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血清胆固醇水平可预测特发性肺纤维化患者的生存率:一项长期随访研究。

Serum cholesterol levels predict the survival in patients with idiopathic pulmonary fibrosis: A long-term follow up study.

作者信息

Chen Ranxun, Zhong Guanning, Ji Tong, Xu Qinghua, Liu Huarui, Xu Qingqing, Chen Lulu, Dai Jinghong

机构信息

Department of Pulmonary and Critical Care Medicine, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China.

Department of Pulmonary and Critical Care Medicine, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China.

出版信息

Respir Med. 2025 Feb;237:107937. doi: 10.1016/j.rmed.2024.107937. Epub 2024 Dec 31.

Abstract

BACKGROUND

The relationship between serum lipid with idiopathic pulmonary fibrosis (IPF) required to be explored. We aim to evaluate the association of serum lipid levels with mortality in patients with IPF.

MATERIALS AND METHODS

This retrospective study included IPF patients with more than three years follow-up. We collected baseline demographics information, forced vital capacity (FVC)% predicted, carbon monoxide diffusion capacity (DLCO)% predicted, gender-age-physiology (GAP) index, and serum lipid levels, including triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C). We evaluate the relationship between the serum lipid levels and the disease severity, and the mortality in IPF.

RESULTS

This study enrolled 146 patients, with the three-year survival rate of 71.23 %. The median follow-up time was 46.5 months. There was no significant difference in baseline lipid levels between the survival and non-survival group. TG levels were positively correlated with DLCO% predicted (r = 0.189, p = 0.022) and negatively correlated with GAP index (r = -0.186, p = 0.025). After adjusting for GAP index, smoking history, body mass index and the use of antifibrotic and lipid-lowering drug, lower TC levels (HR: 0.74, 95 % CI: 0.58-0.94, p = 0.013) were identified as an independent risk factor for mortality.

CONCLUSION

This study demonstrated that lower TC levels were associated with increased mortality in IPF. More investigations are required to explore the role of lipid metabolism in the pathogenesis of pulmonary fibrosis.

摘要

背景

血清脂质与特发性肺纤维化(IPF)之间的关系有待探索。我们旨在评估IPF患者血清脂质水平与死亡率之间的关联。

材料与方法

这项回顾性研究纳入了随访时间超过三年的IPF患者。我们收集了基线人口统计学信息、预测的用力肺活量(FVC)%、预测的一氧化碳弥散量(DLCO)%、性别-年龄-生理学(GAP)指数以及血清脂质水平,包括甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)。我们评估血清脂质水平与疾病严重程度以及IPF患者死亡率之间的关系。

结果

本研究共纳入146例患者,三年生存率为71.23%。中位随访时间为46.5个月。生存组和非生存组的基线脂质水平无显著差异。TG水平与预测的DLCO%呈正相关(r = 0.189,p = 0.022),与GAP指数呈负相关(r = -0.186,p = 0.025)。在调整GAP指数、吸烟史、体重指数以及抗纤维化和降脂药物的使用后,较低的TC水平(HR:0.74,95%CI:0.58 - 0.94,p = 0.013)被确定为死亡率的独立危险因素。

结论

本研究表明,较低的TC水平与IPF患者死亡率增加相关。需要更多研究来探索脂质代谢在肺纤维化发病机制中的作用。

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