目的:本研究的目的是全面评估幼年特发性关节炎(JIA)患者的血脂状况。
方法:检索已发表的关于JIA与血脂水平关系的临床研究文献和相关综述。采用纽卡斯尔-渥太华量表(NOS)对纳入病例对照和队列研究的风险和方法学价值进行评估。使用足够的未经处理的数据得出所有变量的标准化平均差(SMD)和95%置信区间。该荟萃分析遵循系统评价和荟萃分析(PRISMA)指南的首选报告项目。
结果:总计,通过筛选纳入16项研究。分析结果显示,极低密度脂蛋白胆固醇水平[SMD=-0.411,95%CI(-0.774~-0.048),P=0.026],高密度脂蛋白胆固醇[SMD=-0.528,95%CI(-0.976~-0.079),P=0.021],和载脂蛋白A1[SMD=-1.050,95%CI(-1.452~-0.647),JIA患者的P=0.000]在统计学上低于健康对照组。低密度脂蛋白胆固醇水平[SMD=0.202,95%CI(0.003~0.400),JIA患者的P=0.046]明显高于健康对照组。在JIA患者中,体重指数[SMD=-0.189,95%CI(-0.690~0.311),P=0.459],高密度脂蛋白[SMD=-1.235,95%CI(-2.845~0.374),P=0.133),低密度脂蛋白[SMD=0.616,95%CI(-0.813~2.046),P=0.398),甘油三酯(SMD=0.278,95%CI(-0.182~0.738),P=0.236],总胆固醇[SMD=-0.073,95%CI(-0.438~0.293),P=0.696]和载脂蛋白B水平[SMD=0.226,95%CI(-0.133~0.585),P=0.217]与健康对照组无显著差异。
结论:这项荟萃分析的结果表明,与健康对照组相比,JIA患者的血脂异常很常见。JIA患者在以后的生活中患动脉粥样硬化和心血管疾病的风险显着增加。
OBJECTIVE: The purpose of this study was to comprehensively evaluate the lipid profiles in patients with juvenile idiopathic arthritis (JIA).
METHODS: The literature and relevant reviews were searched for published clinical studies on the relationship between JIA and blood lipid levels. The Newcastle-Ottawa scale (NOS) was applied to evaluate the risk and methodological value of the included case‒control and cohort studies. Standardized mean differences (SMDs) and 95% confidence intervals were derived for all variables with adequate unprocessed data. This meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines.
RESULTS: In total, 16 studies were incorporated through screening. The analysis findings revealed that the levels of very low-density lipoprotein cholesterol [SMD=-0.411, 95% CI (-0.774~-0.048), P = 0.026], high-density lipoprotein cholesterol [SMD=-0.528, 95% CI (-0.976~-0.079), P = 0.021], and apolipoprotein A1 [SMD=-1.050, 95% CI (-1.452~-0.647), P = 0.000] in JIA patients were statistically lower than those observed in healthy controls. The level of low-density lipoprotein cholesterol [SMD = 0.202, 95% CI (0.003 ~ 0.400), P = 0.046] was significantly higher in JIA patients than in healthy controls. In JIA patients, body mass index [SMD=-0.189, 95% CI (-0.690 ~ 0.311), P = 0.459], high-density lipoprotein [SMD =-1.235, 95% CI (-2.845 ~ 0.374), P = 0.133), low-density lipoprotein [SMD = 0.616, 95% CI (-0.813 ~ 2.046), P = 0.398), triglycerides (SMD = 0.278, 95% CI (-0.182 ~ 0.738), P = 0.236], total cholesterol [SMD=-0.073, 95% CI (-0.438 ~ 0.293), P = 0.696] and apolipoprotein B levels [SMD = 0.226, 95% CI (-0.133 ~ 0.585), P = 0.217] were not significantly different from those in healthy controls.
CONCLUSIONS: The outcomes of this meta-analysis suggest that dyslipidemia is common in JIA patients compared to healthy controls. Patients with JIA have a significantly increased risk of atherosclerosis and cardiovascular disease later in life.