The Clinical Study On Dyslipoproteinemia Of Systemic Lupus Erythematosus

Objective:To assess the incidence and risk factors of dyslipoproteinemia in systemic lupus erythematosus(SLE) patients without any therapy,and the changes of dyslipoproteinemia after treatment.To provide evidence on prevention and treatment of SLE patients with cardio-cerebral vascular system disease.Methods:By retrospective analysis,we investigated 58 systemic lupus erythematosus patients who accepted the first treatment in our hospital and 58 healthy controls.All SLE patients accepted the treatment with glucocorticoids+cyclophosphamide+hydroxychloroquine.To collecte serum total cholesterol(TC),triglyceride(TG),high density lipoprotein(HDL) and low density lipoprotein(LDL) before and after the third,sixth,twelfth months treatment.Assess the incidence of dyslipoproteinemia and risk factors in systemic lupus erythematosus(SLE) patients without any therapy,and the changes of dyslipoproteinemia after treatment.Choose 24 targets which possibly influence dyslipoproteinemia to do single factor analysis,including age,sex, blood pressure(Bp),Body mass index(BMI),IgG,IgA,IgM,C₃,C₄,erythrocyte sedimentation rate(ESR),serum creatinine(Scr),urea nitrogen(BUN),Fasting plasma glucose(FPG),serum albumin(Alb),serum globulin(Glb),proteinuria,24h urinary protein,anti-double stranded DNA (ds-DNA),anti-Smith antibody(Sm),anti-SSA antibody,anti-SSB antibody,anti-U1RNP antibody,systemic lupus erythematosus disease activity index(SLEDAI),systemic lupus international collaborating clinics/American college of rheumatology damage index(SLICC/ACRDI).Do Logistic regression analysis about the targets which have statistical significance(P＜0.1) in Logistic regression analysis,and assess the risk factors of TC,TG,HDL, LDL.Results:(1).Compaired with controls,SLE complicated with hyperlipoidemia was found in TG(P=0.016),LDL(P=0.042),and hypo-lipoidemia was found in HDL(P=0.002),TC had no significant difference(P=0.097).(2).Fifty patients(86.21%) complicated with dyslipoproteinemia. The rate of dyslipoproteinemia:HDL(58.62%,34 cases),TG(51.72%,30cases),LDL(25.86%, 15 cases) and TC(17.24%,10 cases).(3).The changes of TC hyperlipidemia(10 cases),TG hyperlipidemia(30 cases),HDL hypo-lipoidemia(34 cases) and hyperlipidemia LDL(15 cases) at four time points(before and after the third,sixth,twelfth months treatment):â‘ TC decreased (8.06±2.76,5.40±2.09,5.38±1.31,4.55±0.56,P=0.022);â‘¡TG decreased(2.57±1.05, 1.78±0.96,1.46±0.59,1.62±0.65,P=0.002);â‘¢HDL increased(0.66±0.15,1.33±0.36, 1.32±0.42,1.38±0.32,P=0.000);â‘£LDL decreased(4.47±0.79,3.47±1.53,3.64±1.40, 2.94±1.18,P=0.040).(4).the results of Logistic regression analysis:the risk factors of hyperlipidemia TG were ESR＞20mm/h,urinary protein positive,SLICC＞1 points,anti-Sm antibody positive,P-value were 0.024,0.042,0.001,0.012;the risk factors of hypo-lipoidemia HDL were IgG＞16g/L,SLEDAI≥5 points,anti-SSA antibody positive,P-value were 0.003, 0.002,0.001;the risk factors of hyperlipidemia LDL were IgG＞16g/L,and anti-U1RNP antibody positive,P-value were 0.034,0.026.Conculusions:â‘ Dyslipoproteinemia was a common feature in SLE patients which was characterized by an increase in TG,LDL and decrease in HDL.The total rate of dyslipoproteinemia was 86.21%;â‘¡Dyslipoproteinemia of SLE could be improved significantly by the The treatment of glucocorticoids+cyclophosphamide+hydroxychioroquine;â‘¢The independent risk factor of SLE complicated with dyslipoproteinemia were ESR＞20mm/h, urinary protein positive,SLEDAI≥5 points,SLICC＞1 points,IgG＞16g/L,anti-Smith antibody positive,anti-SSA antibody positive and anti-U1RNP antibody positive.