The Relationship Between TC/HDL-c and Disease Activity in Axial Spondyloarthritis Patients

Abstract Objectives: The study aims to determine the clinical significance of total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDL-c), TC/HDL-c, TG/HDL-c, and LDL-c/ HDL-c in axial spondyloarthritis (axSpA) patients.Methods: Two hundred and five axSpA patients and 71 healthy subjects were enrolled. AxSpA patients were further divided into remission group and active group. The laboratory data were collected. Spearman’s correlation, receiver operation characteristic (ROC) curves, and binary logistic regression analysis were conducted.Results: TC, TG, LDL-c and HDL-c were lower in axSpA group, while LDL-c/HDL-c was higher (P<0.05). ROC curves results revealed that the AUC value of HDL-c for axSpA was 0.752 (CI95%: 0.693-0.811), yielding the highest AUC value. HDL-c was negatively correlated with BASDAI, CRP, and ESR (P<0.05). TC/HDL-c was positively correlated with BASDAI, BASFI, CRP, and ESR (P<0.05). Besides, TC/HDL-c, CRP, and ESR in axSpA of active group were higher than those in remission group, while HDL-c was lower (P<0.05). ROC curves results showed that the AUC value of TC/HDL-c and CRP for axSpA of active group were 0.616 (CI95%: 0.539-0.694) and 0.632 (CI95%: 0.554-0.710), yielding higher AUC value than other parameters. The optimal cutoff value of TC/HDL-c for axSpA of active group was 4.218, with a Youden index of 0.195, a sensitivity of 50.6%, and a specificity of 68.9%. Binary logistic regression analysis indicated that TC/HDL-c was an independent indicator for axSpA disease activity.Conclusions: TC/HDL-c was elevated in axSpA of active group, yielding a high diagnostic value and showing a positively correlation with the disease activity of axSpA. TC/HDL-c may be a novel and reliable indicator for axSpA disease activity.