Makris Anastasios, Palli Nikoletta, Liontos Angelos, Rizos Evangelos C, Tsioutis Constantinos, Papadopoulos Dimitrios, Agouridis Aris P
School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
School of Medicine, European University Cyprus, Nicosia, Cyprus.
Arch Med Sci Atheroscler Dis. 2025 Jun 2;10:e69-e77. doi: 10.5114/amsad/204578. eCollection 2025.
Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system characterized by demyelination and axonal degeneration. Evidence has shown that lipid metabolism is associated with MS clinical outcomes. The aim was to systematically investigate the association between high-density lipoprotein cholesterol (HDL-C) and disease activity in MS.
Medline via PubMed, the Cochrane Library and Clinicaltrials.gov databases were searched for studies with data on HDL-C in patients with MS. A qualitative synthesis of published prospective and retrospective studies on the role of HDL-C and other lipid profile parameters in MS was performed. Additionally, a meta-analysis on HDL-C mean differences (MD) between relapsing remitting MS (RRMS) cases and healthy controls (HC) was performed.
Literature search identified 13 eligible studies evaluating the HDL-C levels of RRMS patients. In total, 1692 participants were included, 859 of which were RRMS patients, and 833 were HC. The pooled analysis demonstrated that RRMS patients had significantly lower HDL-C levels compared with HC (MD: -3.35 mg/dl, 95% CI (-5.69, -1.01), = 0.005). Regarding triglycerides (TG) and total cholesterol (TC), the pooled analysis from 11 and 13 studies, respectively, showed significantly higher TG (MD = 26.33, 95% CI (15.03, 37.62), < 0.00001) and TC levels (MD = 11.03, 95% CI (0.45, 21.60), = 0.04) in RRMS versus HC. No significant differences were observed in low-density lipoprotein cholesterol levels between RRMS and HC.
HDL-C levels were significantly decreased in RRMS patients compared with HC. HDL-C and other lipid profile parameters should be considered in the assessment of patients with RRMS.
多发性硬化症（MS）是一种中枢神经系统的慢性炎症性疾病，其特征为脱髓鞘和轴突变性。有证据表明，脂质代谢与MS的临床结局相关。本研究旨在系统地调查高密度脂蛋白胆固醇（HDL-C）与MS疾病活动之间的关联。
通过PubMed检索Medline、Cochrane图书馆和Clinicaltrials.gov数据库，以查找有关MS患者HDL-C数据的研究。对已发表的关于HDL-C及其他血脂参数在MS中的作用的前瞻性和回顾性研究进行定性综合分析。此外，对复发缓解型MS（RRMS）病例与健康对照（HC）之间的HDL-C平均差异（MD）进行荟萃分析。
文献检索确定了13项评估RRMS患者HDL-C水平的合格研究。总共纳入了1692名参与者，其中859名是RRMS患者，833名是HC。汇总分析表明，与HC相比，RRMS患者的HDL-C水平显著降低（MD：-3.35mg/dl，95%CI（-5.69，-1.01），P = 0.005）。关于甘油三酯（TG）和总胆固醇（TC），分别来自11项和13项研究的汇总分析显示，RRMS患者的TG（MD = 26.33，95%CI（15.03，37.62），P < 0.00001）和TC水平（MD = 11.03，95%CI（0.45，21.60），P = 0.04）显著高于HC。RRMS与HC之间的低密度脂蛋白胆固醇水平未观察到显著差异。
与HC相比，RRMS患者的HDL-C水平显著降低。在评估RRMS患者时应考虑HDL-C和其他血脂参数。
