系统性硬化症中的经典血脂谱和脂蛋白(a)：病例对照研究的系统评价和荟萃分析
Classic lipid profile and lipoprotein(a) in systemic sclerosis: a systematic review and meta-analysis of case-control studies.
作者信息
Mastori-Kourmpani Christina, Makris Anastasios, Liberopoulos Evangelos, Sfikakis Petros P, Agouridis Aris P
机构信息
School of Medicine, European University Cyprus, Diogenis Str 6 Nicosia, Nicosia, 2404, Cyprus.
School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
出版信息
Rheumatol Int. 2025 Aug 5;45(8):182. doi: 10.1007/s00296-025-05932-1.
BACKGROUND AND AIMS
Systemic sclerosis (SSc) is a systemic autoimmune disease characterized by fibrosis, vascular abnormalities, and immune dysfunction. Whether patients with SSc exhibit lipid profile abnormalities, which may increase cardiovascular risk, remains uncertain. Our aim was to systematically investigate whether total cholesterol (TCHOL), triglycerides (TRG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and Lipoprotein (a) [Lp(a)] are affected in SSc patients.
METHODS
PubMed and Cochrane library databases were systematically searched up to 30 November 2024 for studies reporting on lipid profile (TCHOL, TRG, HDL-C, LDL-C) and Lp(a) in patients with SSc. Qualitative and quantitative syntheses of data from published prospective and retrospective studies was performed.
RESULTS
Literature search identified 27 eligible trials including 2503 participants, of whom 1114 were SSc patients and 1389 were healthy controls (HC). The pooled analysis from 24 studies (1001 SSc patients and 1254 HC) demonstrated that SSc patients had significantly lower HDL-C levels compared with the HC group (MD:- 5.61 mg/dl, 95% CI- 8.22,- 3.00, I = 83%). Regarding TRGs, pooled analysis from 24 studies (1016 SSc patients and 1246 HC) showed significantly higher levels in SSc compared with HC (MD: 16.98 mg/dl, 95% CI 8.28, 25.68, I = 68%). Similarly, the pooled analysis from 3 studies (131 SSc patients and 206 HC) showed significantly higher Lp(a) levels in SSc compared with HC (MD: 15.66 mg/dl, 95% CI 6.77, 24.55, I = 5%). No significant differences were observed in TCHOL (MD: 0.94 mg/dl, 95% CI- 10.23, 12.10, I = 93%), and LDL-C (MD:- 6.12 mg/dl, 95% CI- 16.00, 3.77, I = 95%) levels between SSc and HC groups.
CONCLUSIONS
HDL-C levels are decreased in SSc, contrary to TRG and Lp(a) levels, which are increased. These findings may have implications in assessing cardiovascular risk in patients with SSc.
TRAIL REGISTRY
CRD42024607564.
背景与目的
系统性硬化症（SSc）是一种以纤维化、血管异常和免疫功能障碍为特征的全身性自身免疫性疾病。SSc患者是否存在可能增加心血管疾病风险的血脂异常仍不确定。我们的目的是系统地研究总胆固醇（TCHOL）、甘油三酯（TRG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）和脂蛋白（a）[Lp（a）]在SSc患者中是否受到影响。
方法
截至2024年11月30日，系统检索PubMed和Cochrane图书馆数据库，以查找报告SSc患者血脂谱（TCHOL、TRG、HDL-C、LDL-C）和Lp（a）的研究。对已发表的前瞻性和回顾性研究的数据进行定性和定量综合分析。
结果
文献检索确定了27项符合条件的试验，包括2503名参与者，其中1114名是SSc患者，1389名是健康对照（HC）。来自24项研究（1001名SSc患者和1254名HC）的汇总分析表明，与HC组相比，SSc患者的HDL-C水平显著降低（MD：-5.61mg/dl，95%CI -8.22，-3.00，I²=83%）。关于TRG，来自24项研究（1016名SSc患者和1246名HC）的汇总分析显示，SSc患者的TRG水平显著高于HC组（MD：16.98mg/dl，95%CI 8.28，25.68，I²=68%）。同样，来自3项研究（131名SSc患者和206名HC）的汇总分析显示，与HC组相比，SSc患者的Lp（a）水平显著升高（MD：15.66mg/dl，95%CI 6.77，24.55，I²=5%）。在SSc组和HC组之间，未观察到TCHOL（MD：0.94mg/dl，95%CI -10.23，12.10，I²=93%）和LDL-C（MD：-6.12mg/dl，95%CI -16.00，3.77，I²=95%）水平的显著差异。
结论
与TRG和Lp（a）水平升高相反，SSc患者的HDL-C水平降低。这些发现可能对评估SSc患者的心血管风险具有重要意义。
试验注册
CRD42024607564。
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