AB0412 LIPID PROFILE IN IIM PATIENTS AND ITS ASSOCIATION WITH DISEASE ACTIVITY, DURATION, AND GLUCOCORTICOID TREATMENT
Authors: S. Oreska, H. Štorkánová, M. Špiritović, B. Heřmánková, M. Vrablik, K. Pavelka, L. Šenolt, H. Mann, J. Vencovský, M. Tomčík
Journal: Annals of the Rheumatic Diseases (2021)

Background: Systemic inflammation, limited mobility, and glucocorticoid treatment in idiopathic inflammatory myopathies (IIM) can have a negative impact on intermediate metabolic pathways, especially on lipid metabolism. Objectives: The aim of this study was to assess the differences in the lipid profile of IIM patients and healthy controls (HC) and the association with disease-specific features. Methods: 133 patients with IIM (106 females; mean age 60.3; disease duration 2.2 years; DM 47 / PM 41 / IMNM 45) and 133 age-/sex-matched HC (106 females, mean age 60.2) were included. Patients with DM and PM fulfilled the Bohan/Peter criteria for PM/DM; patients with IMNM fulfilled the ENMC criteria. Levels of selected parameters of lipid metabolism were measured in sera. In IIM patients, disease activity, damage, and muscle involvement were evaluated (MITAX, MDI, MMT-8); comorbidities and current treatment were recorded. Data are presented as median. Results: Several differences in disease activity, the dose of glucocorticoids, prevalence of comorbidities, and serum lipid levels were observed in IIM compared to HC, and among the three subtypes of IIM; the most significant changes were observed in IMNM. All the differences in lipid profile between IIM and HC, as well as the correlations of lipid profile parameters with disease-specific features in IIM patients, are demonstrated in the table 1. Conclusion: We have observed significant alterations in serum lipid parameters in our IIM patients compared to healthy age-/sex-matched individuals. Differences were also found among the three subtypes of IIM. These alterations were associated with laboratory parameters of disease activity and the current dose of corticosteroids. Table 1. Lipidogram in IIM patients compared to healthy controls Parameter of lipidogram , median IIM (n = 133) DM (n = 47) PM (n = 41) IMNM (n = 45) HC (n = 133) p-value IM-HC; DM-HC; PM-HC; IMNM-HC TC (mmol/L ); 5.79 5.36 5.65 6.3 5.14 &lt;0.001; 0.135; 0.040; &lt;0.001 TG (mmol/L); 2.02 1.91 1.88 2.27 1.28 &lt;0.001; &lt;0.001; 0.002; &lt;0.001 LDL-C (mmol/L); 3.13 2.95 3.12 3.58 2.82 0.005 ; 0.436; 0.131; &lt;0.001 Apo-B (g/L); 1.06 1.02 0.98 1.26 0.91 &lt;0.001 ; 0.160; 0.017 ; &lt;0.001 Non-HDL-C (mmol/L); 4.4 4.25 4.15 5.1 3.9 &lt;0.001 ; 0.262; 0.040; &lt;0.001 Lp(a) (g/L); 0.1 0.1 0.1 0.12 0.15 0.098; 0.733; 0.242; 0.032 HDL-C (mmol/L); 1.122 1.13 1.18 1.36 1.2 0.913; 0.917; 0.503; 0.928 Apo-A (g/L); 1.7 1.76 1.75 1.68 1.8 0.073; 0.782; 0.267; 0.025 AI (log(TG/ HDL-C); 3.85 3.9 3.85 3.7 3.15 0.003 ; 0.425; 0.071; 0.002 Significant correlations of lipid profile parameters and disease-specific features in all IIM patients (n=133) Correlated parameters Spear-man’s r p-value Correlated parameters Spearman’s r p-value TC : Disease duration; LD; PED; Age; CK; Myoglobin -0.322; 0.343; 0.292; 0.193; 0.198; 0.249 &lt;0.001; &lt;0.001; &lt;0.001; 0.027; 0.025; 0.007 non-HDL-C : Disease duration; LD; BMI; CK; Myoglobin; PED -0.303; 0.322; 0.202; 0.214; 0.270; 0.275 &lt;0.001; &lt;0.001; 0.027; 0.015; 0.003; 0.002 TG : Disease duration; PED; BMI -0.326; 0.316; 0.271 &lt;0.001; &lt;0.001; 0.003 HDL-C : CRP -0.230 0.010 LDL -: Disease duration; LD; Age; CK; Myoglobin; -0.310; 0.359; 0.212; 0.257; 0.289 &lt;0.001; &lt;0.001; 0.015; 0.003; 0.002 Apo-A : CRP; CK; Myoglobin -0.293; -0.214; -0,258 &lt;0.001; 0.016; 0.005 Apo-B : Disease duration; LD; PED; Age; BMI; MMT-8; CK; Myoglobin; Glycemia -0.311; 0.348; 0.307; 0.220; 0.239; -0.214; 0.256; 0.307; 0.201 &lt;0.001; &lt;0.001; &lt;0.001; 0.012; 0.009; 0.017; 0.004; &lt;0.001; 0.031 AI : BMI 0.209 0.021 Acronyms: TC, total cholesterol; TG, triglycerides; LDL-C, low-density lipoprotein; Apo-B, apolipoprotein B; non-HDL-C, non-high-density lipoprotein (TC minus measured HDL-C); Lp(a), lipoprotein A; HDL-C, high-density lipoprotein; Apo-A, apolipoprotein A; AI, atherogenic index of plasma = log(TG/ HDL-C); LD, lactate dehydrogenase; PED, current prednisolone equivalent dose; CK, creatine kinase; BMI, body mass index; MMT-8, manual muscle testing-8; CRP, C-reactive protein Acknowledgements: AZV NV18-01-00161A, MHCR-00023728, GAUK-312218 Disclosure of Interests: None declared