The Blood Lipids Levels And Clinical Characteristics In Acute Stage Of Relapsed Neuromyelitis Optica Spetrum Disorders

Objective: To analyze the levels of blood lipids during acute state of patients with relapsed neuromyelitis optica spectrum disease,and to explore the relationship between the levels of blood lipids and clinical characteristics.Methods: The general data,serum and cerebrospinal fluid biochemical data of 234 patients with relapsed NMOSD who were diagnosed in the first and second affiliated hospitals of Guangxi Medical University betwween January2016 to March 2019 were collected retrospectively.According to the use of low-dose glucocorticoid maintenance therapy(prednisone acetate < 0.5 mg /kg · d)within one month before diagnosed,they were divided into glucocorticoid(-)group and glucocorticoid(+)group.The control group consisted of 150 healthy physical examinees who were matched by age and gender and denied the influence of lipid-related diseases.Compare The blood lipid levels of 3 groups,compare The clinical symptoms,biochemical data of serum and cerebrospinal fluid,and the scores of Expanded Disability Scale(EDSS)of two groups of relapsed NMOSD’s patients.To explore the relationship between the changes of blood lipid levels and clinical characteristics during the acute state of relapsed NMOSD.Results:(1)Compared with the glucocorticoid(-)group and the control group,The level of blood lipid in the glucocorticoid(+)group was higher and has an increasing trend.Apo A-I was significantly higher than that of glucocorticoid(-)group(p<0.05).The level of T-CHO,LDL-C,LP(a)were significantly higher than that of control group(p<0.05).(2)In female,the levels of T-CHO,HDL-C and LDL-C in the glucocorticoid(+)group were higher than those in the control group(p<0.05),and the level of Apo A-I in the glucocorticoid(+)group was higher than that in the glucocorticoid(-)group.In male,the level of HDL-C in the glucocorticoid(-)group was lower than that in the control group.The levels of HDL-C in the two patients groups and Apo A-I in glucocorticoid(+)group were different in gender(p<0.05).(3)The levels of T-CHO,LDL-C and Apo B in glucocorticoid(-)group were positively correlated with QAlb(r1>0,p1<0.05),and the levels of LP(a)in the two patients groups were positively correlated with QAlb(r1>0,p1<0.05).and there was no significant correlation between the levels of blood lipids and QAlb in glucocorticoid(+)group.(4)In glucocorticoid(-)group,T-CHO was positively correlated with EDSS score(r1>0,p1<0.05),HDL-C and Apo A-I were negatively correlated with EDSS score(r1<0,p1<0.05),and there was no significant correlation between blood lipids level and EDSS score in glucocorticoid(+)group.Conclusion:(1)Low dose of glucocorticoid maintenance therapy increased the level of blood lipid in patients with relapsed NMOSD,especially in female.(2)There was gender difference in HDL-C level in relapsed NMOSD;The levels of T-CHO,HDL-C and Apo A-I influence the EDSS score of relapsed NMOSD,while high levels of T-CHO,LDL-C,Apo B and LP(a)aggravate the damage of blood-brain barrier.(3)Low dose glucocorticoid maintenance did not affect the EDSS score of patients with relapsed NMOSD.