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

The Relationship Between TC/HDL-c and Disease Activity in Axial Spondyloarthritis Patients | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research The Relationship Between TC/HDL-c and Disease Activity in Axial Spondyloarthritis Patients Shanmiao Sun, Yukai Huang, Qidang Huang, Meng Liu, Fan Feng, Zhuyi Ji, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-960249/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version 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. Cardiac & Cardiovascular Systems Endocrinology & Metabolism Axial Spondyloarthritis total cholesterol to high-density lipoprotein cholesterol ratio disease activity biomarker Figures Figure 1 Figure 2 Introduction Axial spondyloarthritis (axSpA) is a chronic inflammatory disease that shares a series of clinical features involving inflammation of the sacroiliac and spine joints [ 1 , 2 ] . Continuous progression of axSpA can lead to the bony fusion of vertebral joints and disability, which brings a great burden to patients and the country [ 3 ] . Early initiation and long-term therapy of biologics disease-modifying anti-rheumatic drug (bDMARD) in patients with high disease activity may reduce the rate of developing new lesions [ 3 , 4 ] . Therefore, biomarkers are urgently needed for early diagnosis of axSpA and accurate assessment of disease activity. Currently, several tools for evaluating the disease activity and prognosis of axSpA have been widely used, such as the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and the Bath Ankylosing Spondylitis Functional Index (BASFI) based on self-administered questionnaires of patients [ 3 ] . Regarding laboratory indicators including C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), they mainly reflect short-term inflammation with low discrimination to diagnose axSpA. Inflammation plays an important role in the pathogenesis of axSpA [ 3 ] . Emerging studies suggest that lipids are essential for various cellular stress response mechanisms including inflammation and immunity, serving as hubs for the integration of metabolic and inflammatory processes [ 5 ] . In addition, serum lipids is independent high-risk factor for coronary heart disease. Poor control of serum lipids easily accelerates the progression of atherosclerosis [ 6 ] . An atherogenic lipid profile is defined as a reduced level of high-density lipoprotein cholesterol (HDL-c) and elevated levels of total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-c), which can induce and even aggravate cardiovascular disease [ 7 , 8 ] . According to a population-based study, increasing morbidity and mortality of cardiovascular diseases (CVDs) in axSpA was highlighted [ 9 ] . A clinical trial confirmed the presence of subclinical atherosclerosis in axSpA patients [ 10 ] . Some researches indicated that lipids and inflammatory cells gradually accumulate during the development of atherosclerotic [ 11 ] . Although the risk of CVDs in axSpA patients is high, the serum lipids is closely related to CVDs. None of study has focused on the clinical significance of serum lipids and serum lipid ratios in axSpA. Accordingly, in this study, we retrospectively gathered the clinical data of axSpA patients, and explored the clinical significance of TC, TG, LDL-c, HDL-c, TC/HDL-c, TG/HDL-c, and LDL-c/HDL-c in axSpA. Materials And Methods Subjects A total of 205 axSpA patients, fulfilling the criteria of Assessment of Spondylo- Arthritis International Society (ASAS) for axSpA were recruited from our hospital between December 2015 and March 2019 [ 12 ] . Exclusion criteria included patients with other autoimmune diseases, infections, hematologic diseases, malignancies, or severe liver disease. AxSpA patients were further subclassified as active group (BASDAI ≥4, n=83) or remission group (BASDAI <4, n=122). The control group included 71 age- as well as gender-matched healthy individuals from our hospital at the same period. The design of this study complied with the Declaration of Helsinki. This study was approved by the ethics committee office of Guangdong Second Provincial General Hospital (2017-FSMY-009). Clinical And Laboratory Data Age, Sex, BASDAI, BASFI, TC, TG, LDL-c, HDL-c, CRP and ESR level were collected. TC/HDL-c, TG/HDL-c, and LDL-c/HDL-c were calculated. Statistical analysis All the data management statistical analyses were carried out by SPSS 26.0. Normal distribution data were described as mean ± standard deviation, while non-normal data and categorical variables were expressed as quartiles and frequencies, respectively. Two-sample t-test was performed for normal distribution and homogeneity of variance data to compare the differences in parameters between different groups, then the Mann-Whitney U test was used for non-normal distribution or uneven variance and chi-square test for the categorical variables. Relationships between the parameters and disease activity index were investigated by the Spearman’s correlations analysis. Receiver operation characteristic (ROC) curves were used to discriminate axSpA patients from healthy subjects and active axSpA group from remission axSpA group. Furthermore, binary logistical regression analyses were used to disclose the associated factors of axSpA disease activity. Then, variables with P < 0.05 were introduced to the further forward stepwise regression analyses. A P value < 0.05 was considered as significant difference. Results Basic characteristics between axSpA patients and healthy controls The age and gender between the control group and axSpA group were not significantly different. Compared with controls group, TC, TG, LDL-c, and HDL-c were lower in axSpA group, while LDL-c/HDL-c was higher ( P <0.05). The BASDAI and BASFI of axSpA group were 4.80(4.40,5.70), and 2.20(0.80,3.40) (Table1) . The diagnostic value of serum lipid parameters for axSpA by ROC curves The ROC curves results revealed that the AUC value of HDL-c was 0.752 (CI95%: 0.693-0.811), yielding the highest AUC value. The optimal cutoff value of HDL-c for axSpA was 1.075, with a Youden index of 0.432, a sensitivity of 62.9%, and a specificity of 80.3% (Figure.1 and Table2) . Correlations of serum lipid parameters with BASDAI, BASFI, ESR, and CRP HDL-c was negatively associated with BASDAI (r=-0.153, P =0.029), CRP (r=-0.423, P <0.001), and ESR (r=-0.307, P <0.001). TC/HDL-c was positively associated with BASDAI (r=0.179, P <0.05), BASFI (r=0.149, P <0.05), CRP (r=0.194, P =0.002), and ESR (r=0.185, P =0.004). LDL-c/HDL-c was positively associated with BASDAI (r=0.144, P <0.05), CRP (r=0.225, P <0.001), and ESR (r=0.209, P =0.001) (Table3) . Comparison of serum lipid parameters between axSpA of active group and remission group Compared with axSpA of remission group, TC/HDL-c, LDL-c/HDL-c, CRP and ESR were higher in axSpA of active group, while HDL-c was lower ( P 0.05). (Table4) . The diagnostic value of serum lipid parameters for axSpA of active group by ROC curves 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% (Figure.2 and Table 5) . Binary logistic regression analysis of indicator for axSpA disease activity Binary logistic regression analysis was used to identify the associated factors for axSpA disease activity. And the results revealed that TC/HDL-c was an independent indicator for axSpA disease activity (EXP (β) = 1.626, 95% CI: 1.128-2.343, P < 0.05) (Table6) . Discussion Despite the rapid development of new medical treatments, axSpA patients with persistent high disease activity may suffer from joint fusion and disability. Much more biomarkers are needed to evaluate the axSpA disease activity. In the present study, HDL-c decreased in axSpA patients. TC/HDL-c increased in axSpA of active group, showing a positive correlation with BASDAI. TC/HDL-c possessed a