脂代谢谱对痛风性关节炎的诊断价值及与炎症、肾功能的相关性OA

Objective To investigate alterations in the lipid metabolic profile of patients with gouty arthritis(GA)and analyze the correlation of this profile with inflammation and renal function indicators.Methods A total of 88 GA patients admitted to the depart-ment of rheumatology in the First Affiliated Hospital of Anhui University of Chinese Medicine from October 2023 to October 2024 were selected as the study subjects,and 60 healthy individuals undergoing physical examinations during the same period served as the controls.The levels of triglyceride(TG),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein choles-terol(LDL-C),apolipoprotein-A1(Apo-A1),apolipoprotein-B(Apo-B),high-sensitivity C-reactive protein(hs-CRP),procalcitonin(PCT),interleukin-6(IL-6),serum amyloid A(SAA),erythrocyte sedimentation rate(ESR),uric acid(UA),blood urea nitrogen(BUN),and creatinine(Cr)were measured in both two groups.The t-test and rank-sum test were used to compare differences between groups.The diagnostic value of lipid indicators for GA was evaluated using ROC curves.Spearman correlation analysis,multiple linear regression,and association rule analysis were employed to explore the correlations between lipid indicators and inflammation and renal function indicators.Results The levels of TG,TC,LDL-C,and Apo-B in GA group were significantly higher than those in control group,while the levels of HDL-C and Apo-A1 were significantly lower(all P<0.01).ROC analysis revealed that each lipid indicator had certain diagnostic value for GA,and the combined indicators exhibited a larger area under the curve(AUC)and higher sensitivity than any single indicator(P<0.01).The GA patients with hyperuricemia showed higher TG and lower HDL-C and Apo-A1 levels than GA patients with normouricemia(P<0.05).Correlation analysis demonstrated that TG was positively correlated with hs-CRP,UA,and BUN in GA patients(P<0.05);Apo-A1 was negatively correlated with hs-CRP,IL-6,ESR,UA,and BUN(P<0.05);and Apo-B was positively correlated with UA(P<0.05).Association rule analysis indicated that elevated TG was closely associated with increased hs-CRP,SAA,and UA;elevated TC was associated with increased hs-CRP;decreased HDL-C and Apo-A1 were associated with increased hs-CRP,SAA,and UA;and elevated Apo-B was associated with increased hs-CRP and UA.Multiple linear regression analysis showed that TG was an independent positive factor for hs-CRP,UA,BUN and Cr(P<0.05);Apo-A1 was an independent negative factor for IL-6 and ESR(P<0.05);and Apo-B was an independent positive factor for UA and Cr(P<0.05).Conclusion GA patients exhibit dysregulation of the lipid profile,characterized by elevated levels of TG,TC,LDL-C,and Apo-B,and reduced levels of HDL-C and Apo-A1,indicating the presence of lipid metabolism disorder.The lipid metabolic profile composed of these indicators shows significant correlations with inflammatory and renal function markers,suggesting it can be a serum biomarker for the diagnosis of GA.