The difference of lipid profiles between psoriasis with arthritis and psoriasis without arthritis and sex-specific downregulation of methotrexate on the apolipoprotein B/apolipoprotein A-1 ratio.
The difference of lipid profiles between psoriasis with arthritis and psoriasis without arthritis and sex-specific downregulation of methotrexate on the apolipoprotein B/apolipoprotein A-1 ratio.
复制标题
伴关节炎的银屑病和不伴关节炎的银屑病的血脂差异以及甲氨蝶呤对载脂蛋白 B/载脂蛋白 A-1 比值的性别特异性下调
DOI：
10.1186/s13075-021-02715-4
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发表时间：
2022-01-07
影响因子：
4.9
通讯作者：
Yan K
中科院分区：
文献类型：
--
作者：
Wang B;Deng H;Hu Y;Han L;Huang Q;Fang X;Yang K;Wu S;Zheng Z;Yawalkar N;Zhang Z;Yan K
背景甲氨蝶呤（MTX）对心血管疾病（CVD）具有保护作用，但其机制尚不清楚。目的探讨MTX对血脂谱的影响以及无关节炎银屑病（PsO）和银屑病关节炎（PsA）之间的差异。方法在这项前瞻性研究中，我们招募了288名银屑病患者（136名PsA和152名PsO），他们完成了12周的MTX治疗。测量了总胆固醇 (TC)、甘油三酯 (TG)、脂蛋白 A [LP(a)]、高密度脂蛋白胆固醇 (HDL-C)、低密度脂蛋白 (LDL)、载脂蛋白 A1 (ApoA1) 和 ApoB。 结果与性别和年龄匹配的健康对照相比，银屑病患者的致动脉粥样硬化脂质水平显着较高（p < 0.0001），而促动脉粥样硬化脂质水平较低。抗动脉粥样硬化脂质。 PsA 患者的 ApoB/ApoA1 比值高于 PsO 患者 (p< 0.05)。逐步回归分析发现，炎症标志物 hCRP 与银屑病面积严重指数 (PASI)、ApoB/ApoA1 比值、BMI 和吸烟之间呈正相关。 ApoB 与伴随的关节炎、糖尿病和高血压呈正相关。 MTX 降低促动脉粥样硬化和抗动脉粥样硬化脂质的水平。然而，仅在男性患者中观察到MTX显着降低ApoB/ApoA1比值。结论PsA患者的伴随疾病比例明显高于PsO患者。 MTX对CVD的降低可能与性别有关。试验注册ChiCTR2000036192
BackgroundMethotrexate (MTX) has a protective effect against cardiovascular diseases (CVD), but the mechanism is unclear.ObjectiveTo investigate the effect of MTX on lipid profiles and the difference between psoriasis without arthritis (PsO) and psoriatic arthritis (PsA).MethodsIn this prospective study, we recruited 288 psoriatic patients (136 PsA and 152 PsO) who completed 12 weeks of MTX treatment. Total cholesterol (TC), triglycerides (TG), lipoprotein A [LP(a)], high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein (LDL), apolipoprotein A1 (ApoA1), and ApoB were measured.ResultsCompared with sex- and age-matched healthy controls, psoriatic patients had significantly (p< 0.0001) higher levels of proatherogenic lipids and lower levels of anti-atherogenic lipids. PsA patients had a higher ApoB/ApoA1 ratio than PsO patients (p< 0.05). Stepwise regression analysis found a positive correlation between the inflammatory marker hCRP and the Psoriasis Area Severity Index (PASI), ApoB/ApoA1 ratio, BMI, and smoking. ApoB was positively associated with concomitant arthritis, diabetes, and hypertension. MTX decreased the levels of pro-atherogenic and anti-atherogenic lipids. However, a significant reduction of the ApoB/ApoA1 ratio by MTX was only observed in male patients.ConclusionPsA patients had a significantly higher percentage of concomitant disease than PsO. The decrease of MTX on CVD might be related with sex.Trial registrationChiCTR2000036192