血脂异常及载脂蛋白B/A-1比值对炎症性肠病活动度的预测价值

Predictive value of dyslipidemia and apolipoprotein B/A-1 ratio in inflammatory bowel disease activity

目的探讨血脂水平与IBD疾病活动度的相关性及载脂蛋白(APO)B/A-1比值对活动性IBD的预测价值。方法纳入2019年1月至2020年12月在南京鼓楼医院住院的271例IBD患者和271例健康对照者,分析两组APOA-1、APOB、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)水平差异。同时评价IBD患者临床和内镜活动指数,以及C反应蛋白(CRP)、粪钙卫蛋白(FC)水平,探讨血脂与IBD疾病活动度的关系,比较APOB/A-1比值在缓解期和活动期IBD之间的差异。结果271例IBD患者中克罗恩病(CD)患者224例,溃疡性结肠炎(UC)患者47例。与对照组相比,克罗恩病(CD)组及溃疡性结肠炎(UC)组的APOA-1、APOB、TC、HDL-C、LDL-C水平均降低(P<0.05)。与缓解期CD相比,活动期的APOB/A-1比值升高,且在重度活动性CD中最高(P<0.05)。随着APOB/A-1>0.68时,重度活动性CD的风险增加(P<0.05)。结论IBD患者与健康人群血脂水平不同,且APOB/A-1对重度活动性CD具有预测价值。

Objective To explore the correlation between blood lipid levels and IBD disease activity and the predictive significance of apolipoprotein(APO)B/A-1 ratio in active IBD.Methods A total of 271 IBD patients and 271 healthy controls who were hospitalized in Nanjing Drum Tower Hospital from January 2019 to December 2020 were seleeted.The differences in APOA-1,APOB,TG,TC,HDL-C,and LDL-C levels between the two groups were analyzed.The clinical and endoscopic activity indices,as well as C-reactive protein(CRP)and fecal calprotectin(FC)levels were also evaluated in patients with IBD,and the APOB/A-1 ratio was compared between remission and active IBD.Results A total of 271 IBD patients were included,including 224 patients with Crohn s disease(CD)and 47 patients with ulcerative colitis(UC).Compared with the control group,the levels of APOA-1,APOB,TC,HDL-C and LDL-C in the CD group and UC group were decreased(P<0.05).Compared with CD in remission,the APOB/A-1 ratio in active phase was higher,and it was the highest in severe active CD(P<0.05).With APOB/A-1>0.68,the risk of severe active CD increased(P<0.05).Conclusion IBD patients and healthy people have different blood lipid levels,and APOB/A-1 has predictive value for severe active CD.