high diagnostic value for axSpA of active group, which may be an independent indicator for axSpA disease activity. Lipids mediate the transmission of inflammatory signals by directly or indirectly engaging in signaling pathways [ 5 ] . The cholesterol efflux capacity of HDL-c was negatively correlated with systemic inflammation [ 13 ] . HDL-c prevents inflammation by inhibiting the expression of endothelial cell adhesion molecules [ 14 – 17 ] . In the present study, HDL-c decreased in axSpA patients, showing a negative correlation to BASDAI. The AUC value of HDL-c for axSpA was 0.752(CI95%: 0.693-0.811). The results were consistent with the previous studies [ 18 – 22 ] . However, the correlations between TC, TG and BASDAI, BASFI were not significant. Currently, atherosclerosis has been recognized as a chronic inflammatory disease. AxSpA also belongs to a chronic inflammatory disease. The synthesis of a large number of inflammatory factors, such as interleukin -1(IL-1), interleukin -6 (IL-6), and tumor necrosis factor-α (TNF-α), greatly increases the possibility of atherosclerosis. The increased incidence of cardiovascular disease in axSpA patients was well characterized. Recent systematic review and meta-analysis revealed that comorbidities such as hyperlipidemia (17%) was common in axSpA, which led to a poor prognosis [ 23 ] . Dyslipidemia was a recognized modifiable cardiovascular risk [ 24 ] . In our study, the role of TC/HDL-c, TC/HDL-c, and LDL-c/HDL-c were investigated. The results indicated that TC/HDL-c and LDL-c/HDL-c elevated in active axSpA group. The AUC of TC/HDL-c was higher than other variables. TC/HDL-c and LDL-c/HDL-c were all positively correlated with BASDAI. The AUC of TC/HDL-c for axSpA of active group was higher than other variables. Logistic regression analysis results suggested that TC/HDL-c was an independent indicator for axSpA disease activity. It was reported that the benefits of statin are derived from decreasing in TC levels and increasing in HDL-c [ 25 ] . Our results showed that the increase of TC/HDL-c in active axSpA patients provides clinical evidence for statins to use in axSpA to improve lipid profiles. It is the first time to describe the clinical significance of HDL-c and TC/HDL-c for axSpA in our study. It was public knowledged that CRP and ESR were traditional biomarker of axSpA disease activity. In our study, CRP and ESR increased in active group of axSpA. CRP and ESR were positively correlated with BASDAI and BASFI. It was consistent with the previous studies [ 26 ] . However, ROC curves showed that the AUC of ESR for axSpA of active group were lower than TC/HDL-c. Logistic regression analysis suggested that ESR were not independent indicator for axSpA disease activity, compared with other variables. Although TC/HDL-c would not be a specific marker of axSpA, TC/HDL-c was superior to ESR in assessing disease activity of axSpA. It indicated that TC/HDL-c in combination with CRP and ESR may help to assess disease activity of axSpA more accurately. In conclusion, HDL-c was decreased in axSpA patients with a highest diagnostic value, compared with healthy control. TC/HDL-c was elevated in axSpA of active group, yielding a high diagnostic value and showing a significant correlation to the disease activity of axSpA. TC/HDL-c may be a novel and reliable indicator for axSpA disease activity. The result suggested that the serum lipid changed regularly in axSpA patients, especially in axSpA patients with high disease activity. Declarations Funding This study was funded by Science and Technology Projects in Guangzhou, China (No. 202102020127, 202102080321). Acknowledgments We sincerely thank the researchers and participants in the study. Conflict of interest The authors declare no conflicts of interest in this work. References Robinson PC, van der Linden S, Khan MA, Taylor WJ. Axial spondyloarthritis: concept, construct, classification and implications for therapy. Nat Rev Rheumatol. 2021;17(2):109–18. Sieper J, Poddubnyy D. Axial spondyloarthritis. Lancet. 2017;390(10089):73–84. Taurog JD, Chhabra A, Colbert RA. 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Basic characteristics between axSpA patients and healthy controls Control group (n=71) axSpA group （ n=205 ） P value Age(years) 31.00(29.00,35.00) 30.00(25.00,36.00) 0.076 0.063 Sex(male/female) 52/19 35/170 0.063 TC (mmol/L) 4.79(4.30,5.32) 3.99(3.57,4.64) <0.001 TG (mmol/L 1.14(0.88,1.53) 0.86(0.62,1.20) <0.001 LDL-c(mmol/L) 2.71(2.07,3.11) 2.38(1.96,2.94) 0.027 HDL-c(mmol/L) 1.23(1.10,1.42) 1.03(0.90,1.20) <0.001 TC/HDL-c 3.89(3.26,4.25) 4.01(3.55,4.46) 0.132 TG/HDL-c 0.94(0.72,1.21) 0.85(0.61,1.17) 0.154 LDL-c/HDL-c 2.13±0.62 2.35±0.74 0.022 BASDAI - 4.80(4.40,5.70) BASFI - 2.20(0.80,3.40) TC, total cholesterol; TG, triglycerides; HDL-c, high-density lipoprotein cholesterol; TC/HDL-c, total cholesterol-high-density lipoprotein cholesterol ratio; TG/HDL-c, triglycerides-high-density lipoprotein cholesterol ratio; LDL-c/HDL-c, low-density lipoprotein cholesterol-high-density lipoprotein cholesterol ratio; BASDAI, Bath Ankylosing Spondylitis Disease Activity Index; BASFI, Bath Ankylosing Spondylitis Functional Index Table 2. The diagnostic value of serum lipid parameters for axSpA using ROC cures AUC (CI95%) P value Optimal cut off value Youden index Sensitivity Specificity TC (mmol/L) TG (mmol/L) LDL-c(mmol/L) 0.728(0.662-0.793) 0.668(0.599-0.737) 0.588(0.509-0.667) <0.001 ＜ 0.001 0.027 4.200 0.960 2.700 0.403 0.303 0.214 80.3% 58.5% 50.7% 60.0% 71.8% 70.7% HDL-c(mmol/L) 0.752(0.693-0.811) ＜ 0.001 1.075 0.432 62.9% 80.3% TC/HDL-c TG/HDL-c 0.560(0.484-0.636) 0.557(0.481-0.633) 0.132 0.154 4.268 0.885 0.136 0.152 36.1% 62.0% 77.5% 53.2% LDL-c/HDL-c 0.607(0.534-0.681) 0.007 2.528 0.183 38.0% 80.3% TC, total cholesterol; TG, triglycerides; HDL-c, high-density lipoprotein cholesterol; TC/HDL-c, total cholesterol-high-density lipoprotein cholesterol ratio; TG/HDL-c, triglycerides-high-density lipoprotein cholesterol ratio; LDL-c/HDL-c, low-density lipoprotein cholesterol-high-density lipoprotein cholesterol ratio Table 3. Associations of serum lipid parameters with disease activity indexes in axSpA patients. BASDAI BASFI CRP ESR r P value r P value r P value r P value TC (mmo/L) -0.014 0.842 -0.005 0.942 -0.227 ＜ 0.001 -0.148 0.020 TG (mmol/L) -0.014 0.839 0.030 0.686 -0.171 0.007 -0.217 0.001 LDL-c(mmol/L) 0.018 0.797 0.006 0.941 -0.030 0.639 -0.012 0.857 HDL-c(mmol/L) -0.153 0.029 -0.146 0.051 -0.423 <0.001 -0.307 <0.001 TC/HDL-c 0.179 0.010 0.149 0.047 0.194 0.002 0.185 0.004 TG/HDL-c 0.065 0.352 0.088 0.242 0.009 0.885 -0.079 0.215 LDL-c/HDL-c 0.144 0.040 0.093 0.216 0.225 <0.001 0.209 0.001 CRP (mg/L) 0.257 ＜ 0.001 0.310 ＜ 0.001 - - 0.746 <0.001 ESR (mm/h) 0.257 ＜ 0.001 0.296 ＜ 0.001 0.746 <0.001 - - TC, total cholesterol; TG, triglycerides; HDL-c, high-density lipoprotein cholesterol; TC/HDL-c, total cholesterol-high-density lipoprotein cholesterol ratio; TG/HDL-c, triglycerides-high-density lipoprotein cholesterol ratio; LDL-c/HDL-c, low-density lipoprotein cholesterol-high-density lipoprotein cholesterol ratio; ESR, erythrocyte sedimentation rate; CRP, C-reactive protein; BASDAI, Bath Ankylosing Spondylitis Disease Activity Index; BASFI, Bath Ankylosing Spondylitis Functional Index Table 4. Comparison of serum lipid parameters between axSpA of active group and remission group Remission axSpA (n=122) Active axSpA （ n=83 ） P value Age(years) 29.50(24.00,35.00) 30.00(25.00,37.00) 0.350 Sex(male/female) 103/19 67/16 0.489 TC (mmol/L) 3.98(3.53,4.66) 4.00(3.58,4.61) 0.853 TG (mmol/L) 0.88(0.61,1.24) 0.80(0.63,1.18) 0.752 LDL-c(mmol/L) 2.39(1.90,2.96) 2.37(2.03,2.82) 0.601 HDL-c(mmol/L) 1.04(0.93,1.22) 0.99(0.86,1.17) 0.042 TC/HDL-c 3.84±0.92 4.20±0.75 0.003 TG/HDL-c 0.86(0.58,1.17) 0.84(0.66,1.18) 0.487 LDL-c/HDL-c 2.25±0.76 2.51±0.68 