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青少年皮肌炎中的血脂异常。

Dyslipidemia in Juvenile Dermatomyositis.

机构信息

Department of Pediatrics, College of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia.

Division of Rheumatology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.

出版信息

Sci Rep. 2024 Nov 3;14(1):26528. doi: 10.1038/s41598-024-77985-4.

Abstract

This study investigates the prevalence of dyslipidemia and its association with disease activity in children with Juvenile Dermatomyositis (JDM). A retrospective chart review of 142 JDM patients who had fasting lipid profiles was conducted. Clinical, and laboratory indicators of disease activity at the time of lipid assessment were obtained. JDM patients displayed a high prevalence (72%) of abnormal or borderline fasting lipid profiles, particularly involving HDL and triglycerides. Treatment-naïve patients exhibited the most significant dyslipidemia, with significantly lower median HDL levels compared to those on medication (30 vs. 49 mg/dL, p < 0.0001). HDL levels inversely correlated with various disease activity measures, including disease activity score (DAS) total (r= -0.38, p < 0.001), DAS muscle weakness (r= -0.5, p < 0.001), DAS skin (r= -0.25, p = 0.003), neopterin (r= -0.41, p < 0.001), ESR (r= -0.25, p = 0.006), and vWF Ag (r= -0.21, p = 0.02). In conclusion, JDM patients have a high prevalence of dyslipidemia, especially low HDL and elevated triglycerides. The severity of dyslipidemia (low HDL) correlates with disease activity, with treatment-naïve patients demonstrating the lowest HDL levels. These findings suggest the importance of annual lipid profile monitoring in JDM patients, potentially followed by early interventions such as dietary adjustments and exercise programs.

摘要

本研究调查了青少年皮肌炎(JDM)患儿血脂异常的患病率及其与疾病活动度的关系。对 142 例进行了空腹血脂谱检查的 JDM 患者进行了回顾性图表分析。获得了血脂评估时疾病活动的临床和实验室指标。JDM 患者的异常或边缘空腹血脂谱发生率较高(72%),尤其是涉及高密度脂蛋白和甘油三酯。与接受药物治疗的患者相比,未接受治疗的患者血脂异常最为显著,高密度脂蛋白水平明显较低(30 与 49mg/dL,p<0.0001)。高密度脂蛋白水平与各种疾病活动度指标呈负相关,包括疾病活动评分(DAS)总评分(r= -0.38,p<0.001)、DAS 肌肉无力(r= -0.5,p<0.001)、DAS 皮肤(r= -0.25,p=0.003)、新蝶呤(r= -0.41,p<0.001)、ESR(r= -0.25,p=0.006)和 vWF Ag(r= -0.21,p=0.02)。总之,JDM 患者血脂异常的患病率较高,尤其是高密度脂蛋白水平较低和甘油三酯水平升高。血脂异常的严重程度(低 HDL)与疾病活动度相关,未接受治疗的患者 HDL 水平最低。这些发现表明,JDM 患者需要每年监测血脂谱,可能需要进行早期干预,如饮食调整和运动方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6086/11532421/c8a8aaecd279/41598_2024_77985_Fig1_HTML.jpg

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