Retrospective analysis and preliminary laboratory validation of treatment efficacy and blood lipid levels in patients with rheumatoid arthritis

OBJECTIVE

Rheumatoid arthritis is a systemic disease characterized by progressive chronic inflammation resulting in destruction of synovial joints. In addition to joint involvement, abnormal blood lipid indexes have also been found in RA patients. The correlation between various blood lipid indexes and the treatment effects were assessed in patients with rheumatoid arthritis, for the purposes to find a better medication strategy for RA.

METHODS

One hundred nineteen rheumatoid arthritis patients were recruited and divided into two groups, 45 patients with significant drug treatment effect and 45 patients with insignificant drug treatment effect through the nearest neighbor matching method in propensity score. The correlation between various blood lipid indexes and drug treatment effect of rheumatoid arthritis patients was analyzed. A mouse model of rheumatoid arthritis was constructed in the laboratory; methotrexate was treated as a positive drug. We observe and record the onset of rheumatoid arthritis in mice, as well as the proportion of immune cells, the expression of inflammatory factors, and the changes in blood lipid profiles was done.

RESULTS

The levels of total cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL-C), low density lipoprotein (LDL-C), and erythrocyte sedimentation rate (ESR) in rheumatoid arthritis patients were significantly different between the two groups (P < 0.05). There was no significant difference in other indexes between the two groups (P > 0.05). Methotrexate had a good therapeutic effect on CIA model mice, and the levels of TC and HDL-C in the treatment group were higher than those in the model group.

CONCLUSION

There is a high correlation between the levels of TC and HDL-C in rheumatoid arthritis patients and the effect of drug treatment. In the clinical treatment of rheumatoid arthritis, we should focus on improving the blood lipid indexes such as TC and HDL-C, and explore more targeted individualized administration, so as to achieve better and faster treatment effect in patients with rheumatoid arthritis. Key Points • In this research, we found that the TC and HDL-C level in RA patients' blood is highly related with the therapeutic effect, and a lower level of TC and HDL-C is better for therapeutic effect of RA.

Synergistic effect of blood lipids and uric acid on periodontitis in patients with type 2 diabetes

OBJECTIVE

This study investigated the interaction of dyslipidemia and hyperuricemia on periodontitis in patients with type 2 diabetes mellitus (T2DM).

METHODS

The clinical data of 220 patients with T2DM (diabetes group) treated in Tianjin Baodi Hospital from January 2019 to December 2021 were retrospectively analyzed. Another 200 healthy subjects in the same period were selected as the control group. The correlation of hyperuricemia and hyperlipidemia with diabetes was tested by the spearman correlation coefficient. Multivariate logistic regression was used to analyze the multiplicative interaction and additive interaction of dyslipidemia and hyperuricemia on periodontitis.

RESULTS

Diabetes was positively correlated with hyperuricemia and hyperlipidemia (P<0.05). Patients with dyslipidemia (OR = 8.107, 95% CI: 2.687-24.457) and hyperuricemia (OR = 2.940, 95% CI: 0.970-8.909) had a higher risk of periodontitis, but there was no multiplicative interaction effect of dyslipidemia and hyperuricemia on periodontitis (OR = 1.864, 95% CI: 0.256-13.545, P>0.05). The risk of developing diabetes was higher in individuals with dyslipidemia and hypertension than in those without (OR = 2.887, 95% CI: 1.478-4.855). The evaluation indexes of the combined interaction effect relative excess risk due to interaction, interaction attribution percentage and synergy index were 0.902 (95% CI: 0.379-1.496), 0.273 (95% CI: 0.106-0.458) and 1.485 (95% CI: 0.978-2.165), respectively.

CONCLUSION

Dyslipidemia and hyperuricemia may have a synergistic effect on periodontitis in people with T2DM. Improving blood lipids and controlling blood uric acid may synergistically prevent periodontitis.

A study on the nutritional and biochemical analysis of Selaginella tamariscina powder

This study reports the various nutritional components of Selaginella tamariscina, which is traditionally used in folk or Chinese medicine. The iron nutrient content in S. tamariscina powder was 0.94 ± 0.06 mg/100 g powder, whereas selenium was present in a small amount, which showed strong antioxidant power. The total phenolic content of S. tamariscina powder was 8.65-11.61 mg gallic acid equivalents/g. S. tamariscina showed antioxidant activity in 2,2-azino-bis-(3-ethylbenzothiazoline-6-sulfonic acid) (ABTS) and 2,2-diphenyl-1-picrylhydrazyl (DPPH) radical scavenging activity. The ferric reducing antioxidant power of S. tamariscina powder was higher in the ethanol extract. Additionally, the ethanol extract demonstrated antimicrobial activity against Bacillus subtilis KCTC 2189. The level of high-density lipoprotein-cholesterol in the blood of ICR mice was significantly higher in the HF 20% + S. tamariscina 20% group than in the other groups (p < 0.05). The present study demonstrates that S. tamariscina, an abundantly existing plant, possesses antimicrobial, antioxidant, and anticytotoxic activities. S. tamariscina powder has potential as a functional food.

