Serum Low-Density Lipoprotein Cholesterol Levels are Associated with Relapse in Neuromyelitis Optica Spectrum Disorder

Jie Ding; Fu-Ping Chen; Ya-Ying Song; Hong-Yan Li; Xi-Wen Ai; Yi Chen; Lu Han; Xia-Jun Zhou; De-Sheng Zhu; Yang-Tai Guan

doi:10.2147/JIR.S489723

Serum Low-Density Lipoprotein Cholesterol Levels are Associated with Relapse in Neuromyelitis Optica Spectrum Disorder

J Inflamm Res. 2024 Nov 5:17:8227-8240. doi: 10.2147/JIR.S489723. eCollection 2024.

Authors

Jie Ding^#¹, Fu-Ping Chen^#¹, Ya-Ying Song^#¹, Hong-Yan Li¹, Xi-Wen Ai¹, Yi Chen¹, Lu Han¹, Xia-Jun Zhou¹, De-Sheng Zhu¹, Yang-Tai Guan^{1

2}

Affiliations

¹ Department of Neurology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200127, People's Republic of China.
² Department of Neurology, Pu Nan Branch of Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.

^# Contributed equally.

Abstract

Background: The relationship between serum low-density lipoprotein cholesterol (LDL-C) and the risk of relapse in neuromyelitis optica spectrum disorder (NMOSD) remains uncertain. We aimed to examine the association between serum LDL-C level and relapse in NMOSD patients.

Methods: We conducted an analysis of the prospective observational NMOSD cohort study with consecutive 184 hospitalized NMOSD patients from department of neurology. Blood samples were collected to measure LDL-C level upon admission. Primary and relapse were evaluated during hospitalization. The relationship between serum LDL-C level and relapse were analyzed by linear curve fitting analyses. Crude and adjusted odds ratios (OR) of LDL-C for relapse with 95% confidence intervals were analyzed using multiple logistic regression models. ROC curve analysis was used to identify the target lipid-lowering value of LDL-C and the probability of relapse was evaluated by the Kaplan-Meier Plot.

Results: Over a mean disease course of 100±87 days, 59.24% (n=109) participants developed relapse with higher LDL-C than the primary group (n=75) (p<0.001). Adjusted smoothed plots suggested that there were linear relationships between serum LDL-C level and relapse (p< 0.001). The OR (95% CI) between serum LDL-C level and relapse were 2.67 (1.76-4.04, p<0.001), and 2.38 (1.48-3.83, p<0.001) respectively in NMOSD patients before and after adjusting for potential confounders. The target LDL-C lowering values were 2.795 mmol/L with potential benefits to prevent relapse in NMOSD.

Conclusion: In this sample of NMOSD patients, we found that the elevated serum LDL-C was independently and positively associated with the relapse, and serum LDL-C should be well-controlled to prevent the relapse of NMOSD.

Keywords: NMOSD; low-density lipoprotein cholesterol; multivariate analysis; neuromyelitis optica spectrum disorder; relapse.

Grants and funding

This work was supported by The Interdisciplinary Program of Shanghai Jiao Tong University (No. YG2023LC04). Key projects of basic research of Shanghai Municipal Science and Technology Commission, 20JC1412000(YG). The China Stroke Association Whole Course Management of Cerebrovascular Disease Sailing Fund, No 202001(DZ). The Municipal Commission of Health and Family Planning Foundation of Shanghai Pudong New Area (No. PW2022E-01) (YG). The National Natural Science Foundation of China, 82101352(YS).