Objective: Clinical characterization of lipid metabolism in untreated patients with anti-melanoma differentiation-associated gene 5 antibodies-positive (anti-MDA5⁺).
Methods: Body-mass index (BMI), autoantibodies, lipid levels, and serum ferritin levels in 57 anti-MDA5⁺ patients were determined in the Department of Rheumatology and Immunology of the Second Affiliated Hospital of Chongqing Medical University.
Results: Plasma high-density lipoprotein (HDL) and apolipoprotein A1 (ApoA1) levels were significantly lower in deceased group than in the survival group (P < 0.05). Plasma levels of HDL and ApoA1 were significantly lower in patients who were simultaneously anti-MDA5⁺ and anti-Ro-52⁺ than in patients who were anti-MDA5⁺ alone (P < 0.05). Plasma levels of total cholesterol, low-density lipoprotein, HDL, and ApoA1 were significantly decreased in patients with high levels of serum ferritin compared with patients with low levels (P < 0.05). There were no significant differences in blood lipid levels between patients grouped according to BMI.
Conclusion: 1) HDL and ApoA1 levels are important indicators of poor prognosis in anti-MDA5⁺ patients; 2) Dysregulated lipid metabolism in anti-MDA5⁺ patients is closely associated with anti-Ro-52 antibody and ferritin levels but independent of BMI; 3) HDL involvement in inflammation and immune regulation merits close attention by rheumatologists.
Keywords: anti-melanoma differentiation-associated gene 5 antibodies, anti-Ro-52 antibody, lipid, high-density lipoprotein, apolipoprotein A1