Wilson病血脂异常情况及影响因素分析

Analysis of dyslipidemia and its influencing factors in patients with Wilson's disease

目的分析Wilson病(WD)血脂代谢特点,了解其异常血脂的影响因素。方法收集2021年6月至2023年3月就诊于我院的170例WD患者的临床资料及59名健康体检者的血脂指标并进行对比;比较WD患者不同性别、年龄、体重指数(BMI)、疾病分型的血脂代谢特点;根据血脂是否异常,将WD患者分为血脂正常组与血脂异常组,比较两组生化指标;将一般情况与生化指标纳入单因素回归分析,筛选出可能影响血脂代谢的相关因素;将单因素筛选的相关因素纳入多因素Logistic回归分析,确定血脂异常的异常因素。结果WD组甘油三酯(TG)水平明显低于健康对照组(P<0.05)。WD组血脂异常率为40.59%。WD组女性患者低密度脂蛋白胆固醇明显小于男性患者(P<0.05);WD患者血脂异常组BMI、丙氨酸转氨酶(ALT)、尿酸(UA)值明显高于正常组(均P<0.05);多因素Logistic回归分析显示,BMI 24~28(OR=4.526,P<0.05)、BMI>28(OR=6.360,P<0.05),UA(OR=1.006,P<0.01),透明质酸(HA)(OR=1.003,P<0.01)与血脂异常高风险相关。结论WD患者脂代谢异常发生率高,以低高密度脂蛋白胆固醇血症和高TG血症为主。WD患者血脂异常受多种因素影响,BMI、UA、HA是WD患者血脂异常的独立危险因素。

Objective To analyze the characteristics of blood lipid metabolism in patients with Wilson's disease(WD)and understand the influencing factors of abnormal blood lipid.Methods The clinical data of 170 patients with WD and 59 healthy people were collected from June 2021 to March 2023,the blood lipids of the two groups were compared.To compare the characteristics of blood lipid metabolism in WD patients with different gender,age,body mass index(BMI)and disease types.According to whether the blood lipid was abnormal or not,WD patients were divided into normal blood lipid group and abnormal blood lipid group,and the biochemical indexes of the two groups were compared.The general situation and biochemical indicators were included in the single factor regression analysis,and the related factors that might affect blood lipid metabolism were screened out.The related factors of single factor screening were included in multivariate Logistic regression analysis to determine the abnormal factors affecting blood lipid.Results The triglyceride(TG)level of WD patients was lower than that of healthy controls,the difference was statistically significant(P<0.05).The rate of dyslipidemia in WD patients was 40.59%.Low density liporotein cholestrol in female WD patients was significantly lower than that in male WD patients(P<0.05).The values of BMI,alanine aminotransferase(ALT)and uric acid(UA)in dyslipidemia group of WD patients were significantly higher than those in normal group(all P<0.05).Multivariate Logistic regression analysis showed that BMI 24~28(OR=4.526,P<0.05),BMI>28(OR=6.360,P<0.05),UA(OR=1.006,P<0.01)and hyaluronic acid(HA)(OR=1.003,P<0.01)were associated with the high risk of dyslipidemia,with statistical significance.Conclusions WD patients have a high incidence of abnormal lipid metabolism,mainly with low high density liporotein cholestrol and high TG.The dyslipidemia in WD patients is affected by many factors.BMI,UA and HA are independent risk factors for dyslipidemia in WD patients.