Department of Rheumatology and Immunology, The Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing, China.
Department of Rheumatology and Immunology, The first Hospital of Changshu, Changshu, China.
PLoS One. 2020 Apr 16;15(4):e0231622. doi: 10.1371/journal.pone.0231622. eCollection 2020.
Nonthyroidal illness syndrome (NTIS), also known as low triiodothyronine (T3) syndrome, frequently affects patients with systemic lupus erythematosus (SLE) and may affect lipid metabolism. Dyslipidemia is highly prevalent and associated with the long-term prognosis of SLE. The aim of the present study was to explore the clinical significance of NTIS on disease activity and dyslipidemia in patients with SLE.
Clinical and laboratory data were collected retrospectively from 223 patients with SLE. The correlation between free triiodothyronine (FT3), SLE disease activity, and lipid profiles were estimated. The correlation coefficient (r) was calculated using a Pearson's regression model. Univariate and multivariate logistic regression analyses were performed to identify the risk factors for dyslipidemia in SLE.
Serum FT3 levels were negatively correlated with the levels of 24 h urine protein (UP), blood urea nitrogen (BUN), creatinine (Cr) and SLE disease activity index (SLEDAI) (all p < 0.001) in NTIS patients but not in euthyroid patients. ApoB/ApoA1 was significantly correlated with SLEDAI (p < 0.01) in NTIS patients and CRP (p < 0.001) and ESR (p < 0.01) in euthyroid patients. A multivariate analysis revealed that only FT3 exhibited an independent negative association with dyslipidemia (P = 0.01; OR = 0.48; 95% CI 0.27-0.85).
NTIS frequently occurs in patients with SLE. Low FT3 is associated with disease activity in SLE patients complicated with NTIS. Low FT3 is an independent risk factor for dyslipidemia in patients with SLE.
非甲状腺疾病综合征（NTIS）又称低三碘甲状腺原氨酸（T3）综合征，常影响系统性红斑狼疮（SLE）患者，并可能影响脂代谢。血脂异常在 SLE 患者中非常普遍，并与 SLE 的长期预后相关。本研究旨在探讨 NTIS 对 SLE 患者疾病活动度和血脂异常的临床意义。
回顾性收集 223 例 SLE 患者的临床和实验室数据。评估游离三碘甲状腺原氨酸（FT3）与 SLE 疾病活动度和血脂谱之间的相关性。使用 Pearson 回归模型计算相关系数（r）。进行单变量和多变量逻辑回归分析，以确定 SLE 血脂异常的危险因素。
在 NTIS 患者中，血清 FT3 水平与 24 小时尿蛋白（UP）、血尿素氮（BUN）、肌酐（Cr）和 SLE 疾病活动指数（SLEDAI）水平呈负相关（均 p<0.001），但在甲状腺功能正常患者中无相关性。在 NTIS 患者中，ApoB/ApoA1 与 SLEDAI 显著相关（p<0.01），在甲状腺功能正常患者中，CRP（p<0.001）和 ESR（p<0.01）与 ApoB/ApoA1 显著相关。多变量分析显示，只有 FT3 与血脂异常呈独立负相关（P=0.01；OR=0.48；95%CI 0.27-0.85）。
NTIS 常发生在 SLE 患者中。在合并 NTIS 的 SLE 患者中，低 FT3 与疾病活动度相关。低 FT3 是 SLE 患者血脂异常的独立危险因素。
