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原发性胆汁性胆管炎患者血脂异常的临床特征:中国单中心经验

Clinical characteristics of dyslipidemia in patients with primary biliary cholangitis: a single-center experience in China.

作者信息

Wang Xu, Shao Tihong, Tian Ran, Liu Jia, Wei Yi, Wang Li, Zhang Fengchun

机构信息

Department of Rheumatology and Clinical Immunology, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, National Clinical Research Center for Dermatologic and Immunologic Diseases, Beijing, China.

Department of Rheumatology and Immunology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.

出版信息

Clin Rheumatol. 2025 Sep 5. doi: 10.1007/s10067-025-07662-y.

Abstract

AIMS

Dyslipidemia is frequently observed among individuals diagnosed with primary biliary cholangitis (PBC), though its specific characteristics remain incompletely defined. This study aimed to examine the lipid profile patterns and medical features of dyslipidemia in people suffering from PBC.

METHODS

Following the classification criteria proposed by the National Lipid Association, dyslipidemia is classified on the basis of abnormal plasma concentrations of high-density lipoprotein cholesterol (HDL-C), total cholesterol (TC), triglycerides (TG), and low-density lipoprotein cholesterol (LDL-C). Clinically, it is categorized into simple high TC, simple high TG, mixed hyperlipidemia, simple HDL-C decrease, and simple high LDL-C. In total, 257 individuals diagnosed with PBC who had dyslipidemia were enrolled in the study, along with 78 age- and sex- matched patients with simple dyslipidemia as the comparison group.

RESULTS

In contrast to the control group, patients with PBC exhibited markedly increased concentrations of HDL-C, TC, and TG, while LDL-C levels were somewhat reduced. Analysis revealed that HDL-C, TC, and LDL-C levels were positively correlated with liver enzyme levels, whereas TG levels showed a negative correlation with bilirubin levels. In terms of clinical classification, patients with PBC had higher rates of simple TC increase and mixed hyperlipidemia, but a lower proportion had isolated LDL-C increase compared with controls. Patients with PBC who had simple high TC and mixed hyperlipidemia showed higher liver enzyme levels than those with simple high TG, while clinical symptoms were similar across groups.

CONCLUSION

Dyslipidemia in PBC exhibits unique characteristics, indicating a distinct pathogenesis compared to conventional dyslipidemia. These findings highlight the potential benefit of proactive lipid management in supporting liver function. Key Points • Compared with patients who have simple dyslipidemia, dyslipidemia in patients with PBC has distinct characteristics. • Dyslipidemia is clinically associated with liver damage, and correlation analysis showed a relationship between blood lipid levels and liver function.

摘要

目的

血脂异常在原发性胆汁性胆管炎(PBC)患者中较为常见,但其具体特征尚未完全明确。本研究旨在探讨PBC患者血脂异常的血脂谱模式和医学特征。

方法

按照美国国家脂质协会提出的分类标准,根据血浆高密度脂蛋白胆固醇(HDL-C)、总胆固醇(TC)、甘油三酯(TG)和低密度脂蛋白胆固醇(LDL-C)浓度异常对血脂异常进行分类。临床上,分为单纯高TC、单纯高TG、混合性高脂血症、单纯HDL-C降低和单纯高LDL-C。本研究共纳入257例诊断为PBC且伴有血脂异常的患者,以及78例年龄和性别匹配的单纯血脂异常患者作为对照组。

结果

与对照组相比,PBC患者的HDL-C、TC和TG浓度显著升高,而LDL-C水平有所降低。分析显示,HDL-C、TC和LDL-C水平与肝酶水平呈正相关,而TG水平与胆红素水平呈负相关。在临床分类方面,与对照组相比,PBC患者单纯TC升高和混合性高脂血症的发生率较高,但单纯LDL-C升高的比例较低。单纯高TC和混合性高脂血症的PBC患者肝酶水平高于单纯高TG患者,而各组临床症状相似。

结论

PBC患者的血脂异常具有独特特征,表明其发病机制与传统血脂异常不同。这些发现凸显了积极进行血脂管理对支持肝功能的潜在益处。要点 • 与单纯血脂异常患者相比,PBC患者的血脂异常具有明显特征。 • 血脂异常在临床上与肝损伤相关,相关性分析显示血脂水平与肝功能之间存在关联。

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