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Abstract：
Background: Lipids are known to accumulate abnormally in the alveoli and circulate during pulmonary alveolar proteinosis (PAP). However, the relationship between lipid ratios and PAP is not clear. In this study, we investigated the lipid ratios in PAP patients and explored the relationships between lipid ratios and the severity of PAP. Methods: A total of 122 PAP patients were diagnosed and divided the mild- moderate PAP group (n = 61) and the severe PAP group (n = 61) according to the value of disease severity score (DSS). One hundred thirty healthy volunteers were classified as the control group. Routine blood examination and pulmonary function tests were performed and lipid profile were measured. Results: Compared with the control group, patients with PAP had significantly higher TG, TC/HDL-C, TG/HDL-C, and non-HDL-C, while lower HDL-C (all P < 0.05). Patients with the severe PAP had higher TC, TG, LDL-C, TC/HDL-C, and non-HDL-C, while lower HDL-C than patients with the mild- moderate PAP (all P < 0.05). Binary logistic regression analysis indicated that TC/HDL-C (OR = 2.322, 95% CI 1.621-3.713, P = 0.024) and non-HDL-C (OR = 1.797, 95% CI 1.239-3.109, P = 0.036) were all significantly correlated with the severity of PAP after adjustment for other risk factors. The AUC value of TC/HDL-C for predicting the severity of PAP was larger than that of non-HDL-C. The AUROC for TC/HDL-C was 0.741 (0.654-0.828), and the optimal cut-off point for TC/HDL-C was 5.05 (sensitivity: 73.6%, specificity: 68.1%). Conclusions: Lipid ratios, including TC-HDL-C and non-HDL-C, were independent risk factors for the severity of PAP. TC/HDL-C is a promising biomarker for the severity of PAP.
摘要：
背景：已知脂质在肺泡蛋白沉积症（PAP）期间在肺泡中异常积累并循环。然而,血脂比率与PAP之间的关系尚不清楚。在这项研究中,我们调查了PAP患者的血脂比率，并探讨了血脂比率与PAP严重程度之间的关系。方法:122例确诊的PAP患者,根据病情严重度评分(DSS)分为轻中度PAP组(61例)和重度PAP组(61例)。130名健康志愿者被归类为对照组。进行常规血液检查和肺功能检查，并测量血脂。结果:与对照组相比,PAP患者的TG明显升高，TC/HDL-C,TG/HDL-C,和非HDL-C，同时降低HDL-C(均P<0.05)。重度PAP患者TC较高,TG,LDL-C,TC/HDL-C,和非HDL-C，而HDL-C低于轻中度PAP患者(均P<0.05)。二元Logistic回归分析显示，TC/HDL-C（OR=2.322，95%CI1.621-3.713，P=0.024）和非HDL-C（OR=1.797，95%CI1.239-3.109，P=0.036）均与PAP严重程度相关。TC/HDL-C预测PAP严重程度的AUC值大于非HDL-C。TC/HDL-C的AUROC为0.741（0.654-0.828），TC/HDL-C的最佳切点为5.05（灵敏度：73.6%，特异性：68.1%）。结论：脂质比率，包括TC-HDL-C和非HDL-C，是PAP严重程度的独立危险因素。TC/HDL-C是PAP严重程度的有前途的生物标志物。
