类风湿性关节炎患者血脂和炎性指标的关系

Correlation between Serum Lipids and Inflammatory Indexes inPatients with Rheumatoid Arthritis

目的探讨类风湿性关节炎(RA)患者血脂与炎症指标的关系。方法选择RA患者(RA组)132例和健康体检者(对照组)127例,比较2组血脂指标水平[包括总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、非高密度脂蛋白胆固醇(NHDL-C)、低密度脂蛋白胆固醇(LDL-C)、TC/HDL-C比值、LDL-C/HDL-C比值];同时按炎症指标C反应蛋白(CRP)水平将132例RA患者分为CRP异常组与CRP正常组,比较2组血脂指标水平。采用Spearman相关检验分析RA患者CRP值、疾病活动度(DAS28-CRP评分)与血脂的相关性。结果RA组血清TC、HDL-C、NHDL-C水平均明显低于对照组(P<0.05);CRP异常组血清TC、HDL-C水平明显低于CRP正常组(P<0.05),LDL-C/HDL-C比值明显高于CRP正常组(P<0.05)。血清TC、HDL-C、NHDL-C水平与CRP值呈显著负相关(r=-0.300、P<0.001,r=-0.423、P<0.001,r=-0.207、P=0.017),血清TC、TG、HDL-C、NHDL-C水平与DAS28-CRP评分呈显著负相关(r=-0.254、P=0.003,r=-0.204、P=0.019,r=-0.179、P=0.040,r=-0.207、P=0.017)。结论炎症导致类风湿性关节炎患者血脂水平下降。相比于常规的血脂水平监测,CRP可能是评估类风湿性关节炎患者心血管疾病风险的更好选择。

Objective To investigate the relationship between serum lipids and inflammatory indexes in patients with rheumatoid arthritis(RA).Methods Serum total cholesterol(TC),triglycerides(TG),high-density lipoprotein cholesterol(HDL-C),non-high-density lipoprotein cholesterol(NHDL-C),low-density lipoprotein cholesterol(LDL-C),TC/HDL-C ratio and LDL-C/HDL-C ratio were compared between 132 RA patients and 127 healthy controls.According to C-reactive protein(CRP)levels,the RA patients were divided into abnormal CRP group and normal CRP group,and blood lipid indexes were compared between the two groups.The correlations of CRP levels and the Disease Activity Score 28-joint CRP(DAS28-CRP)with lipid profile were analyzed using the Spearman’s correlation test.Results The levels of TC,HDL-C and NHDL-C in the RA group were lower than those in the control group(P<0.05).The levels of TC and HDL-C in abnormal CRP group were lower than those in normal CRP group(P<0.05).The TC/HDL-C ratio in abnormal CRP group was higher than that in normal CRP group(P<0.05).Serum TC,HDL-C and NHDL-C levels were negatively correlated with CRP levels(r=-0.300,r=-0.423 and r=-0.207,respectively;P<0.001,P<0.001 and P=0.017,respectively).Serum TC,TG,HDL-C and NHDL-C levels were negatively correlated with DAS28-CRP(r=-0.254,r=-0.204,r=-0.179 and r=-0.207,respectively;P=0.003,P=0.019,P=0.040 and P=0.017,respectively).Conclusion Inflammation causes a decrease in serum lipid levels in RA patients.CRP detection may be a better option than routine lipid monitoring for assessing cardiovascular disease risk in patients with RA.