| Background: Patients with systemic lupus erythematosus and rheumatoid arthritis are more likely associated with dyslipidemia,and the risk of cardiovascular disease is several times higher than the healthy controls.It is an urgent problem for clinicians to early detect and prevent the occurrence of cardiovascular events.At present,many plasma lipid-related parameters are used to assess the risk of cardiovascular disease,such as total cholesterol,low density lipoprotein cholesterol,high density lipoprotein cholesterol,etc.But the estimated value of single indicator in predicting cardiovascular disease is limited.Atherogenic index of plasma(AIP)is an independent index,which has been proposed to predict the risk of cardiovascular disease in recent years.And AIP was calculated by logarithmically transformed ratio of TG to HDL-C.Compared with previous single index,AIP is more accurate and scientific,but it is not yet widely applied in domestic clinical practice.Objectives: To investigate the changes of AIP in patients with SLE and RA after being administrated hydroxychloroquine combined with glucocorticoid,and to explore the value of AIP in assessing cardiovascular disease risk of autoimmune diseases,SLE and RA,and to provide a scientific basis for clinical application of AIP.Methods: 21 out of 25 SLE patients were administrated glucocorticoid combined with hydroxychloroquine,4 patients only glucocorticoid;11 out of 24 RA patients were administrated glucocorticoid combined with hydroxylchloroquine,13 patients only glucocorticoid.On the second day of admission and the second day of end of treatment,the fasting venous blood anticoagulated with heparin was collected,and plasma was separated for determination of TG,HDL-C and LDL-C.TG was detected by GPO-PAP method,HDL-C and LDL-C were detect by direct method,they are all tested on the US SIEMENS ADVIA Chemistry XPT system,calculated AIP value by formula(log [TG/HDL-C]),changes of AIP before and after treatment was assessed,and compared with the TG,HDL-C and LDL-C statistical results.Results: AIP was significantly lower(p<0.05)and HDL-C was significantly increased(p<0.05)in 21 patients with SLE who had been treated by glucocorticoid combined with hydroxychloroquine,which indicated that a significant improvement in dyslipidemia after combination therapy,while TG and LDL-C were have no significant changes,it indicated that AIP was superior to TG and LDL-C in assessing patient's CVD risk.According to the dose of glucocorticoid,it was divided into three groups: large(>40mg),medium(15?40mg)and small(<15mg).In the high-dose group,AIP was significantly decreased(p<0.05),and HDL-C was significant increased.In the moderate and low-dose group,AIP,TG,HDL-C and LDL-C were all have no significant differences(p>0.05).It suggested that hydroxychloroquine may be more effectively improve the blood lipids in patients treated with high-dose of glucocorticoids.AIP was significantly increased(p<0.05)and HDL-C was significantly decreased(p<0.05)in 13 patients with RA who had been treated with low-dose glucocorticoids,but TG and LDL-C had no statistically significant(p>0.05).The results suggest that glucocorticoid alone may cause dyslipidemia in patients AIP,TG,HDL-C,and LDL-C had no significant differences(p>0.05)in 11 patients with RA who had been treated by low-dose glucocorticoid combined with hydroxychloroquine.It indicated that hydroxylchloroquine can improve the dyslipidemia induced from glucocorticoids.Similarly,AIP is better than TG and LDL-C in assessing patient's CVD risk.Conclusion: Down-regulation of AIP with SLE patients treated by glucocorticoid combined with hydroxychloroquine indicated the low risk of cardiovascular disease.Up-regulation of AIP with RA patients treated by glucocorticoid alone indicated the increase risk of cardiovascular disease in patients.Compared with TG and LDL-C,AIP is an effective index evaluating the risk of cardiovascular disease in patients with SLE and RA. |
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