The etiology of giant cell arteritis (GCA) and its predictors are incompletely understood. Previous studies have indicated reduced risk of future development of GCA in individuals with obesity and/or diabetes mellitus. There is limited information on blood lipids before the onset of GCA. The objective of the study was to investigate the relation between apolipoprotein levels and future diagnosis of GCA in a nested case–control analysis. Individuals who developed GCA after inclusion in a population-based health survey (the Malmö Diet Cancer Study; N = 30,447) were identified by linking the health survey database to the local patient administrative register and the national patient register. A structured review of medical records was performed. Four controls for every validated case, matched for sex, year of birth, and year of screening, were selected from the database. Anthropometric measures, self-reported physical activity, based on a comprehensive, validated questionnaire, and non-fasting blood samples had been obtained at health survey screening. Concentrations of apolipoprotein A-I (ApoA-I) and apolipoprotein B (ApoB) in stored serum were measured using an immunonephelometric assay. Potential predictors of GCA were examined in conditional logistic regression models. There were 100 cases with a confirmed clinical diagnosis of GCA (81% female; mean age at diagnosis 73.6 years). The median time from screening to diagnosis was 12 years (range 0.3–19.1). The cases had significantly higher ApoA-I at baseline screening compared to controls (mean 168.7 vs 160.9 mg/dL, odds ratio [OR] 1.57 per standard deviation (SD); 95% confidence interval [CI] 1.18–2.10) (SD 25.5 mg/dL). ApoB levels were similar between cases and controls (mean 109.3 vs 110.4 mg/dL, OR 0.99 per SD; 95% CI 0.74–1.32) (SD 27.1 mg/dL). The ApoB/ApoA1 ratio tended to be lower in cases than in controls, but the difference did not reach significance. The association between ApoA-I and GCA development remained significant in analysis adjusted for body mass index and physical activity (OR 1.48 per SD; 95% CI 1.09–1.99). Subsequent development of GCA was associated with significantly higher levels of ApoA-I. These findings suggest that a metabolic profile associated with lower risk of cardiovascular disease may predispose to GCA.

中文翻译：

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载脂蛋白与巨细胞动脉炎的风险——一项巢式病例对照研究

巨细胞动脉炎（GCA）的病因及其预测因素尚不完全清楚。先前的研究表明，肥胖和/或糖尿病患者未来发生 GCA 的风险降低。有关 GCA 发病前血脂的信息有限。本研究的目的是通过巢式病例对照分析探讨载脂蛋白水平与未来 GCA 诊断之间的关系。通过将健康调查数据库与当地患者管理登记册和国家患者登记册联系起来，确定了纳入基于人群的健康调查（马尔默饮食癌症研究；N = 30,447）后发生 GCA 的个人。对医疗记录进行了结构化审查。从数据库中为每个经过验证的病例选择四个对照，并与性别、出生年份和筛查年份相匹配。在健康调查筛查中获得了基于全面、经过验证的调查问卷的人体测量测量、自我报告的身体活动以及非空腹血液样本。使用免疫比浊法测定储存血清中载脂蛋白 AI (ApoA-I) 和载脂蛋白 B (ApoB) 的浓度。在条件逻辑回归模型中检查了 GCA 的潜在预测因子。有 100 例临床确诊为 GCA（81% 为女性；诊断时平均年龄 73.6 岁）。从筛查到诊断的中位时间为 12 年（范围 0.3-19.1）。与对照相比，病例在基线筛查时的 ApoA-I 显着升高（平均 168.7 vs 160.9 mg/dL，优势比 [OR] 1.57/标准差 (SD)；95% 置信区间 [CI] 1.18–2.10）（SD 25.5）毫克/分升）。病例和对照之间的 ApoB 水平相似（平均 109.3 vs 110.4 mg/dL，OR 0.99/SD；95% CI 0.74–1.32）（SD 27.1 mg/dL）。病例中的 ApoB/ApoA1 比率往往低于对照组，但差异并未达到显着性。在根据体重指数和体力活动进行调整的分析中，ApoA-I 和 GCA 发育之间的关联仍然显着（OR 1.48/SD；95% CI 1.09-1.99）。GCA 的后续发展与 ApoA-I 水平显着升高相关。这些发现表明，与心血管疾病风险较低相关的代谢特征可能易患 GCA。