Relevant Factors Of High TC/HDL-C In Adult Patients With Brucellosis

Objective:Brucellosis is a zoonotic infectious disease that causes damage to multiple systems.Brucellosis tends to be chronic and persistent,which may cause a heavier disease burden.Although brucellosis patients have a low case fatality rate,they are often accompanied by risk factors for noncommunicable chronic diseases(NCDs).Dyslipidemia is an important risk factor for NCDs,and the ratio of total cholesterol to high-density lipoprotein cholesterol(TC/HDL-C)is a classic and significant lipid index for predicting NCDs.Dyslipidemia is more common in patients with infectious diseases.And brucellosis patients are no exception,with a high prevalence of dyslipidemia,but there are fewer studies on TC/HDL-C.Therefore,this study intended to provide clues for the risk control of high TC/HDL-C and NCDs in brucellosis patients by describing the distribution of TC/HDL-C and analyzing the relevant factors of high TC/HDL-C in patients with brucellosis.Methods:The medical records of all adult inpatients with brucellosis in a hospital in Liaoning,China from 2015 to 2016 were collected,including clinically diagnosed cases and confirmed cases of brucellosis.522 patients who met the criteria for selecting and excluding were selected as the study subjects.Subjects with TC/HDL-C≥5.0 was classified into the high TC/HDL-C group.Multivariate logistic regression was used to ananlyze the relevant factors of high TC/HDL-C in adult brucellosis patients.All tests were 2-sided,and significance was set at P<0.05.Results:1.Clinical characteristics of 522 adult brucellosis patients.The subjects were 50(41,57)years old.The male to female sex ratio was 2.43:1.The occupation was mainly farmers and herdsmen,accounting for 55.75%.332 patients(63.50%)with a history of contact with sheep,and 208 patients(39.85%)with a history of contact with cattle.The main clinical symptoms were joint pain,fatigue,and fever,which the prevalence rates were 82.76%,68.58%,and 61.49% in sequence.In addition,178 patients were positive for Brucella spp.,with the positive rate of 34.10%(178/517).The incidences of elevated C-reactive protein and elevated procalcitonin(PCT)were64.94%(339/522)and 43.00%(218/507),respectively.Alanine aminotransferase(ALT)was elevated in 133(25.48%)patients.The prevalence of dyslipidemia was55.75%(291/522),and the incidences of decreased HDL-C was 38.12%(199/522),followed by elevated triglycerides,with 27.78%(145/522).2.Relevant factors of high TC/HDL-C in adult brucellosis patients.The prevalence of TC/HDL-C≥5.0 was 42.72%(223/522).The multivariate logistic regression model revealed that diabetes [OR(95%CI)=2.064(1.131,3.768)],non-alcoholic fatty liver disease [2.799(1.576,4.972)],sheep contact history [2.888(1.859,4.486)],Brucellaemia [1.652(1.070,2.551)],elevated PCT [1.730(1.120,2.673)],elevated ALT [2.043(1.262,3.307)] were all positively associated with the risk of high TC/HDL-C in brucellosis patients.Conclusions:1.Most adult brucellosis patients were middle-aged male farmers and herdsmen,which had an epidemiological history of contact with cattle or sheep.The clinical manifestations were mainly joint pain,fatigue and fever.Most of the patients were combined with dyslipidemia,the incidence of elevated inflammatory indexes and abnormal liver function were high.2.The risk of high TC/HDL-C in adult brucellosis patients was positively associated with diabetes and non-alcoholic fatty liver disease.However,the association between gender,stroke and the risk of high TC/HDL-C in brucellosis patients were not found.Compared with patients with cattle exposure history,adult brucellosis patients with sheep contact history,Brucellaemia,abnormal inflammatory markers and liver function may have an increased risk of high TC/HDL-C.