Department of Nutritional Sciences, The Pennsylvania State University, Pollock Road, University Park, PA 16802, USA.
Department of Rheumatology and Immunology, Kailuan General Hospital, Xinhua E Avenue, Tangshan 063007, China.
Nutrients. 2022 Mar 15;14(6):1240. doi: 10.3390/nu14061240.
Objective: This study aimed to investigate whether low-density lipoprotein cholesterol (LDL-C) concentration was associated with the risk of rheumatoid arthritis (RA) in Chinese adults. Methods: The study included the 97,411 participants in the Kailuan Study without RA, with complete baseline LDL-C data, and who did not use lipid-lowering medications at baseline or during follow-up. We used Cox proportional hazards modeling to calculate the hazard ratio (HR) and 95% confidence interval (95% CI) of RA according to baseline LDL-C tertiles, adjusting for age, sex, body mass index, HDL-C, triglycerides, diabetes, hypertension, alcohol consumption, and smoking. We also calculated the HR and 95% CI of RA using updated LDL-C measurements prior to the end of follow-up, adjusting for covariates. Results: We identified 97 incident RA cases between 2006 and 2018. After adjusting for potential confounders, updated LDL-C concentration—rather than baseline LDL-C—was inversely associated with RA risk. The adjusted HR of RA was 0.64 (95% CI: 0.38, 1.09; p-trend = 0.10) comparing the two extreme baseline LDL-C tertiles, and 0.38 (95% CI: 0.22, 0.64; p-trend < 0.01) comparing the two extreme tertiles of the updated LDL-C concentrations. Conclusions: In this prospective study, high LDL-C concentrations, when measured closest to RA diagnosis or the end of follow-up, were associated with a low risk of RA. These findings highlight the changes in LDL-C prior to RA diagnosis, and the importance of including lipid analyses into studies of the pathogenesis of RA.
本研究旨在探讨中国成年人的低密度脂蛋白胆固醇（LDL-C）浓度与类风湿关节炎（RA）风险之间的关系。
该研究纳入了 97411 名无 RA 的开滦研究参与者，他们具有完整的基线 LDL-C 数据，且在基线或随访期间未使用降脂药物。我们使用 Cox 比例风险模型，根据基线 LDL-C 三分位值，计算 RA 的风险比（HR）和 95%置信区间（95%CI），并调整年龄、性别、体重指数、HDL-C、甘油三酯、糖尿病、高血压、饮酒和吸烟等因素。我们还使用更新的 LDL-C 测量值，在随访结束前计算 RA 的 HR 和 95%CI，并调整协变量。
我们在 2006 年至 2018 年期间发现了 97 例新发 RA 病例。在调整潜在混杂因素后，更新的 LDL-C 浓度而非基线 LDL-C 浓度与 RA 风险呈负相关。与两个极端基线 LDL-C 三分位值相比，RA 的调整 HR 为 0.64（95%CI：0.38，1.09；p 趋势=0.10），与两个极端更新 LDL-C 浓度三分位值相比，RA 的调整 HR 为 0.38（95%CI：0.22，0.64；p 趋势<0.01）。
在这项前瞻性研究中，当 LDL-C 浓度最接近 RA 诊断或随访结束时，高 LDL-C 浓度与 RA 风险较低相关。这些发现强调了 RA 诊断前 LDL-C 的变化，以及将脂质分析纳入 RA 发病机制研究的重要性。
