北京大学学报（医学版）2023，Vol.55Issue(6)：982-992,11.DOI:10.19723/j.issn.1671-167X.2023.06.005
血脂异常与类风湿关节炎肺间质病变的相关性分析
Correlation between dyslipidemia and rheumatoid arthritis associated interstitial lung disease
摘要
Abstract
Objective:To study the correlation between dyslipidemia and rheumatoid arthritis associa-ted interstitial lung disease(RA-ILD)by retrospective analysis of the clinical data.Methods:The clini-cal data of patients with rheumatoid arthritis(RA),who were hospitalized in the Department of Rheuma-tism and Immunology of Peking University Shenzhen Hospital from January 2015 to July 2020 and fulfilled the criteria of the 2010 Rheumatoid Arthritis Classification Criteria established by American College of Rheumatology/European League Against Rheumatism collaborative initiative,were collected and analyzed.Results:There were 737 RA patients included,of whom 282(38.26％)were with interstitial lung disease(ILD).The median time from the onset of the first RA-related clinical symptoms to the on-set of ILD was 13 years(95％CI 11.33-14.67).By multivariate Logistic regression analysis,we found that low-density lipoprotein cholesterol(LDL-C)was an independent risk factor for RA-ILD(OR 1.452,95％CI 1.099-1.918,P=0.009),whereas high-density lipoprotein cholesterol(HDL-C)was a pro-tective factor for RA-ILD(OR 0.056,95％CI 0.025-0.125,P＜0.001).The RA patients with high LDL-C or low HDL-C had higher incidence of ILD than that of the RA patients with normal LDL-C or HDL-C(57.45％vs.36.96％,P＜0.001;47.33％vs.33.81％,P＜0.001,respectively).The me-dian time of ILD onset in the RA patients with low HDL-C was shorter than that of the RA patients with normal HDL-C[10.0(95％CI 9.33-10.67)years vs.17.0(95％CI 14.58-19.42)years,P＜0.001].HDL-C level was negatively correlated with disease activity.Among the RA-ILD patients,the patients with low HDL-C had higher percentage of usual interstitial pneumonia(UIP)then that of the pa-tients with normal HDL-C(60.00％vs.53.29％,P=0.002).The RA-ILD patients with high LDL-C had higher incidence rate of decrease in forced vital capacity(FVC)than that of the RA-ILD patients with normal LDL-C(50.00％vs.21.52％,P=0.015).The RA-ILD patients with low HDL-C had higher incidence rate of decrease in FVC(26.92％vs.16.18％,P=0.003)and carbon monoxide dif-fusion(80.76％vs.50.00％,P=0.010)than that of RA-ILD patients with normal HDL-C.Conclu-sion:LDL-C was possibly a potential independent risk factor for RA-ILD.HDL-C was possibly a poten-tial protective factor for RA-ILD.HDL-C level was negatively correlated with disease activity of RA.The median time of ILD onset in the RA patients with low HDL-C was significantly shorter than that of the RA patients with normal HDL-C.关键词
类风湿关节炎/肺间质病变/血脂异常Key words
Rheumatoid arthritis/Interstitial lung disease/Dyslipidemia分类
医药卫生引用本文复制引用
吴琦,蔡月明,何娟,黄文蒂,王庆文..血脂异常与类风湿关节炎肺间质病变的相关性分析[J].北京大学学报（医学版）,2023,55(6):982-992,11.基金项目
国家自然科学基金(81974253、81901641),广东省自然科学基金面上项目(2019A1515011112),深圳市科创委重点基础研究项目(JCYJ20200109140203849),深圳市卫健委医防融合项目(0102018-2019-YBXM-1499-01-0414),深圳市卫计委学科建设能力提升项目(SZXJ2017046)Supported by the National Natural Science Foundation of China(81974253,81901641),Natural Science Foundation of Guangdong Province(2019A1515011112),Key Project of Basic Research of Shenzhen Science and Technology Innovation Commission(JCYJ20200109140203849),Prevention and Treatment Integration Project of Shenzhen Municipal Health Commission(0102018-2019-YBXM-1499-01-0414),Project of Shenzhen Mu-nicipal Health Commission(SZXJ2017046) （81974253、81901641）
