (CVD) incidence rate, yet OP incidence rate was lower. HDL was a predictor of RA-related OP, indicating potential value as predictor of disease complications in RA patients.
高脂血症在类风湿关节炎（RA）患者中很常见，无论是在疾病的早期还是晚期都会出现。本回顾性研究旨在探讨高密度脂蛋白（HDL）在合并骨质疏松症（OP）和不合并 OP 的中国 RA 患者中的临床意义。通过逻辑回归和 ROC 曲线分析 HDL 与 OP 的相关性，比较 RA 患者中合并 OP 和不合并 OP 患者的总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白（HDL）和低密度脂蛋白（LDL）的血清水平。然后分析不同 HDL 水平的 RA 患者的 C 反应蛋白（CRP）、红细胞沉降率（ESR）、类风湿因子（RF）、抗环瓜氨酸肽抗体（抗-CCP）、28 关节疾病活动度（DAS28）以及器官受累率。合并 OP 的 RA 患者血清 HDL 水平为 1.2±0.3mmol/L，明显高于不合并 OP 的患者；HDL 是 RA 合并 OP 的危险因素，调整性别、年龄和体重指数（BMI）后，OR（95%CI）为 10.2（4.5-23.0）。HDL≤1.04mmol/L 的 RA 患者 CRP、ESR、DAS28 和心血管疾病（CVD）发生率明显更高，而 OP 发生率较低。HDL 是 RA 相关 OP 的预测因子，表明其作为 RA 患者疾病并发症预测指标具有潜在价值。
