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Published on: October 12, 2017
Risk for Behçet's disease gauged via high-density lipoprotein cholesterol: a nationwide population-based study in
Yeong Ho Kim1, Hyun Jee Kim2, Jin Woo Park1
1Department of Dermatology, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea.
Insights
Low levels and high variability in high-density lipoprotein cholesterol (HDL-C) increase Behçet's disease (BD) risk. These findings highlight HDL-C as a potential biomarker for BD development.
Area of Science:
- Cardiovascular Health
- Immunology
- Chronic Disease Epidemiology
Background:
- Behçet's disease (BD) is a chronic inflammatory disorder with unclear risk factors.
- Low plasma high-density lipoprotein cholesterol (HDL-C) is linked to other inflammatory conditions like Crohn's disease.
- The specific impact of HDL-C levels and their variability on BD risk remains largely unknown.
Purpose of the Study:
- To investigate the association between high-density lipoprotein cholesterol (HDL-C) levels and variability with the incidence of Behçet's disease (BD).
- To identify whether low mean HDL-C and high HDL-C variability are independent risk factors for BD.
Main Methods:
- Utilized the Korean National Health Insurance System database, analyzing data from 5,587,754 adults with at least three medical examinations between 2010 and 2013.
- Calculated variability independent of the mean (VIM) and coefficient of variation (CV) for mean HDL-C levels across visits.
- Performed multivariate-adjusted analyses to determine hazard ratios for BD incidence based on HDL-C levels and variability.
Main Results:
- Identified 676 new cases of Behçet's disease (BD) over the study period.
- Found increased BD risk associated with both low mean HDL-C levels and high variability in HDL-C.
- Multivariate analysis revealed significant hazard ratios for BD incidence in groups with low mean/high VIM (2.096) and low mean/low VIM (1.527) compared to high mean/low VIM.
Conclusions:
- Low mean high-density lipoprotein cholesterol (HDL-C) levels are an independent risk factor for Behçet's disease (BD).
- High variability in HDL-C levels, independent of the mean, also significantly increases the risk of developing BD.
- These findings suggest that HDL-C dynamics play a crucial role in BD pathogenesis and could serve as a predictive marker.
Abstract:
Behçet's disease (BD) is a chronic inflammatory disease. Low levels of plasma high-density lipoprotein cholesterol (HDL-C) are associated with Crohn's disease, another chronic inflammatory disease. However, the effects of low HDL-C levels on BD are unclear. We investigated the effects of HDL-C levels, and variability therein, on the risk for BD. We used the Korean National Health Insurance System database to identify 5,587,754 adults without a history of BD who underwent ≥ 3 medical examinations between 2010 and 2013. Mean HDL-C levels at each visit were used to calculate variability independent of the mean (VIM) and the coefficient of variation (CV). There were 676 new cases of BD (0.012%). The risk for BD was increased in participants with highly variable and low mean HDL-C levels. In a multivariate-adjusted model, the hazard ratios (95% confidence intervals) for BD incidence were 1.335 (1.058-1.684) in a high mean/high VIM group, 1.527 (1.211-1.925) in a low mean/low VIM group, and 2.096 (1.67-2.63) in a low mean/high VIM group compared to a high mean/low VIM group. Low mean HDL-C levels, and high variability therein, are independent risk factors for BD.
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