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Systematic review and meta-analysis of individual serum lipids and analysis of lipid ratios in ankylosing spondylitis and healthy control cohorts: significantly lower mean HDL-cholesterol level in ankylosing spondylitis cohorts
A.T. Masi1, S.L. Fessler2, M.L. Brezka3, Y. Wang4, S.E. Donohue5
- Department of Medicine, University of Illinois College of Medicine at Peoria (UICOMP), Peoria, USA. amasi@uic.edu
- Department of Biology, Bradley University, Peoria, IL, USA.
- Department of Biochemistry and Molecular Biology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
- Department of Medicine, University of Illinois College of Medicine at Peoria (UICOMP), Peoria, and Research Services, University of Illinois College of Medicine at Peoria (UICOMP), Peoria, IL, USA.
- Research Services, University of Illinois College of Medicine at Peoria (UICOMP), Peoria, IL, USA.
CER16413
2023 Vol.41, N°9
PI 1862, PF 1874
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PMID: 36826790 [PubMed]
Received: 30/11/2022
Accepted : 23/01/2023
In Press: 23/02/2023
Published: 17/08/2023
Abstract
OBJECTIVES:
Ankylosing spondylitis (AS) is suspected to have increased risk of atherosclerosis and cardiovascular disease (CVD) mortality. This systematic review and meta-analysis aims to critically study serum lipids and lipoprotein ratios in AS compared to healthy control (HC) subjects and determine any significant difference.
METHODS:
English-language articles were systematically searched in PubMed, Ovid Medline, Embase (Medline records removed), and Scopus databases from 1970 to 2021. Random-effects model was used to pool results expressed as standardised mean difference (SMD) in the lipid outcomes. Lipid ratios of total ÷ HDL-C and the log10 (TG/HDL-C), i.e. atherogenic index of plasma (AIP), were analysed by histograms of differences in weighted means and weighted SDs between AS and HC exposure cohorts.
RESULTS:
The meta-analysis included a total of 68 articles, 47 from database search and 21 from reference reviews. Pooled Hedges’ g effect size revealed no difference in mean total cholesterol, mean triglycerides, and mean LDL-C between AS and HC subjects. However, mean HDL-C was significantly (p<0.001) lower in AS than HC subjects, with pooled Hedges’ g (SE) for HDL-C of -0.484 (0.092), with 95% mean CIs [-0.664, -0.305]. In comparing differences
in AS minus HC weighted means of total HDL-C ratios, 8 values in HC were below the lowest ratio in AS.
CONCLUSIONS:
Highly significantly lower HDL-C levels occurred in AS versus HC subjects. The lower HDL-C levels in AS than HC populations deserve further study and may be attributable to uninvestigated demographic, exercise capacity, or clinical manifestations.