0.011 CRP (mg/L) 7.83(3.14,23.50) 18.30(6.55,32.25) 0.001 ESR (mm/L) 20.00(10.00,40.00) 31.00(16.50,50.00) 0.006 BASDAI 2.00(1.00,3.00) 4.80(4.40,5.70) ＜ 0.001 BASFI 0.30(0.00,1.50) 2.20(0.80,3.40) ＜ 0.001 TC, total cholesterol; TG, triglycerides; HDL-c, high-density lipoprotein cholesterol; TC/HDL-c, total cholesterol-high-density lipoprotein cholesterol ratio; TG/HDL-c, triglycerides-high-density lipoprotein cholesterol ratio; LDL-c/HDL-c, low-density lipoprotein cholesterol-high-density lipoprotein cholesterol ratio; ESR, erythrocyte sedimentation rate; CRP, C-reactive protein; BASDAI, Bath Ankylosing Spondylitis Disease Activity Index; BASFI, Bath Ankylosing Spondylitis Functional Index Table 5. The diagnostic value of serum lipid parameters, CRP and ESR for axSpA of active group using ROC cures Parameters AUC(CI95%) P value Optimal cut off value Youden index Sensitivity Specificity TC (mmol/L) TG (mmol/L) LDL-c(mmol/L) 0.616(0.539,0.694) 0.513(0.432-0.594) 0.522(0.441-0.602) 0.005 0.752 0.601 5.70 0.795 1.805 0.071 0.101 0.084 9.60% 49.4% 90.4% 97.5% 60.7% 18.0% HDL-c(mmol/L) 0.584(0.503-0.664) 0.420 0.955 0.162 48.2% 68.0% TC/HDL-c TG/HDL-c 0.616(0.539-0.694) 0.529(0.449-0.608) 0.005 0.487 4.218 0.528 0.195 0.117 50.6% 90.4% 68.9% 21.3% LDL-c/HDL-c 0.600(0.523-0.678) 0.015 2.371 0.192 60.2% 59.0% CRP 0.632(0.554-0.710) 0.001 11.000 0.285 71.1% 57.4% ESR 0.614(0.537,0.690) 0.006 14.500 0.236 84.3% 39.3% TC, total cholesterol; TG, triglycerides; HDL-c, high-density lipoprotein cholesterol; TC/HDL-c, total cholesterol-high-density lipoprotein cholesterol ratio; TG/HDL-c, triglycerides-high-density lipoprotein cholesterol ratio; LDL-c/HDL-c, low-density lipoprotein cholesterol-high-density lipoprotein cholesterol ratio; ESR, erythrocyte sedimentation rate; CRP, C-reactive protein Table 6. Logistic regression analysis of independent indicator for axSpA disease activity Risk factor OR(CI95%) P value TC - 0.991 TG - 0.821 LDL-c - 0.557 HDL-c - 0.587 TC/HDL- 1.626(1.128-2.343) 0.009 TG/HDL-c - 0.672 LDL-C/HDL-c - 0.599 CRP 1.019(1.003-1.035) 0.019 ESR - 0.637 TC, total cholesterol; TG, triglycerides; HDL-c, high-density lipoprotein cholesterol; TC/HDL-c, total cholesterol-high-density lipoprotein cholesterol ratio; TG/HDL-c, triglycerides-high-density lipoprotein cholesterol ratio; LDL-c/HDL-c, low-density lipoprotein cholesterol-high-density lipoprotein cholesterol ratio; ESR, erythrocyte sedimentation rate; CRP, C-reactive protein; BASDAI, Bath Ankylosing Spondylitis Disease Activity Index; BASFI, Bath Ankylosing Spondylitis Functional Index Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-960249","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research","associatedPublications":[],"authors":[{"id":57441318,"identity":"dc2ea834-bf7e-412c-97e3-34a9c0640ebb","order_by":0,"name":"Shanmiao Sun","email":"","orcid":"","institution":"Guangdong Second Provincial General Hospital","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Shanmiao","middleName":"","lastName":"Sun","suffix":""},{"id":57441319,"identity":"948ba4ba-9a57-46ee-89b9-2d071354b549","order_by":1,"name":"Yukai Huang","email":"","orcid":"","institution":"Guangdong Second Provincial General Hospital","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Yukai","middleName":"","lastName":"Huang","suffix":""},{"id":57441320,"identity":"91e787de-24ed-4c2f-b683-4bacd02ef845","order_by":2,"name":"Qidang Huang","email":"","orcid":"","institution":"Guangdong Second Provincial General Hospital","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Qidang","middleName":"","lastName":"Huang","suffix":""},{"id":57441321,"identity":"d5eccbc1-790f-43b3-ac00-e702434b0388","order_by":3,"name":"Meng Liu","email":"","orcid":"","institution":"Guangdong Second Provincial General Hospital","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Meng","middleName":"","lastName":"Liu","suffix":""},{"id":57441322,"identity":"e3e305af-d3ab-40dd-bff6-0dc507bd23f7","order_by":4,"name":"Fan Feng","email":"","orcid":"","institution":"Guangdong Second Provincial General Hospital","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Fan","middleName":"","lastName":"Feng","suffix":""},{"id":57441323,"identity":"610fcb8a-b2af-4784-8159-65378a75bf91","order_by":5,"name":"Zhuyi Ji","email":"","orcid":"","institution":"Guangdong Second Provincial General Hospital","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Zhuyi","middleName":"","lastName":"Ji","suffix":""},{"id":57441324,"identity":"47a7ce5f-9c7c-4b55-b62c-edbb1e2f6fff","order_by":6,"name":"Lixin Huang","email":"","orcid":"","institution":"Guangdong Second Provincial General Hospital","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Lixin","middleName":"","lastName":"Huang","suffix":""},{"id":57441325,"identity":"34fbcc09-4b1d-4f4e-99d0-0f4a3184316e","order_by":7,"name":"Weiming Deng","email":"","orcid":"","institution":"Guangdong Second Provincial General Hospital","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Weiming","middleName":"","lastName":"Deng","suffix":""},{"id":57441326,"identity":"aeecd23d-64fa-47d1-b799-21a1dfdedea1","order_by":8,"name":"Tian-wang Li","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA40lEQVRIie3RsWrDMBCA4SsH8qJGq0xL+goqhoa+zRmDt0JHDYF4KM5QBa/NW2TseMbgSd09pm/gbN1a7y2Rs3XQN+vndBJAFP1DQjUjk/1GlTSnI9l1OFlovufRY5I6zszR9+FkCZS1+xqVeaOH9PMFZ1wMmDrpxY2RXNq8EqC2r3Q+wYo7aWW2Sqp+yN9vQfuPQ2BKW01TdPHo2nrIvQCjn0JJAd11bTaHoRDPeY1zkhKm9QnNUAqYl2gP0yMzps6jJt/L4C53jcORLE9f6a5OX3a9VNvd+eQXednxKIqi6E8/aBJO+QUI9lgAAAAASUVORK5CYII=","orcid":"https://orcid.org/0000-0001-6438-2691","institution":"Guangdong Second Provincial General Hospital","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Tian-wang","middleName":"","lastName":"Li","suffix":""}],"badges":[],"createdAt":"2021-10-08 10:13:19","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-960249/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-960249/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":14724531,"identity":"5e82a234-38b4-424d-82f0-6a451086cfe8","added_by":"auto","created_at":"2021-10-20 16:30:15","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":97187,"visible":true,"origin":"","legend":"The diagnostic value of serum lipid parameters for axSpA using ROC cures. A: TC/HDL-c and LDL-c/HDL-c; B: TC, TG, LDL-c, HDL-c, and TG/HDL-c.","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-960249/v1/33109c870f2ab80d631f7e21.png"},{"id":14724532,"identity":"e519e314-1385-427d-84db-13280bfdd887","added_by":"auto","created_at":"2021-10-20 16:30:15","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":103813,"visible":true,"origin":"","legend":"The diagnostic value of serum lipid parameters, CRP and ESR for axSpA of active group using ROC cures. A: TC, LDL-c, TC/HDL-c, TG/HDL-c, LDL-c/HDL-c, CRP, and ESR; B: TG and HDL-c. \n\n","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-960249/v1/290de40298c45612800a484a.png"},{"id":14724767,"identity":"da43c445-5438-4a32-b6f8-41b89aaf8f2e","added_by":"auto","created_at":"2021-10-20 16:33:22","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":871905,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-960249/v1/24e46cbb-7050-40ad-a12b-b5259ac74260.pdf"}],"financialInterests":"","formattedTitle":"\u003cp\u003eThe Relationship Between TC/HDL-c and Disease Activity in Axial Spondyloarthritis Patients\u003c/p\u003e","fulltext":[{"header":"Introduction","content":"\u003cp\u003eAxial spondyloarthritis (axSpA) is a chronic inflammatory disease that shares a series of clinical features involving inflammation of the sacroiliac and spine joints \u003csup\u003e[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]\u003c/sup\u003e. Continuous progression of axSpA can lead to the bony fusion of vertebral joints and disability, which brings a great burden to patients and the country \u003csup\u003e[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]\u003c/sup\u003e. Early initiation and long-term therapy of biologics disease-modifying anti-rheumatic drug (bDMARD) in patients with high disease activity may reduce the rate of developing new lesions \u003csup\u003e[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]\u003c/sup\u003e. Therefore, biomarkers are urgently needed for early diagnosis of axSpA and accurate assessment of disease activity.