| Objective:To explore the lipid metabolism abnormality state and the clinical significance of dyslipidemias in patients with systemic lupus erythematosus (SLE), and investigate the related factors that affecting lipid levels in SLE patients.Methods:According to inclusion and exclusion criteria, a total of 274 SLE patients hospitalized in ZhongDa Hospital Southeast University from 2013 to February 2016 were included. Detected the serum lipid levels, including total cholesterol(TC), triglycerides(TG), high density lipoproteins (HDL) and low density lipoprotein (LDL), as well as some clinical, humoral parameters and autoantibodies. To evaluate the activity of SLE, the Systemic Lupus Erythematosus Disease Activity Index 2000(SLEDAI-2K) was used. The correlation of serum lipids level were partially compared in subgroups. The correlation of serum TC, TG, HDL, LDL with laboratory and manifestations findings in SLE was analyzed by the statistical package SPSS 22.0.Result:1) There were 162 (59.12%) SLE patients with dyslipidemias, respectively elevated TC 32 (19.75%), elevated TG 86 (53.08%), decreased HDL 86 (53.08%), elevated LDL 22 (13.58%)2) The incidences of SLEDAI>5,24 hours urine protein(24hUpro)?0.5g, anti-dsDNA antibody positive and complemant C4 decreasing in SLE patients with dyslipidemias were 90.12%,48.15%,43.21%,36.42% respectively, and significantly higher than those of SLE patients without dyslipidemias (63.40%?18.75%?31.25%?25.00%)(P<0.05); There was no significant difference in age, sex and disease duration between the two groups(P>0.05);3) The serum level of HDL [1.25(1.00?1.43)mmol/L] was significantly lower in anti-dsDNA antibody positive patients than that of negative group [1.29(1.11?1.56)mmol/L](P<0.05), the serum level of TG [1.37(1.02?2.06)mmol/L] was significantly higher in anti-dsDNA antibody positive patients than that of negative ones [1.28(0.91?1.78)mmol/L](P<0.05);4) The serum level of HDL [1.25(1.01?1.46)mmol/L] was significantly lower in the group of SLEDAI?5 than that of SLEDAI<5 group [1.35(1.18?1.56)mmol/L](P<0.05);5) The serum level of TG [1.83(1.18?2.61)mmol/L] was significantly higher in the group of 24hUpro?0.5g than that of 24hUpro<0.5g group [1.27(0.92?1.73)mmol/L](P<0.01);6) The serum level of TC [4.43(3.79?5.31)mmol/L], HDL [1.31(1.12?1.56)mmol/L] and LDL [2.54(2.20?3.02)mmol/L] were significantly higher in SLE patients with glucocorticoid (GC) than patients without using of GC [(3.87(3.29?4.77) 1.14(0.99?1.34),2.37(2.06?2.78)mmol/L](P<0.01;<0.01;<0.05);7) The serum level of TC [4.10(3.47?4.98)mmol/L], LDL [2.41(2.08-2.89)mmol/L] were significantly lower in complement C3 decreased group than that of normal group[4.64(3.84?5.31),2.61(2.23?3.10)mmol/L](P<0.01; P<0.05);The serum level of TC [3.90(3.38?5.07)mmol/L] was lower in complement C4 decreased group than that of normalone [4.47(3.76?5.21)mmol/L](P<0.05);8) The serum level of HDL [1.20(0.98-1.46)mmol/L] was significantly lower in the ESR increasing group than that of ESR normal group [1.29(1.11?1.52)mmol/L] (P<0.05);9) Spearman sequential correlation analysis showed that:TC level was positively correlated with age, GC therapy (r=0.238;0.190)(P<0.01;0.01), was negatively correlated with descending of complement C3 and C4 (r=-0.166;-0.139)(P<0.01;0.05); TG level was positively correlated with 24hUpro, anti-dsDNA antibody positive, SLEDAI (r=0.199;0.123;0.125)(P<0.01;0.05;0.05); HDL level was positively correlated with age, GC therapy(r=0.213; 0.214)(P<0.01;0.01), was negatively correlated with the increase of ESR,24hUpro, anti-dsDNA antibody positive and SLEDAI (r= - 0.125; 0.199;0.138;-0.165)(P<0.05;0.01;0.05;0.01); LDL level was positively correlated with age (r=0.194) (P<0.01), was negatively correlated with descending of complement C3 (r=-0.143)(P<0.05).Conclusion:1) There were obvious dyslipidemias in SLE patients, the incidence was 59.12%. Elevated TG and decreased HDL are the most common abnormality.2) The dyslipidemias in SLE patients have close correlation with disease activity, hypocomplementemia,24hUpro, anti-dsDNA antibody and GC therapy. |
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