Chen Jingyuan, Rathinasabapathy Anandharajan, Luo Jun, Yang Xiaojie, Luo Peng, Chen Yusi, Li Zilu, Li Jiang
Department of Cardiovascular Medicine, Second Xiangya Hospital of Central South University, Changsha City, Hunan Province, China; Research Institute of Blood Lipid and Atherosclerosis, Central South University, Changsha City, Hunan Province, China; Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
Respir Med. 2022 Jan;191:106711. doi: 10.1016/j.rmed.2021.106711. Epub 2021 Dec 3.
Lipid homeostasis is dysregulated in pulmonary arterial hypertension (PAH). A decrease in serum high- and low-density lipoprotein cholesterol (HDL-C and LDL-C) is significantly associated with the worse prognosis of PAH. However, no study has investigated the differential distribution of lipids in various PAH subtypes. We enrolled 190 patients in this retrospective study, which includes 20 patients with congenital heart disease without PAH (CHD-nonPAH), 101 patients with PAH associated with congenital heart disease (CHD-PAH), 69 patients with idiopathic PAH (IPAH) and 81 healthy controls. Laboratory parameters such as liver and renal function, serum lipids, C-reactive protein, N-terminal pro-brain natriuretic peptide (NT-proBNP), echocardiography, right heart catheterization and 6-min walk distance (6MWD) were performed. All types of cholesterol including HDL-C, LDL-C and total cholesterol (CHOL) were significantly lower in IPAH patients in association with right heart function. Although LDL-C and CHOL were lower in CHD-PAH, they were not associated with disease severity or heart failure. Thus, we conclude that IPAH and CHD-PAH patients exhibited a differential distribution pattern of serum lipids.
肺动脉高压（PAH）中脂质稳态失调。血清高密度脂蛋白胆固醇（HDL-C）和低密度脂蛋白胆固醇（LDL-C）降低与PAH的不良预后显著相关。然而，尚无研究调查不同PAH亚型中脂质的差异分布情况。我们纳入了190例患者进行这项回顾性研究，其中包括20例无PAH的先天性心脏病患者（CHD-非PAH）、101例与先天性心脏病相关的PAH患者（CHD-PAH）、69例特发性PAH（IPAH）患者和81例健康对照。进行了肝功能、肾功能、血脂、C反应蛋白、N末端脑钠肽前体（NT-proBNP）、超声心动图、右心导管检查和6分钟步行距离（6MWD）等实验室检查。与右心功能相关，IPAH患者中包括HDL-C、LDL-C和总胆固醇（CHOL）在内的所有类型胆固醇均显著降低。虽然CHD-PAH患者的LDL-C和CHOL较低，但它们与疾病严重程度或心力衰竭无关。因此，我们得出结论，IPAH和CHD-PAH患者表现出血清脂质的差异分布模式。