\u003c/p\u003e \u003cp\u003eCurrently, several tools for evaluating the disease activity and prognosis of axSpA have been widely used, such as the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and the Bath Ankylosing Spondylitis Functional Index (BASFI) based on self-administered questionnaires of patients \u003csup\u003e[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]\u003c/sup\u003e. Regarding laboratory indicators including C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), they mainly reflect short-term inflammation with low discrimination to diagnose axSpA. Inflammation plays an important role in the pathogenesis of axSpA \u003csup\u003e[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]\u003c/sup\u003e. Emerging studies suggest that lipids are essential for various cellular stress response mechanisms including inflammation and immunity, serving as hubs for the integration of metabolic and inflammatory processes \u003csup\u003e[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]\u003c/sup\u003e. In addition, serum lipids is independent high-risk factor for coronary heart disease. Poor control of serum lipids easily accelerates the progression of atherosclerosis \u003csup\u003e[\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]\u003c/sup\u003e. An atherogenic lipid profile is defined as a reduced level of high-density lipoprotein cholesterol (HDL-c) and elevated levels of total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-c), which can induce and even aggravate cardiovascular disease \u003csup\u003e[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]\u003c/sup\u003e. According to a population-based study, increasing morbidity and mortality of cardiovascular diseases (CVDs) in axSpA was highlighted \u003csup\u003e[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]\u003c/sup\u003e. A clinical trial confirmed the presence of subclinical atherosclerosis in axSpA patients \u003csup\u003e[\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]\u003c/sup\u003e. Some researches indicated that lipids and inflammatory cells gradually accumulate during the development of atherosclerotic \u003csup\u003e[\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]\u003c/sup\u003e. Although the risk of CVDs in axSpA patients is high, the serum lipids is closely related to CVDs. None of study has focused on the clinical significance of serum lipids and serum lipid ratios in axSpA.\u003c/p\u003e \u003cp\u003eAccordingly, in this study, we retrospectively gathered the clinical data of axSpA patients, and explored the clinical significance of TC, TG, LDL-c, HDL-c, TC/HDL-c, TG/HDL-c, and LDL-c/HDL-c in axSpA.\u003c/p\u003e"},{"header":"Materials And Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eSubjects\u003c/h2\u003e \u003cp\u003eA total of 205 axSpA patients, fulfilling the criteria of Assessment of Spondylo- Arthritis International Society (ASAS) for axSpA were recruited from our hospital between December 2015 and March 2019 \u003csup\u003e[\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]\u003c/sup\u003e. Exclusion criteria included patients with other autoimmune diseases, infections, hematologic diseases, malignancies, or severe liver disease. AxSpA patients were further subclassified as active group (BASDAI \u0026ge;4, n=83) or remission group (BASDAI \u0026lt;4, n=122). The control group included 71 age- as well as gender-matched healthy individuals from our hospital at the same period. The design of this study complied with the Declaration of Helsinki. This study was approved by the ethics committee office of Guangdong Second Provincial General Hospital (2017-FSMY-009).\u003c/p\u003e \u003c/div\u003e\n\u003ch2\u003eClinical And Laboratory Data\u003c/h2\u003e\n\u003cp\u003eAge, Sex, BASDAI, BASFI, TC, TG, LDL-c, HDL-c, CRP and ESR level were collected. TC/HDL-c, TG/HDL-c, and LDL-c/HDL-c were calculated.\u003c/p\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eStatistical analysis\u003c/h2\u003e \u003cp\u003eAll the data management statistical analyses were carried out by SPSS 26.0. Normal distribution data were described as mean \u0026plusmn; standard deviation, while non-normal data and categorical variables were expressed as quartiles and frequencies, respectively. Two-sample t-test was performed for normal distribution and homogeneity of variance data to compare the differences in parameters between different groups, then the Mann-Whitney U test was used for non-normal distribution or uneven variance and chi-square test for the categorical variables. Relationships between the parameters and disease activity index were investigated by the Spearman\u0026rsquo;s correlations analysis. Receiver operation characteristic (ROC) curves were used to discriminate axSpA patients from healthy subjects and active axSpA group from remission axSpA group. Furthermore, binary logistical regression analyses were used to disclose the associated factors of axSpA disease activity. Then, variables with \u003cem\u003eP\u003c/em\u003e \u0026lt; 0.05 were introduced to the further forward stepwise regression analyses. A \u003cem\u003eP\u003c/em\u003e value \u0026lt; 0.05 was considered as significant difference.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003eBasic characteristics between axSpA patients and healthy controls\u003c/h2\u003e \u003cp\u003eThe age and gender between the control group and axSpA group were not significantly different. Compared with controls group, TC, TG, LDL-c, and HDL-c were lower in axSpA group, while LDL-c/HDL-c was higher (\u003cem\u003eP\u003c/em\u003e\u0026lt;0.05). The BASDAI and BASFI of axSpA group were 4.80(4.40,5.70), and 2.20(0.80,3.40)\u003cb\u003e(Table1)\u003c/b\u003e.\u003c/p\u003e \u003cp\u003e \u003cb\u003eThe diagnostic value of serum lipid parameters for axSpA by ROC curves\u003c/b\u003e \u003c/p\u003e \u003cp\u003eThe ROC curves results revealed that the AUC value of HDL-c was 0.752 (CI95%: 0.693-0.811), yielding the highest AUC value. The optimal cutoff value of HDL-c for axSpA was 1.075, with a Youden index of 0.432, a sensitivity of 62.9%, and a specificity of 80.3% \u003cb\u003e(Figure.1 and Table2)\u003c/b\u003e.\u003c/p\u003e \u003cp\u003e \u003cb\u003eCorrelations of serum lipid parameters with BASDAI, BASFI, ESR, and CRP\u003c/b\u003e \u003c/p\u003e \u003cp\u003eHDL-c was negatively associated with BASDAI (r=-0.153, \u003cem\u003eP\u003c/em\u003e=0.029), CRP (r=-0.423, \u003cem\u003eP\u003c/em\u003e\u0026lt;0.001), and ESR (r=-0.307, \u003cem\u003eP\u003c/em\u003e\u0026lt;0.001). TC/HDL-c was positively associated with BASDAI (r=0.179, \u003cem\u003eP\u003c/em\u003e\u0026lt;0.05), BASFI (r=0.149, \u003cem\u003eP\u003c/em\u003e\u0026lt;0.05), CRP (r=0.194, \u003cem\u003eP\u003c/em\u003e=0.002), and ESR (r=0.185, \u003cem\u003eP\u003c/em\u003e=0.004). LDL-c/HDL-c was positively associated with BASDAI (r=0.144, \u003cem\u003eP\u003c/em\u003e\u0026lt;0.05), CRP (r=0.225, \u003cem\u003eP\u003c/em\u003e\u0026lt;0.001), and ESR (r=0.209, \u003cem\u003eP\u003c/em\u003e=0.001) \u003cb\u003e(Table3)\u003c/b\u003e.