Zhang Yifan, Wen Zhiguo, Xia Cong, Chen Meiqiu, Cai Fang, Chu Lan
Department of Neurology, Affiliated Hospital of Guizhou Medical University, Guiyang, China.
Heliyon. 2024 Aug 22;10(17):e36737. doi: 10.1016/j.heliyon.2024.e36737. eCollection 2024 Sep 15.
Dyslipidemia has been implicated in autoimmunity; however, its association with myasthenia gravis (MG) prognosis is unclear. We aimed to investigate the correlation between baseline lipid profiles and risk of MG worsening.
This 7-year retrospective cohort study conducted at a Chinese hospital included 264 adult patients with MG. Data on baseline lipids, 1-year worsening, and covariates, including demographics, MG characteristics, comorbidities, and treatments were extracted.
Univariate and multivariate logistic regression analyses failed to show a significant association between the risk of 1-year MG worsening and any of the seven blood lipid-related indicators. However, the subsequent non-linear analysis revealed an inflection point in the risk curve of ln[lipoprotein(a)], at 4.06 (58 nmol/L). The lipoprotein(a) levels on the left side of the inflection point presented a positive significant correlation with the risk of MG worsening (relative risk [RR]: 6.06, 95 % confidence interval [CI]: 1.00-38.57), whereas those on the right side of the inflection point demonstrated no significant correlation (RR: 0.86, 95 % CI: 0.55-1.34).
Except for lipoprotein(a) levels being associated with worsening of myasthenia gravis, most lipid parameters were not associated with changes in the clinical course and severity of myasthenia gravis.we observed that lower levels of lipoprotein(a) were associated with a better prognosis in the interval 7-58 nml/L, whereas beyond this interval this was not observed, suggesting dyslipidemia may impact MG prognosis. Further studies are required to validate these findings.
血脂异常与自身免疫有关；然而，其与重症肌无力（MG）预后的关联尚不清楚。我们旨在研究基线血脂水平与MG病情恶化风险之间的相关性。
这项在中国一家医院进行的为期7年的回顾性队列研究纳入了264例成年MG患者。提取了基线血脂、1年病情恶化情况以及包括人口统计学、MG特征、合并症和治疗等协变量的数据。
单因素和多因素逻辑回归分析均未显示1年MG病情恶化风险与七个血脂相关指标中的任何一个之间存在显著关联。然而，随后的非线性分析显示，ln[脂蛋白(a)]风险曲线的拐点为4.06（58 nmol/L）。拐点左侧的脂蛋白(a)水平与MG病情恶化风险呈显著正相关（相对风险[RR]：6.06，95%置信区间[CI]：1.00 - 38.57），而拐点右侧的脂蛋白(a)水平则无显著相关性（RR：0.86，95% CI：0.55 - 1.34）。
除脂蛋白(a)水平与重症肌无力病情恶化有关外，大多数血脂参数与重症肌无力的临床病程和严重程度变化无关。我们观察到，在7 - 58 nml/L区间内，较低的脂蛋白(a)水平与较好的预后相关，而超出此区间则未观察到这种情况，这表明血脂异常可能影响MG预后。需要进一步研究来验证这些发现。
