CAJ | 학술논문

目的探讨系统性硬化病(SSc)的血脂及与炎症的关系.方法采用病例对照研究,纳入67例SSc患者及67名年龄、性别配对的健康体检者.检测所有纳入患者的甘油三酯、总胆固醇、低密度脂蛋白胆固醇(LDL-c)、高密度脂蛋白胆固醇(HDL-c)、C反应蛋白(CRP)及红细胞沉降率(ESR),MannWhitney U及Kruskal-Wallis法用于检验各组之间的差异,血脂与炎症指标的关系采用Spearman相关分析.结果 23例(34％) SSc患者甘油三酯升高,而65例(97％)患者的HDL-c下降.与对照组相比,SSc患者总胆固醇(P=0.004)、LDL-c(P=0.014)及HDL-c (P=0.000)偏低,甘油三酯(P=0.023)、极低密度脂蛋白胆固醇(VLDL-c) (P=0.023)、VLDL-c/LDL-c(P=0.000)及TC/HDL-c比值(P=0.026)偏高.Spearman分析显示HDL-c水平与CRP(r=-0.259,P=0.036)及ESR(r=-0.256,P=0.038)呈负相关.结论 SSc患者血脂异常相当普遍,常以甘油三酯升高,HDL-c降低,并伴总胆固醇、LDL-c降低为主,该现象可能与炎症部分相关.这种血脂异常的“剩余风险”可能提示高风险的动脉粥样硬化的发生.
목적 탐토계통성경화병(SSc)적혈지급여염증적관계.방법 채용병례대조연구,납입67례SSc환자급67명년령、성별배대적건강체검자.검측소유납입환자적감유삼지、총담고순、저밀도지단백담고순(LDL-c)、고밀도지단백담고순(HDL-c)、C반응단백(CRP)급홍세포침강솔(ESR),MannWhitney U급Kruskal-Wallis법용우검험각조지간적차이,혈지여염증지표적관계채용Spearman상관분석.결과 23례(34％) SSc환자감유삼지승고,이65례(97％)환자적HDL-c하강.여대조조상비,SSc환자총담고순(P=0.004)、LDL-c(P=0.014)급HDL-c (P=0.000)편저,감유삼지(P=0.023)、겁저밀도지단백담고순(VLDL-c) (P=0.023)、VLDL-c/LDL-c(P=0.000)급TC/HDL-c비치(P=0.026)편고.Spearman분석현시HDL-c수평여CRP(r=-0.259,P=0.036)급ESR(r=-0.256,P=0.038)정부상관.결론 SSc환자혈지이상상당보편,상이감유삼지승고,HDL-c강저,병반총담고순、LDL-c강저위주,해현상가능여염증부분상관.저충혈지이상적“잉여풍험”가능제시고풍험적동맥죽양경화적발생.
Objective Altered lipid levels may occur in autoimmune diseases,such as systemic lupus erythematosus (SLE) and rheumatoid arthritis.However,serum lipid profiles in patients with systemic sclerosis (SSc) have rarely been reported.Our aim was to identify lipid profiles in untreated SSc patients,and to assess the relationship between the inflammatory condition of SSc with lipid profiles.Methods This work was conducted as a case-control study.Sixty-seven SSc patients and 67 age-and gender-matched healthy controls were included.None of the patients had received corticosteroids or disease-modifying antirheumatic drugs prior to the study.Triglyceride (TG),total cholesterol (TC),low-density lipoprotein-cholesterol (LDL-c) and high-density lipoprotein-cholesterol (HDL-c),C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were assessed using standard techniques.Comparison of lipid profiles and CRP/ESR between groups was analyzed by Mann-Whitney U or Kruskal-Wallis test.Corrections between variables were analyzed using Spearman's correlation test.Results Twenty-three patients (34％) had an increased level of TG,and 65patients (97％) had a decreased level of HDL-C.The levels of HDL-c (P=0.000),TC (P=0.004) and LDL-c (P=0.014) in SSc were significantly lower than in controls.The levels of TG (P=0.023),VLDL-c (P=0.023),VLDL-c/LDL-c (P=0.000),and TC/HDL-c ratio (P=0.026) were significantly higher than in controls.Spearman's correlation test demonstrated that HDL-c levels correlated negatively with serum CRP (r=-0.259,P=0.036) and ESR (r=-0.256,P=0.038),and LDL-c/HDL-c (r=0.263,P=0.033) and TC/HDL-e ratio (r=0.262,P=0.034) correlated positively with ESR in SSc (P＜0.05).Conclusion Dyslipoproteinemia is a common feature in patients with SSc that is characterized by an increase in TG and a decrease in HDL-c,sug-gesting a high risk of atherosclerosis.Inflammation might partly account for the changes of serum lipid profiles in SSc.