\u003c/p\u003e \u003cp\u003e \u003cb\u003eComparison of serum lipid parameters between axSpA of active group and remission group\u003c/b\u003e \u003c/p\u003e \u003cp\u003eCompared with axSpA of remission group, TC/HDL-c, LDL-c/HDL-c, CRP and ESR were higher in axSpA of active group, while HDL-c was lower (\u003cem\u003eP\u003c/em\u003e \u0026lt;0.05). There were no significant difference in age, TC, TG, LDL-c and TG/HDL-c between the two group (\u003cem\u003eP\u003c/em\u003e\u0026gt;0.05). \u003cb\u003e(Table4)\u003c/b\u003e.\u003c/p\u003e \u003cp\u003e \u003cb\u003eThe diagnostic value of serum lipid parameters for axSpA of active group by ROC curves\u003c/b\u003e \u003c/p\u003e \u003cp\u003eROC 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% \u003cb\u003e(Figure.2 and Table 5)\u003c/b\u003e.\u003c/p\u003e \u003cp\u003e \u003cb\u003eBinary logistic regression analysis of indicator for axSpA disease activity\u003c/b\u003e \u003c/p\u003e \u003cp\u003eBinary logistic regression analysis was used to identify the associated factors for axSpA disease activity. And the results revealed that TC/HDL-c was an independent indicator for axSpA disease activity (EXP (β) = 1.626, 95% CI: 1.128-2.343, \u003cem\u003eP\u003c/em\u003e\u0026lt; 0.05) \u003cb\u003e(Table6)\u003c/b\u003e.\u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eDespite the rapid development of new medical treatments, axSpA patients with persistent high disease activity may suffer from joint fusion and disability. Much more biomarkers are needed to evaluate the axSpA disease activity. In the present study, HDL-c decreased in axSpA patients. TC/HDL-c increased in axSpA of active group, showing a positive correlation with BASDAI. TC/HDL-c possessed a high diagnostic value for axSpA of active group, which may be an independent indicator for axSpA disease activity.\u003c/p\u003e \u003cp\u003eLipids mediate the transmission of inflammatory signals by directly or indirectly engaging in signaling pathways \u003csup\u003e[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]\u003c/sup\u003e. The cholesterol efflux capacity of HDL-c was negatively correlated with systemic inflammation \u003csup\u003e[\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]\u003c/sup\u003e. HDL-c prevents inflammation by inhibiting the expression of endothelial cell adhesion molecules \u003csup\u003e[\u003cspan additionalcitationids=\"CR15 CR16\" citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]\u003c/sup\u003e. In the present study, HDL-c decreased in axSpA patients, showing a negative correlation to BASDAI. The AUC value of HDL-c for axSpA was 0.752(CI95%: 0.693-0.811). The results were consistent with the previous studies \u003csup\u003e[\u003cspan additionalcitationids=\"CR19 CR20 CR21\" citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]\u003c/sup\u003e. However, the correlations between TC, TG and BASDAI, BASFI were not significant.\u003c/p\u003e \u003cp\u003eCurrently, atherosclerosis has been recognized as a chronic inflammatory disease. AxSpA also belongs to a chronic inflammatory disease. The synthesis of a large number of inflammatory factors, such as interleukin -1(IL-1), interleukin -6 (IL-6), and tumor necrosis factor-α (TNF-α), greatly increases the possibility of atherosclerosis. The increased incidence of cardiovascular disease in axSpA patients was well characterized. Recent systematic review and meta-analysis revealed that comorbidities such as hyperlipidemia (17%) was common in axSpA, which led to a poor prognosis \u003csup\u003e[\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]\u003c/sup\u003e. Dyslipidemia was a recognized modifiable cardiovascular risk \u003csup\u003e[\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]\u003c/sup\u003e. In our study, the role of TC/HDL-c, TC/HDL-c, and LDL-c/HDL-c were investigated. The results indicated that TC/HDL-c and LDL-c/HDL-c elevated in active axSpA group. The AUC of TC/HDL-c was higher than other variables. TC/HDL-c and LDL-c/HDL-c were all positively correlated with BASDAI. The AUC of TC/HDL-c for axSpA of active group was higher than other variables. Logistic regression analysis results suggested that TC/HDL-c was an independent indicator for axSpA disease activity. It was reported that the benefits of statin are derived from decreasing in TC levels and increasing in HDL-c \u003csup\u003e[\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]\u003c/sup\u003e. Our results showed that the increase of TC/HDL-c in active axSpA patients provides clinical evidence for statins to use in axSpA to improve lipid profiles. It is the first time to describe the clinical significance of HDL-c and TC/HDL-c for axSpA in our study.\u003c/p\u003e \u003cp\u003eIt was public knowledged that CRP and ESR were traditional biomarker of axSpA disease activity. In our study, CRP and ESR increased in active group of axSpA. CRP and ESR were positively correlated with BASDAI and BASFI. It was consistent with the previous studies \u003csup\u003e[\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]\u003c/sup\u003e. However, ROC curves showed that the AUC of ESR for axSpA of active group were lower than TC/HDL-c. Logistic regression analysis suggested that ESR were not independent indicator for axSpA disease activity, compared with other variables. Although TC/HDL-c would not be a specific marker of axSpA, TC/HDL-c was superior to ESR in assessing disease activity of axSpA. It indicated that TC/HDL-c in combination with CRP and ESR may help to assess disease activity of axSpA more accurately.\u003c/p\u003e \u003cp\u003eIn conclusion, HDL-c was decreased in axSpA patients with a highest diagnostic value, compared with healthy control. TC/HDL-c was elevated in axSpA of active group, yielding a high diagnostic value and showing a significant correlation to the disease activity of axSpA. TC/HDL-c may be a novel and reliable indicator for axSpA disease activity. The result suggested that the serum lipid changed regularly in axSpA patients, especially in axSpA patients with high disease activity.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was funded\u0026nbsp;by\u0026nbsp;Science\u0026nbsp;and\u0026nbsp;Technology\u0026nbsp;Projects\u0026nbsp;in\u0026nbsp;Guangzhou, China (No. 202102020127, 202102080321).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe sincerely thank the researchers and participants in the study. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflict of interest\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no conflicts of interest in this work.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eRobinson PC, van der Linden S, Khan MA, Taylor WJ. Axial spondyloarthritis: concept, construct, classification and implications for therapy. Nat Rev Rheumatol. 2021;17(2):109\u0026ndash;18.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSieper J, Poddubnyy D. Axial spondyloarthritis. Lancet. 2017;390(10089):73\u0026ndash;84.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTaurog JD, Chhabra A, Colbert RA. Ankylosing Spondylitis and Axial Spondyloarthritis. N Engl J Med. 2016;374(26):2563\u0026ndash;74.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003evan der Heijde D, Ramiro S, Landew\u0026eacute; R, et al. 2016 update of the ASAS-EULAR management recommendations for axial spondyloarthritis. Ann Rheum Dis. 2017;76(6):978\u0026ndash;91.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJarc E, Petan T. A twist of FATe: Lipid droplets and inflammatory lipid mediators. Biochimie. 2020;169:69\u0026ndash;87.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFerence BA, Graham I, Tokgozoglu L, Catapano AL. Impact of Lipids on Cardiovascular Health: JACC Health Promotion Series. J Am Coll Cardiol. 2018;72(10):1141\u0026ndash;56.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRosenson RS, Brewer HB Jr, Ansell BJ, et al. Dysfunctional HDL and atherosclerotic cardiovascular disease. Nat Rev Cardiol. 2016;13(1):48\u0026ndash;60.