The Study On The Relationship Between Treponema Pallidum Infection And Blood Lipid Metabolism

Background:The incidence of syphilis has a rising trend in recent years.The compliance of stage I syphilis is poor,and it is easy to develop into stage ?,stage III or recessive syphilis,resulting in a series of complications.The results of retrospective survey also showed that the incidence of diabetes,cardiovascular and other diseases in syphilis patients was significantly higher than that in uninfected patients.More and more studies have confirmed that chronic infection of a variety of pathogens can cause abnormal metabolic indexes such as blood lipids and blood glucose,leading to the occurrence of related diseases.Therefore,the infection of Treponema pallidum(Tp)may also promote the occurrence and development of metabolic diseases through the above mechanisms.Objective: Through the cross-sectional investigation of blood lipid levels in patients with syphilis and the comparison of the changes of blood lipid indexes before and after the treatment of the patients with different outcomes,in order to find the changes of blood lipid metabolism after treponema pallidum infection and explore its possible mechanism.Methods:(1)Cross-sectional investigation of blood lipid levels in patients with syphilis: The serum of syphilis patients in different stages and healthy control in the same period were collected and in which the levels of triglyceride(TG),total cholesterol(TC),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),apolipoprotein A1(APOA1),apolipoprotein B(APOB)and C-reactive protein(CRP)were detected.The test date from each group were compared to look for the differences.(2)Follow-up analysis of the changes of blood lipid levels in patients with syphilis: patients with syphilis were followed up for a long time after treatment.Their blood lipid indexes were dynamically observed,and then divided into groups according to their outcome,and the changes of blood lipids in each group before and after treatment were compared.Results:(1)The rates of abnormal blood lipids(TG?2.26mmol/L,TC?6.22mmol/L,LDL-C?4.14mmol/L,HDL-C?1.04mmol/L)in syphilis patients were 5.4%,14.8%,8.4%,and 27.1%,which were significantly higher than those in the healthy control group(2.3%,11.4%,5.5%,7.5%).The total abnormal rate was 39.4%,which was higher than the healthy control group's 20.4%,and the reduction of high-density lipoprotein cholesterol is a prominent feature.(2)The levels of TG and HDL-C in syphilis patients serum were lower than those in healthy controls,while the levels of CRP and TC/HDL-C were higher than those in healthy controls.The levels of TC and LDL-C were increased in young female patients and decreased in elderly male patients.(3)Multivariate regression analysis showed that syphilis infection was negatively correlated with TG and HDL-C levels,with correlation coefficients of-0.360 and-0.101,and positively correlated with CRP and TC/HDL-C,with correlation coefficients of 0.213 and 0.070.(4)After standard treatment,the levels of TG,HDL-C and APOA1 increased and the ratio of TC/HDL-C decreased in syphilis patients whose TRUST result turned negative(5)After the standard treatment,the level of HDL-C increased and the ratio of TC/HDL-C decreased in syphilis patients with decreased TRUST titer during the whole follow-up period.(6)There was no significant difference in the serum lipid leve between the Serofast patients with syphilis and the control group.Conclusions:(1)Tp infection can make patients with higher risk of dyslipidemia than normal people.(2)The main dyslipidemia in patients with syphilis is the decrease of HDL-C,Apo A1,and the increase of TC/HDL-C,and other dyslipidemia could be secondary or accompanied(3)After treatment,the levels of HDL-C and APOA1 increased and TC/HDL-C decreased in patients with syphilis,which is expected to be used as an auxiliary marker for monitoring the therapeutic effect and predicting the outcome of syphilis patients.