GPIHBP1 自身抗体是引发复发性甘油三酯血症性急性胰腺炎的独立危险因素。

GPIHBP1 autoantibody is an independent risk factor for the recurrence of hypertriglyceridemia-induced acute pancreatitis.

机构信息

Department of Critical Care Medicine, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, China (Drs G. Zhang, Yang, Hu, Pu, J. Zhang, Zhou, Ye, G. Li, B. Li, Ke, Tong, Liu, and W. Li).

出版信息

J Clin Lipidol. 2022 Sep-Oct;16(5):626-634. doi: 10.1016/j.jacl.2022.08.001. Epub 2022 Aug 6.

DOI:10.1016/j.jacl.2022.08.001

PMID:36064883

Abstract

BACKGROUND

GPIHBP1, a glycolipid-anchored protein of capillary endothelial cells, is a crucial partner for lipoprotein lipase (LPL) in plasma triglyceride metabolism. GPIHBP1 autoantibodies block LPL binding to GPIHBP1 and lead to severe hypertriglyceridemia (HTG) and HTG-induced acute pancreatitis (HTG-AP). We sought to define the incidence of GPIHBP1 autoantibodies in patients with HTG-AP.

OBJECTIVE

We determined the incidence of GPIHBP1 autoantibody in HTG-AP patients, and compared the clinical features and long-term outcomes between GPIHBP1 autoantibody-positive and negative groups.

METHODS

An enzyme-linked immunosorbent assay was used to screen for GPIHBP1 autoantibody in 116 HTG-AP patients hospitalized from Jan 1, 2015 to Aug 31, 2019. All patients were followed up for 24 months. The primary outcome was the recurrence rate of HTG-AP during the two-year follow-up period. The incidence of recurrent episodes was analyzed by the Kaplan-Meier method and multivariable Cox regression was used to identify risk factors.

RESULTS

GPIHBP1 autoantibodies were present in 17 of 116 study patients (14.66%). The 2-year recurrence rate of HTG-AP was much higher in the GPIHBP1 autoantibody-positive group (35%, 6 in 17) than in the negative group (4%, 4 in 99). The multivariable Cox regression analysis showed that GPIHBP1 autoantibody was an independent risk factor for HTG-AP recurrence in two years.

CONCLUSIONS

The presence of GPIHBP1 autoantibody is common in patients with HTG-AP, and is an independent risk factor for two-year recurrence of HTG-AP.

摘要

背景

GPIHBP1 是毛细血管内皮细胞的糖脂锚定蛋白，是血浆甘油三酯代谢中脂蛋白脂肪酶（LPL）的关键伴侣。GPIHBP1 自身抗体阻断 LPL 与 GPIHBP1 的结合，导致严重的高甘油三酯血症（HTG）和 HTG 诱导的急性胰腺炎（HTG-AP）。我们旨在确定 HTG-AP 患者中 GPIHBP1 自身抗体的发生率。

目的

我们确定了 HTG-AP 患者中 GPIHBP1 自身抗体的发生率，并比较了 GPIHBP1 自身抗体阳性和阴性组的临床特征和长期结局。

方法

采用酶联免疫吸附试验（ELISA）检测 2015 年 1 月 1 日至 2019 年 8 月 31 日住院的 116 例 HTG-AP 患者的 GPIHBP1 自身抗体。所有患者均随访 24 个月。主要结局是在两年随访期间 HTG-AP 的复发率。Kaplan-Meier 法分析复发事件发生率，多变量 Cox 回归分析识别危险因素。

结果

116 例研究患者中有 17 例（14.66%）存在 GPIHBP1 自身抗体。GPIHBP1 自身抗体阳性组（35%，17 例中有 6 例）的 HTG-AP 两年复发率明显高于阴性组（4%，99 例中有 4 例）。多变量 Cox 回归分析显示，GPIHBP1 自身抗体是 HTG-AP 两年内复发的独立危险因素。