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSharrett AR, Ballantyne CM, Coady SA, et al. Coronary heart disease prediction from lipoprotein cholesterol levels, triglycerides, lipoprotein(a), apolipoproteins A-I and B, and HDL density subfractions: The Atherosclerosis Risk in Communities (ARIC) Study. Circulation. 2001;104(10):1108\u0026ndash;13.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHaroon NN, Paterson JM, Li P, Inman RD, Haroon N. Patients With Ankylosing Spondylitis Have Increased Cardiovascular and Cerebrovascular Mortality: A Population-Based Study. Ann Intern Med. 2015;163(6):409\u0026ndash;16.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRueda-Gotor J, Corrales A, Blanco R, et al. Atherosclerotic disease in axial spondyloarthritis: increased frequency of carotid plaques. Clin Exp Rheumatol. 2015;33(3):315\u0026ndash;20.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eB\u0026auml;ck M, Yurdagul A Jr, Tabas I, \u0026Ouml;\u0026ouml;rni K, Kovanen PT. Inflammation and its resolution in atherosclerosis: mediators and therapeutic opportunities. Nat Rev Cardiol. 2019;16(7):389\u0026ndash;406.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZeidler H, Amor B. The Assessment in Spondyloarthritis International Society (ASAS) classification criteria for peripheral spondyloarthritis and for spondyloarthritis in general: the spondyloarthritis concept in progress. Ann Rheum Dis. 2011;70(1):1\u0026ndash;3.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCharles-Schoeman C, Lee YY, Grijalva V, et al. Cholesterol efflux by high density lipoproteins is impaired in patients with active rheumatoid arthritis. Ann Rheum Dis. 2012;71(7):1157\u0026ndash;62.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eToth PP. Reverse cholesterol transport: high-density lipoprotein's magnificent mile. Curr Atheroscler Rep. 2003;5(5):386\u0026ndash;93.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eToth PP. Reducing cardiovascular risk by targeting high-density lipoprotein cholesterol. Curr Atheroscler Rep. 2007;9(1):81\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKingwell BA, Chapman MJ, Kontush A, Miller NE. HDL-targeted therapies: progress, failures and future. Nat Rev Drug Discov. 2014;13(6):445\u0026ndash;64.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMaxfield FR, W\u0026uuml;stner D. Intracellular cholesterol transport. J Clin Invest. 2002;110(7):891\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003evan Halm VP, van Denderen JC, Peters MJ, et al. Increased disease activity is associated with a deteriorated lipid profile in patients with ankylosing spondylitis. Ann Rheum Dis. 2006;65(11):1473\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMathieu S, Gossec L, Dougados M, Soubrier M. Cardiovascular profile in ankylosing spondylitis: a systematic review and meta-analysis. Arthritis Care Res (Hoboken). 2011;63(4):557\u0026ndash;63.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDivecha H, Sattar N, Rumley A, Cherry L, Lowe GD, Sturrock R. Cardiovascular risk parameters in men with ankylosing spondylitis in comparison with non-inflammatory control subjects: relevance of systemic inflammation. Clin Sci (Lond). 2005;109(2):171\u0026ndash;6.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003evan Eijk IC, Peters MJ, Sern\u0026eacute; EH, et al. Microvascular function is impaired in ankylosing spondylitis and improves after tumour necrosis factor alpha blockade. Ann Rheum Dis. 2009;68(3):362\u0026ndash;6.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGordon DJ, Probstfield JL, Garrison RJ, et al. High-density lipoprotein cholesterol and cardiovascular disease. Four prospective American studies. Circulation. 1989;79(1):8\u0026ndash;15.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZhao SS, Robertson S, Reich T, Harrison NL, Moots RJ, Goodson NJ. Prevalence and impact of comorbidities in axial spondyloarthritis: systematic review and meta-analysis. Rheumatology. 2020;59(Suppl4):iv47\u0026ndash;57.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBea AM, Civeira F, Jarauta E, et al. Association Between the Presence of Carotid Artery Plaque and Cardiovascular Events in Patients With Genetic Hypercholesterolemia. Rev Esp Cardiol (Engl Ed). 2017;70(7):551\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNicholls SJ, Tuzcu EM, Sipahi I, et al. Statins, high-density lipoprotein cholesterol, and regression of coronary atherosclerosis. Jama. 2007;297(5):499\u0026ndash;508.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eChen CH, Chen HA, Liao HT, Liu CH, Tsai CY, Chou CT. The clinical usefulness of ESR, CRP, and disease duration in ankylosing spondylitis: the product of these acute-phase reactants and disease duration is associated with patient's poor physical mobility. Rheumatol Int. 2015;35(7):1263\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003e\u003cstrong\u003eTable 1. Basic characteristics between axSpA patients and healthy controls\u003c/strong\u003e\u003c/p\u003e\n\u003cdiv align=\"left\"\u003e\n \u003ctable border=\"1\" cellpadding=\"0\" cellspacing=\"0\" width=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"27.435064935064936%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"28.40909090909091%\"\u003e\n \u003cp\u003e\u003cstrong\u003eControl group (n=71)\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"28.40909090909091%\"\u003e\n \u003cp\u003e\u003cstrong\u003eaxSpA group\u003c/strong\u003e\u003cstrong\u003e（\u003c/strong\u003e\u003cstrong\u003en=205\u003c/strong\u003e\u003cstrong\u003e）\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.746753246753247%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eP\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003evalue\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"27.435064935064936%\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge(years)\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"28.40909090909091%\"\u003e\n \u003cp\u003e31.00(29.00,35.00)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"28.40909090909091%\"\u003e\n \u003cp\u003e30.00(25.00,36.00)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.746753246753247%\"\u003e\n \u003cp\u003e0.076\u003c/p\u003e\n \u003cp\u003e0.063\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"27.435064935064936%\"\u003e\n \u003cp\u003e\u003cstrong\u003eSex(male/female)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"28.40909090909091%\"\u003e\n \u003cp\u003e52/19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"28.40909090909091%\"\u003e\n \u003cp\u003e35/170\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.746753246753247%\"\u003e\n \u003cp\u003e0.063\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"27.435064935064936%\"\u003e\n \u003cp\u003e\u003cstrong\u003eTC (mmol/L)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"28.40909090909091%\"\u003e\n \u003cp\u003e4.79(4.30,5.32)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"28.40909090909091%\"\u003e\n \u003cp\u003e3.99(3.57,4.64)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.746753246753247%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"27.435064935064936%\"\u003e\n \u003cp\u003e\u003cstrong\u003eTG (mmol/L\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"28.40909090909091%\"\u003e\n \u003cp\u003e1.14(0.88,1.53)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"28.40909090909091%\"\u003e\n \u003cp\u003e0.86(0.62,1.20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.746753246753247%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"27.435064935064936%\"\u003e\n \u003cp\u003e\u003cstrong\u003eLDL-c(mmol/L)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"28.40909090909091%\"\u003e\n \u003cp\u003e2.71(2.07,3.11)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"28.40909090909091%\"\u003e\n \u003cp\u003e2.38(1.96,2.94)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.746753246753247%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.027\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"27.435064935064936%\"\u003e\n \u003cp\u003e\u003cstrong\u003eHDL-c(mmol/L)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"28.40909090909091%\"\u003e\n \u003cp\u003e1.23(1.10,1.42)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"28.40909090909091%\"\u003e\n \u003cp\u003e1.03(0.90,1.20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.746753246753247%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"27.435064935064936%\"\u003e\n \u003cp\u003e\u003cstrong\u003eTC/HDL-c\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"28.40909090909091%\"\u003e\n \u003cp\u003e3.89(3.26,4.25)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"28.40909090909091%\"\u003e\n \u003cp\u003e4.01(3.55,4.46)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.746753246753247%\"\u003e\n \u003cp\u003e0.132\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"27.435064935064936%\"\u003e\n \u003cp\u003e\u003cstrong\u003eTG/HDL-c\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"28.40909090909091%\"\u003e\n \u003cp\u003e0.94(0.72,1.21)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"28.40909090909091%\"\u003e\n \u003cp\u003e0.85(0.61,1.17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.746753246753247%\"\u003e\n \u003cp\u003e0.154\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"27.435064935064936%\"\u003e\n \u003cp\u003e\u003cstrong\u003eLDL-c/HDL-c\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"28.40909090909091%\"\u003e\n \u003cp\u003e2.13\u0026plusmn;0.62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"28.40909090909091%\"\u003e\n \u003cp\u003e2.35\u0026plusmn;0.74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.746753246753247%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.022\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"27.435064935064936%\"\u003e\n \u003cp\u003e\u003cstrong\u003eBASDAI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"28.40909090909091%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"28.40909090909091%\"\u003e\n \u003cp\u003e4.80(4.40,5.70)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.746753246753247%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"27.435064935064936%\"\u003e\n \u003cp\u003e\u003cstrong\u003eBASFI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"28.40909090909091%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"28.40909090909091%\"\u003e\n \u003cp\u003e2.20(0.80,3.40)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.746753246753247%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eTC, total cholesterol;\u0026nbsp;TG, triglycerides; HDL-c, high-density lipoprotein cholesterol; TC/HDL-c,\u0026nbsp;total cholesterol-high-density lipoprotein cholesterol ratio; TG/HDL-c, triglycerides-high-density lipoprotein cholesterol ratio; LDL-c/HDL-c, low-density lipoprotein cholesterol-high-density lipoprotein cholesterol ratio; BASDAI, Bath Ankylosing Spondylitis Disease Activity Index; BASFI, Bath Ankylosing Spondylitis Functional Index\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2. The diagnostic value of serum lipid parameters for axSpA using ROC cures\u003c/strong\u003e\u003c/p\u003e\n\u003cdiv align=\"center\"\u003e\n \u003ctable border=\"1\" cellpadding=\"0\" cellspacing=\"0\" width=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"19.967532467532468%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.967532467532468%\"\u003e\n \u003cp\u003e\u003cstrong\u003eAUC (CI95%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.227272727272727%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eP\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"14.123376623376624%\"\u003e\n \u003cp\u003e\u003cstrong\u003eOptimal cut off value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.064935064935066%\"\u003e\n \u003cp\u003e\u003cstrong\u003eYouden index\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.14935064935065%\"\u003e\n \u003cp\u003e\u003cstrong\u003eSensitivity\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"12.5%\"\u003e\n \u003cp\u003e\u003cstrong\u003eSpecificity\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"19.967532467532468%\"\u003e\n \u003cp\u003e\u003cstrong\u003eTC (mmol/L)\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eTG (mmol/L)\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eLDL-c(mmol/L)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.967532467532468%\"\u003e\n \u003cp\u003e0.728(0.662-0.793)\u003c/p\u003e\n \u003cp\u003e0.668(0.599-0.737)\u003c/p\u003e\n \u003cp\u003e0.588(0.509-0.667)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.227272727272727%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e＜\u003c/strong\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e0.027\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"14.123376623376624%\"\u003e\n \u003cp\u003e4.200\u003c/p\u003e\n \u003cp\u003e0.960\u003c/p\u003e\n \u003cp\u003e2.700\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.064935064935066%\"\u003e\n \u003cp\u003e0.403\u003c/p\u003e\n \u003cp\u003e0.303\u003c/p\u003e\n \u003cp\u003e0.214\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.14935064935065%\"\u003e\n \u003cp\u003e80.3%\u003c/p\u003e\n \u003cp\u003e58.5%\u003c/p\u003e\n \u003cp\u003e50.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"12.5%\"\u003e\n \u003cp\u003e60.0%\u003c/p\u003e\n \u003cp\u003e71.8%\u003c/p\u003e\n \u003cp\u003e70.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"19.967532467532468%\"\u003e\n \u003cp\u003e\u003cstrong\u003eHDL-c(mmol/L)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.967532467532468%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.752(0.693-0.811) \u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.227272727272727%\"\u003e\n \u003cp\u003e\u003cstrong\u003e＜\u003c/strong\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"14.123376623376624%\"\u003e\n \u003cp\u003e1.075\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.064935064935066%\"\u003e\n \u003cp\u003e0.432\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.14935064935065%\"\u003e\n \u003cp\u003e62.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"12.5%\"\u003e\n \u003cp\u003e80.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"19.967532467532468%\"\u003e\n \u003cp\u003e\u003cstrong\u003eTC/HDL-c\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eTG/HDL-c\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.967532467532468%\"\u003e\n \u003cp\u003e0.560(0.484-0.636)\u003c/p\u003e\n \u003cp\u003e0.557(0.481-0.633)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.227272727272727%\"\u003e\n \u003cp\u003e0.132\u003c/p\u003e\n \u003cp\u003e0.154\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"14.123376623376624%\"\u003e\n \u003cp\u003e4.268\u003c/p\u003e\n \u003cp\u003e0.885\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.064935064935066%\"\u003e\n \u003cp\u003e0.136\u003c/p\u003e\n \u003cp\u003e0.152\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.14935064935065%\"\u003e\n \u003cp\u003e36.1%\u003c/p\u003e\n \u003cp\u003e62.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"12.5%\"\u003e\n \u003cp\u003e77.5%\u003c/p\u003e\n \u003cp\u003e53.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"19.967532467532468%\"\u003e\n \u003cp\u003e\u003cstrong\u003eLDL-c/HDL-c\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.967532467532468%\"\u003e\n \u003cp\u003e0.607(0.534-0.681)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.227272727272727%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.007\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"14.123376623376624%\"\u003e\n \u003cp\u003e2.528\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.064935064935066%\"\u003e\n \u003cp\u003e0.183\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.14935064935065%\"\u003e\n \u003cp\u003e38.