A Study on the Correlation between Serum Lipid Levels and Disease Activity in Patients with Systemic Lupus...

The pathogenesis of systemic lupus erythematosus (SLE) remains complex, and studies have found that abnormal lipid metabolism may be involved in the disease. Therefore, we aim to investigate the dyslipidemia in SLE patients and analyze the relationship between lipid metabolism and the disease activity.

A total of 174 patients diagnosed with SLE were enrolled in Henan Provincial People's Hospital from December 2016 to September 2022. Clinical data and laboratory indicators were collected, and SLE patients were grouped according to the levels of serum lipid. SPSS 26.0 statistical software was used for comparative analysis of SLE patients.

The prevalence of dyslipidemia was about 92.53% (161/174), mainly with decreased high-density lipoprotein cholesterol (HDL; 125/174, 77.64%) and increased triglyceride (TG; 86/174, 53.42%). The lipids were positively correlated with inflammatory indexes, such as white blood cell (WBC), neutrophil, systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio, lymphocyte-to-monocyte ratio, and so on. Furthermore, the blood lipid levels were significantly correlated with SLEDAI-2K, erythrocyte sedimentation rate, C3, C4, blood urea nitrogen (BUN), serum creatinine (Scr), and 24-h urine protein (p < 0.05). With the increasing types of dyslipidemia, the value of inflammatory indicators such as WBC and SII were higher, as well as the rate of kidney involvement. This is manifested by the elevation of renal function parameters such as BUN, Scr, eGFR and 24-h urine protein levels, while the levels of IgG, total protein and albumin decrease accordingly. The area under the curve (AUC) values of total cholesterol (TC), TG and low-density lipoprotein cholesterol (LDL) predicting lupus nephritis were 0.759, 0.713, and 0.729, which provided 69.6%, 81.4% and 63.7% sensitivity, and 76.4%, 56.9% and 73.6% specificity, respectively. With an AUC of 0.771, the combined detection of TC, TG, HDL, and LDL exhibited a greater potential for discrimination than any separate measurements.

Dyslipidemia is prevalent among SLE patients, and the levels of lipid can be informative in predicting renal involvement in SLE. It is crucial to monitor lipid levels and inflammation indexes and take lipid-lowering therapy along the discourse of SLE.