Hou Y K, Cai Q M, Liu X J, Yun Z L, Li C, Zhang X W
Department of Rheumatology and Immunology, Peking University People's Hospital, Beijing 100044, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2022 Dec 18;54(6):1117-1122. doi: 10.19723/j.issn.1671-167X.2022.06.010.
To investigate the significance and distribution of oxidized low-density lipoprotein antibodies (ox-LDL-Ab) in patients with antiphospholipid syndrome (APS).
In this study, 334 patients who were hospitalized in the Department of Rheumatology and Immunology, Peking University People's Hospital were included. There were 162 APS patients, 122 patients with other autoimmune diseases without thrombosis or obstetric disease as disease control and 50 healthy controls. The clinical data and laboratory indicators were retrospectively collected. The ox-LDL-Ab, anticardiolipin (aCL) IgG/IgA/IgM, and anti-β2-glycoprotein Ⅰ (aβ2GPI) IgG/IgA/IgM were detected by enzyme-linked immunosorbent assay (ELISA). The relationship between ox-LDL-Ab and clinical and laboratory parameters were analyzed by SPSS 27.0.
In APS group, 60.5% of patients had thrombosis, 48.1% had pregnancy morbidity, 34.0% had thrombocytopenia. The positive rates of aCL, aβ2GPI and lupus anticoagulant (LAC) were 17.9%, 34.6%, and 46.9%, respectively. The ox-LDL-Ab titers and positive rate in APS group were higher than that in healthy controls [titers: 40.8 (25.4-66.0) U/mL 24.1 (12.3-36.5) U/mL, =0.001; positive rate: 67.3% 36.0%, =0.001]. The diffe-rences in titers and positive rate of ox-LDL-Ab between APS patients and disease controls were not statistically significant [titers: 40.8 (25.4-66.0) U/mL . 35.9 (24.2-53.1) U/mL, =0.118; positive rate: 67.3% 61.5%, =0.318]. The area under curve (AUC) for aβ2GPI, aCL, and ox-LDL-Ab were 0.745 (95%: 0.692-0.797), 0.666 (95%: 0.608-0.724), 0.609 (95%: 0.549-0.669), respectively. The Youden's index was 0.388, 0.269, and 0.132, respectively. The AUC for ox-LDL-Ab in seronegative APS patients was 0.562 (95%: 0.480-0.645). The sensitivity and specificity of ox-LDL-Ab in seronegative APS patients were 63.9% and 47.0%, respectively, and the Youden's index was 0.109. The ox-LDL-Ab positive group had higher positive rate of aβ2GPI (42.2% . 18.9%, =0.003) and aCL (22.9% . 7.5%, =0.017) than the ox-LDL-Ab negative group. There was no correlation between ox-LDL-Ab and thrombosis, coronary artery disease, pregnancy morbidity, hyperlipidemia, hypocomplementemia, and LAC positivity.
Ox-LDL-Ab was correlated with aCL and aβ2GPI, and no association were observed between ox-LDL-Ab and thrombosis, coronary artery disease, and pregnancy morbidity.
探讨抗磷脂综合征（APS）患者中氧化型低密度脂蛋白抗体（ox-LDL-Ab）的意义及分布情况。
本研究纳入北京大学人民医院风湿免疫科住院的334例患者。其中APS患者162例，以122例无血栓形成或产科疾病的其他自身免疫性疾病患者作为疾病对照，50例健康人作为健康对照。回顾性收集临床资料和实验室指标。采用酶联免疫吸附试验（ELISA）检测ox-LDL-Ab、抗心磷脂（aCL）IgG/IgA/IgM以及抗β2糖蛋白Ⅰ（aβ2GPI）IgG/IgA/IgM。运用SPSS 27.0分析ox-LDL-Ab与临床及实验室参数之间的关系。
APS组中，60.5%的患者有血栓形成，48.1%有妊娠并发症，34.0%有血小板减少症。aCL、aβ2GPI及狼疮抗凝物（LAC）的阳性率分别为17.9%、34.6%和46.9%。APS组的ox-LDL-Ab滴度和阳性率高于健康对照组[滴度：40.8（25.4 - 66.0）U/mL对24.1（12.3 - 36.5）U/mL，P = 0.001；阳性率：67.3%对36.0%，P = 0.001]。APS患者与疾病对照组之间ox-LDL-Ab滴度和阳性率的差异无统计学意义[滴度：40.8（25.4 - 66.0）U/mL对35.9（24.2 - 53.1）U/mL，P = 0.118；阳性率：67.3%对61.5%，P = 0.318]。aβ2GPI、aCL和ox-LDL-Ab的曲线下面积（AUC）分别为0.745（95%：0.692 - 0.797）、0.666（95%：0.608 - 0.724）、0.609（95%：0.549 - 0.669）。约登指数分别为0.388、0.269和0.132。血清阴性APS患者中ox-LDL-Ab的AUC为0.562（95%：0.480 - 0.645）。血清阴性APS患者中ox-LDL-Ab的敏感性和特异性分别为63.9%和47.0%，约登指数为0.109。ox-LDL-Ab阳性组的aβ2GPI（42.2%对18.9%，P = 0.003）和aCL（22.9%对7.5%，P = 0.017）阳性率高于ox-LDL-Ab阴性组。ox-LDL-Ab与血栓形成、冠状动脉疾病、妊娠并发症、高脂血症、低补体血症及LAC阳性之间无相关性。
ox-LDL-Ab与aCL和aβ2GPI相关，且未观察到ox-LDL-Ab与血栓形成、冠状动脉疾病及妊娠并发症之间存在关联。