Effects of Copper Supplementation on Blood Lipid Level: a Systematic Review and a Meta-Analysis on Randomized Clinical Trials

Studies have evaluated the effect of copper (Cu) supplementation on blood lipid level. We therefore investigated whether the supplement of Cu on blood lipid level will have an impact in a meta-analysis on randomized controlled trials (RCTs). Literature search was conducted in Scopus, PubMed, Web of Science, and Cochrane Library (from database to January 2020). Randomized controlled trials of Cu supplementation on blood lipid level were retrieved according to the requirements of systematic review, and the quality of the included research was evaluated. Then the meta-analysis was performed. Data from 5 trials representing 176 participants were examined. Pooled mean net change in total cholesterol (TC) (standard mean difference(SMD) [95% CI] = - 0.05 [- 0.52, 0.43]), low density lipoprotein cholesterol (LDL-C) (SMD [95% CI] = 0.22 [- 0.46, 0.89]), and high density lipoprotein cholesterol (HDL-C) (SMD [95% CI] = 0.18 [- 0.14, 0.49]) for those treated with Cu supplementation had no significant difference when compared with control. Cu supplementation has not affected blood lipids in the result of meta-analysis. More research is needed to determine if this pattern will apply broadly.

Short-term exposure to air pollution and its interaction effects with two ABO SNPs on blood lipid levels in northern China: A family-based study

We examined the main effects of ambient particulate matters, as well as whether single-nucleotide polymorphisms (SNPs), located within ABO gene would modify the relationship. Data were collected from a family-based study conducted in Northern China. A generalized additive model with a Gaussian link and with each family as a stratum was applied to estimate the percentage change in blood lipid levels following a 10 μg/m³ increase in ambient particulate matter concentrations. Interaction analyses were conducted by including a cross-product term of PM_2.5 or PM₁₀ by SNP. Results showed that a 10 μg/m³ increase in Particulate matter with aerodynamic diameter <2.5 μm (PM_2.5) concentrations corresponded to the highest 0.010% (95% CI: 0.002%-0.018%), 0.018% (95% CI: 0.006%-0.029%), 0.019% (95% CI: 0.010%-0.029%) increase in total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), respectively and 0.005% (95% CI: 0.002%-0.008%) decrease in high density lipoprotein cholesterol (HDL-C)-to-LDL-C ratio. As for the PM₁₀, similar results were observed. Furthermore, our finding showed an interaction effect of PM₁₀ and rs505922/rs579459 C allele on TG. Specifically, individuals carrying the rs505922 and rs579459 T allele have higher TG concentrations following PM₁₀ exposure, with a 10 μg/m³ increase in PM₁₀ concentrations corresponding to the highest 0.028% and 0.034% increase in TG, respectively. In conclusion, short-term exposures to ambient particulate matters are associated with a higher blood lipid level, which can be modified by ABO polymorphism. The findings may be useful in identifying vulnerable population according to genetic background.

Assessment of carotid plaque hardness in patients with fatty liver by shear wave elastography: Correlation with blood lipid levels

BACKGROUND

Ultrasound plays an important role in carotid plaque screening, density structure determination, and stability evaluation. Shear wave elastography (SWE), as a new method of ultrasonic elastography, can quantitatively evaluate the elastic hardness of biological tissues by analyzing the propagation velocity of shear wave. Therefore, quantitative analysis of hardness characteristics of different types of carotid plaques by SWE can provide a valuable reference for clinical evaluation of plaque stability.

AIM

To determine the hardness of different types of carotid plaques in patients with fatty liver by SWE, and to explore the correlation between the hardness and blood lipid levels.

Methods

Clinical data of 130 fatty liver patients with single carotid plaque were retrospectively analyzed. According to the echo of plaque under conventional ultrasound, the patients were divided into three groups: soft plaque group (40 cases), mixed plaque group (52 cases), and hard plaque group (38 cases). All plaques were examined by SWE. The mean Young's modulus (mean YM) of each plaque was measured and its correlation with low density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C) levels was analyzed.

Results

The mean YM and HDL-C levels in the hard plaque group were significantly higher than those in the mixed plaque group and soft plaque group (P < 0.05). The mean YM and HDL-C levels in the mixed plaque group were significantly higher than those in the soft plaque group (P < 0.05). The LDL-C level in the hard plaque group was significantly lower than that in the mixed plaque group and soft plaque group (P < 0.05). The LDL-C level in the mixed plaque group was significantly lower than that in the soft plaque group (P < 0.05). The mean YM of carotid plaque was negatively correlated with LDL-C (r = -0.71, P < 0.05), and positively correlated with HDL-C (r = 0.75, P < 0.05).

Conclusion

SWE can quantitatively evaluate the hardness of different types of carotid plaques, and the mean YM is correlated with blood lipids levels. SWE can provide elastic hardness information for clinical evaluation of plaque stability.

Long-term treatment study of global standard dose metformin in Japanese patients with type 2 diabetes mellitus

In 169 Japanese patients with type 2 diabetes mellitus with blood glucose levels that were inadequately controlled with diet and exercise therapy alone, or with diet and exercise therapy plus a sulfonylurea (SU) drug, we evaluated the safety and efficacy of global standard dose metformin given up to a maximum daily dose of 2250 mg for 54 weeks. The changes in HbA1c from baseline to the final evaluation visit were -1.32 ± 0.76% for metformin monotherapy and -1.29 ± 0.81% for metformin plus SU, both significantly lower than baseline. The incidences of adverse events and adverse drug reactions were 91.1% (154/169 patients) and 67.5% (114/169 patients), respectively. The most common adverse events were gastrointestinal symptoms, and most of the gastrointestinal symptoms were considered by investigators to be related to metformin treatment. An increased blood lactic acid level was observed in three subjects (1.8%); however, no clinical symptoms were reported, and there was no increase in mean lactic acid concentration throughout the evaluation period. Symptoms of hypoglycemia were reported in 16 patients, all receiving metformin plus SU, but none received metformin monotherapy. There was a decrease in mean body weight. Global standard dose metformin may be useful for maintaining good blood glucose control over the long term in the treatment of type 2 diabetes mellitus in Japanese patients.