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类风湿关节炎患者的治疗效果和血脂水平的回顾性分析及初步实验室验证。

Retrospective analysis and preliminary laboratory validation of treatment efficacy and blood lipid levels in patients with rheumatoid arthritis.

机构信息

State Key Laboratory of Quality Research in Chinese Medicine and School of Pharmacy, Macau University of Science and Technology, Macau, 999078, China.

Department of Rheumatology and Immunology, The Affiliated Drum Tower Hospital of Nanjing University, Nanjing, 210093, China.

出版信息

Clin Rheumatol. 2023 Dec;42(12):3213-3223. doi: 10.1007/s10067-023-06683-9. Epub 2023 Jul 24.

Abstract

OBJECTIVE

Rheumatoid arthritis is a systemic disease characterized by progressive chronic inflammation resulting in destruction of synovial joints. In addition to joint involvement, abnormal blood lipid indexes have also been found in RA patients. The correlation between various blood lipid indexes and the treatment effects were assessed in patients with rheumatoid arthritis, for the purposes to find a better medication strategy for RA.

METHODS

One hundred nineteen rheumatoid arthritis patients were recruited and divided into two groups, 45 patients with significant drug treatment effect and 45 patients with insignificant drug treatment effect through the nearest neighbor matching method in propensity score. The correlation between various blood lipid indexes and drug treatment effect of rheumatoid arthritis patients was analyzed. A mouse model of rheumatoid arthritis was constructed in the laboratory; methotrexate was treated as a positive drug. We observe and record the onset of rheumatoid arthritis in mice, as well as the proportion of immune cells, the expression of inflammatory factors, and the changes in blood lipid profiles was done.

RESULTS

The levels of total cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL-C), low density lipoprotein (LDL-C), and erythrocyte sedimentation rate (ESR) in rheumatoid arthritis patients were significantly different between the two groups (P < 0.05). There was no significant difference in other indexes between the two groups (P > 0.05). Methotrexate had a good therapeutic effect on CIA model mice, and the levels of TC and HDL-C in the treatment group were higher than those in the model group.

CONCLUSION

There is a high correlation between the levels of TC and HDL-C in rheumatoid arthritis patients and the effect of drug treatment. In the clinical treatment of rheumatoid arthritis, we should focus on improving the blood lipid indexes such as TC and HDL-C, and explore more targeted individualized administration, so as to achieve better and faster treatment effect in patients with rheumatoid arthritis. Key Points • In this research, we found that the TC and HDL-C level in RA patients' blood is highly related with the therapeutic effect, and a lower level of TC and HDL-C is better for therapeutic effect of RA.

摘要

目的

类风湿关节炎是一种以进行性慢性炎症为特征的系统性疾病,可导致滑膜关节破坏。除关节受累外,类风湿关节炎患者还存在异常血脂指标。本研究旨在评估类风湿关节炎患者各种血脂指标与治疗效果的相关性,以期为类风湿关节炎寻找更好的药物治疗策略。

方法

采用倾向性评分的最近邻匹配法,将 119 例类风湿关节炎患者分为两组,药物治疗效果显著组 45 例,药物治疗效果不显著组 45 例。分析类风湿关节炎患者各种血脂指标与药物治疗效果的相关性。在实验室构建类风湿关节炎小鼠模型,以甲氨蝶呤作为阳性药物。观察并记录类风湿关节炎小鼠的发病情况、免疫细胞比例、炎症因子表达及血脂谱变化。

结果

两组患者的总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)和红细胞沉降率(ESR)水平差异有统计学意义(P<0.05),两组其他指标比较差异无统计学意义(P>0.05)。甲氨蝶呤对 CIA 模型小鼠有较好的治疗作用,治疗组 TC 和 HDL-C 水平高于模型组。

结论

类风湿关节炎患者 TC 和 HDL-C 水平与药物治疗效果高度相关,在类风湿关节炎的临床治疗中,应注重改善 TC 和 HDL-C 等血脂指标,探索更具针对性的个体化给药,以达到更好、更快的类风湿关节炎患者的治疗效果。

关键点

在这项研究中,我们发现 RA 患者血液中的 TC 和 HDL-C 水平与治疗效果高度相关,较低的 TC 和 HDL-C 水平对 RA 的治疗效果更好。

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