Lipid Profiles in Anti-neutrophil Cytoplasmic Antibody-associated Vasculitis: A Cross-sectional Analysis

Abstract

Objective. Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is an autoimmune disease (AID) characterised by necrotising intravascular inflammation. Growing evidence suggests that immune system triggers altered lipid metabolism in AIDs. We investigated whether changes in lipid profile correlate with severity of disease in AAV. Methods. Seven lipid profiles were evaluated utilizing frozen serum samples from 67 patients registered in the Severance Hospital ANCA-associated VasculitidEs cohort by a chemistry autoanalyzer. The Birmingham Vasculitis Activity Score (BVAS) version 3 was used to measure patient's assessment of global disease activity. The relationship between the BVAS with continuous variables was calculated by Pearson's correlation analysis. Results. Thirty-five (52.2%), 19 (28.4%), and 13 (19.4%) patients were diagnosed with microscopic polyangiitis, granulomatosis with polyangiitis, and eosinophilic granulomatosis with polyangiitis, respectively. Patients' mean age was 60.0 years, and 22 (32.8%) were male. Among the lipid profiles investigated, total cholesterol, high-density lipoprotein, and low-density lipoprotein, and apolipoprotein A1 and B were significantly associated with BVAS; apolipoprotein A1 showed the highest correlation with BVAS (r=−0.521, p＜0.001), remaining consistent even in patients with new-onset disease (r=−0.430, p=0.012). Apolipoprotein A1 had the highest association with the renal manifestation score among the clinical scores comprising BVAS (r=−0.457, p＜0.001). Conclusion. Decreased lipid levels, especially apolipoprotein A1, are relevant to increased AAV disease activity, and differ according to organ involvement. Measuring lipid profiles could have clinical implications regarding the assessment of global disease activity and organ involvement patterns.

Association Between Serum Alarmin Levels and Disease-specific Indices in Patients With Anti-neutrophil Cytoplasmic Antibody-associated Vasculitis

“…Patient inclusion. We utilized serum samples and data from 79 patients who were included in the Severance Hospital ANCAassociated VasculitidEs (SHAVE) cohort, which is an observational registry of patients with AAV established at Severance Hospital, Republic of Korea (14). Patients were classified into AAV subtypes according to the 2007 European Medicines Agency algorithm (15) and the 2012 revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides (16).…”

What Can Lipids in Anti-neutrophil Cytoplasmic Antibody-associated Vasculitis Tell Us?

“…It also implies that lipid profile decreases in active disease state with active inflammation which is consistent with findings in other inflammatory rheumatic diseases. Ahn et al [18] also demonstrated relationship between lipid profile and disease activity in AAV in a cross-sectional study. It was irrespective of treatment of corticosteroids and immunosuppressant and apolipoprotein A1 (apoA1) showed the most significant correlation.…”

“…Ahn et al [ 18 ] also demonstrated relationship between lipid profile and disease activity in AAV in a cross-sectional study. It was irrespective of treatment of corticosteroids and immunosuppressant and apolipoprotein A1 (apoA1) showed the most significant correlation.…”

“…However, dysfunctional proinflammatory HDL has been suggested as a key component of increased cardiovascular risk in autoimmune inflammatory diseases such as systemic lupus erythematosus (SLE) [ 23 ]. Ahn et al [ 18 ] have shown that apoA1, an important component of HDL, is significantly associated with AAV disease activity and it will be interesting to see how it correlates with cardiovascular diseases.…”

Acute coronary syndrome in antineutrophil cytoplasmic antibody-associated vasculitis: a Korean single-centre cohort study

“…The primary limitation of this study was that the sample size was not large enough to sufficiently represent all Korean patients with AAV, and the study was retrospectively conducted. Owing to the small number of patients with ACS, the subgroup analysis on the effects of the traditional risks for ACS such as hypertension, DM, CKD, and dyslipidaemia on ACS occurrence in AAV patients could not be performed [37], and in particular, the baseline high-sensitive CRP levels, which are associated with ACS more closely than CRP levels, could not be collected owing to the retrospective study design [38]. However, because the same three rheuma-…”