陕西中医药大学学报2026，Vol.49Issue(5)：20-26,7.DOI:10.13424/j.cnki.jsctcm.2026.05.005
血清Lp(A)、载脂蛋白及代谢相关指标与类风湿关节炎疾病活动度的相关性研究
Correlation Between Serum Lp(A),Apolipoprotein and Metabolism-Related Indicators and RA Disease Activity
摘要
Abstract
Objective To investigate the associations of lipoprotein(A)[Lp(A)],apolipoprotein A-1(ApoA-1),apolipoprotein B(ApoB),apolipoprotein ratios,homocysteine(HCY),and angiotensin-converting enzyme(ACE)with the prevalence and activity of rheumatoid arthritis(RA).Methods Fifty RA patients who were hospitalized in the First Affiliated Hospital of Anhui University of Traditional Chinese Medicine,Departments Ⅰ and Ⅱ of Rheumatology,from 2024/01/04 to 2024/09/08 were selected as the RA group,and 117 healthy check-ups from the First Affiliated Hospital of Anhui University of Traditional Chinese Medicine during the same period of time were taken as the healthy controls.Logistic regression was used to analyze the relationship between prevalence of RA and lipid metabolism.Scatter plots were generated for lipid metabolism-related indicators versus rheumatoid factor(RF),C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),and anti-cyclic citrullinated peptide(anti-CCP)antibody levels in the RA group,followed by multiple linear regression analysis to assess associations with RA activity.Results After adjustment for covariates,elevated Lp(A)[OR:1.008(1.004～1.011),P<0.001],ApoB[OR:5.633(1.241～25.568),P=0.025],and HCY[OR:1.368(1.162～1.610),P<0.001]were positively associated with RA prevalence,while reduced ApoA-1[OR:0.174(0.035～0.864),P=0.033]and lower apolipoprotein ratios[OR:0.247(0.089～0.680),P=0.007]were inversely correlated with RA prevalence(all statistically significant).ACE showed no significant association with RA prevalence(P=0.992).The total score of the nomogram ranged from 56 to 116,and the corresponding probability of disease risk ranged from 0.1 to 0.999.The AUC area of the joint prediction ROC curve was calculated as 0.84.The Hosmer-Lemeshow test was P>0.05,and the calibration curve was basically consistent with the 45° standard curve.In RA patients,Lp(A)positively correlated with RF,CRP,and ESR levels;ApoA-1 inversely correlated with CRP and ESR;ApoB and apolipoprotein ratios positively correlated with CRP;and HCY positively correlated with RF and ESR(all P<0.05).No significant associations were observed between anti-CCP antibody and any lipid metabolism-related indicators.Conclusion Lipid metabolism-related indicators are correlated with both the prevalence and activity of RA.Lp(A)and ApoA-1 exhibit significant positive and negative associations with RA prevalence and activity,respectively.Further studies are expected to elucidate the detailed mechanisms,causal relationships,and regulatory pathways linking lipid metabolism and RA.关键词
脂代谢/类风湿关节炎/脂蛋白(A)/载脂蛋白-A1/同型半胱氨酸Key words
lipidomics/regulators rheumatoid arthritis/lipoprotein(a)/apolipoprotein A-1/homocysteine分类
医药卫生引用本文复制引用
梁思瑀,万磊,王颖,张玉,闵雯雯..血清Lp(A)、载脂蛋白及代谢相关指标与类风湿关节炎疾病活动度的相关性研究[J].陕西中医药大学学报,2026,49(5):20-26,7.基金项目
国家自然基金面上项目(82474482) （82474482）
国家自然基金面上项目(82274501) （82274501）
综合性国家科学中心大健康研究院项目:新安医学与中医药现代化研究所揭榜挂帅项目(2023CXMMTCM02) （2023CXMMTCM02）
安徽省自然科学基金(2308085MH289) （2308085MH289）
安徽省高端人才引育行动项目领军人才特聘教授(皖教工委函[2024]217号) （皖教工委函[2024]217号）
安徽中医药大学中医痹病学科专项研究项目(2024YFYLCZX42) （2024YFYLCZX42）