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"12.5%\"\u003e\n \u003cp\u003e80.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eTC, total cholesterol; TG, triglycerides; HDL-c, high-density lipoprotein cholesterol; TC/HDL-c,\u0026nbsp;total cholesterol-high-density lipoprotein cholesterol ratio; TG/HDL-c, triglycerides-high-density lipoprotein cholesterol ratio; LDL-c/HDL-c, low-density lipoprotein cholesterol-high-density lipoprotein cholesterol ratio\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3. Associations of serum lipid parameters with disease activity indexes in axSpA patients.\u003c/strong\u003e\u003c/p\u003e\n\u003cdiv align=\"left\"\u003e\n \u003ctable border=\"1\" cellpadding=\"0\" cellspacing=\"0\" width=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"19.412724306688418%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" width=\"19.412724306688418%\"\u003e\n \u003cp\u003e\u003cstrong\u003eBASDAI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" width=\"20.0652528548124%\"\u003e\n \u003cp\u003e\u003cstrong\u003eBASFI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" width=\"20.554649265905383%\"\u003e\n \u003cp\u003e\u003cstrong\u003eCRP\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" width=\"20.554649265905383%\"\u003e\n \u003cp\u003e\u003cstrong\u003eESR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"19.444444444444443%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.823529411764707%\"\u003e\n \u003cp\u003e\u003cstrong\u003er\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.620915032679738%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eP\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.130718954248366%\"\u003e\n \u003cp\u003e\u003cstrong\u003er\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.803921568627452%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eP\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" width=\"10.294117647058824%\"\u003e\n \u003cp\u003e\u003cstrong\u003er\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.294117647058824%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eP\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003evalue\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.620915032679738%\"\u003e\n \u003cp\u003e\u003cstrong\u003er\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.967320261437909%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eP\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003evalue\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"19.444444444444443%\"\u003e\n \u003cp\u003e\u003cstrong\u003eTC (mmo/L)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.823529411764707%\"\u003e\n \u003cp\u003e-0.014\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.620915032679738%\"\u003e\n \u003cp\u003e0.842\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.130718954248366%\"\u003e\n \u003cp\u003e-0.005\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.803921568627452%\"\u003e\n \u003cp\u003e0.942\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" width=\"10.294117647058824%\"\u003e\n \u003cp\u003e-0.227\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.294117647058824%\"\u003e\n \u003cp\u003e\u003cstrong\u003e＜\u003c/strong\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.620915032679738%\"\u003e\n \u003cp\u003e-0.148\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.967320261437909%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.020\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"19.444444444444443%\"\u003e\n \u003cp\u003e\u003cstrong\u003eTG (mmol/L)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.823529411764707%\"\u003e\n \u003cp\u003e-0.014\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.620915032679738%\"\u003e\n \u003cp\u003e0.839\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.130718954248366%\"\u003e\n \u003cp\u003e0.030\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.803921568627452%\"\u003e\n \u003cp\u003e0.686\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" width=\"10.294117647058824%\"\u003e\n \u003cp\u003e-0.171\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.294117647058824%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.007\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.620915032679738%\"\u003e\n \u003cp\u003e-0.217\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.967320261437909%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"19.444444444444443%\"\u003e\n \u003cp\u003e\u003cstrong\u003eLDL-c(mmol/L)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.823529411764707%\"\u003e\n \u003cp\u003e0.018\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.620915032679738%\"\u003e\n \u003cp\u003e0.797\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.130718954248366%\"\u003e\n \u003cp\u003e0.006\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.803921568627452%\"\u003e\n \u003cp\u003e0.941\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" width=\"10.294117647058824%\"\u003e\n \u003cp\u003e-0.030\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.294117647058824%\"\u003e\n \u003cp\u003e0.639\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.620915032679738%\"\u003e\n \u003cp\u003e-0.012\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.967320261437909%\"\u003e\n \u003cp\u003e0.857\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"19.444444444444443%\"\u003e\n \u003cp\u003e\u003cstrong\u003eHDL-c(mmol/L)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.823529411764707%\"\u003e\n \u003cp\u003e-0.153\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.620915032679738%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.029\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.130718954248366%\"\u003e\n \u003cp\u003e-0.146\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.803921568627452%\"\u003e\n \u003cp\u003e0.051\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" width=\"10.294117647058824%\"\u003e\n \u003cp\u003e\u003cstrong\u003e-0.423\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.294117647058824%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.620915032679738%\"\u003e\n \u003cp\u003e-0.307\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.967320261437909%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"19.444444444444443%\"\u003e\n \u003cp\u003e\u003cstrong\u003eTC/HDL-c\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.823529411764707%\"\u003e\n \u003cp\u003e0.179\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.620915032679738%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.010\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.130718954248366%\"\u003e\n \u003cp\u003e0.149\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.803921568627452%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.047\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" width=\"10.294117647058824%\"\u003e\n \u003cp\u003e0.194\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.294117647058824%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.002\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.620915032679738%\"\u003e\n \u003cp\u003e0.185\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.967320261437909%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.004\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"19.444444444444443%\"\u003e\n \u003cp\u003e\u003cstrong\u003eTG/HDL-c\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.823529411764707%\"\u003e\n \u003cp\u003e0.065\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.620915032679738%\"\u003e\n \u003cp\u003e0.352\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.130718954248366%\"\u003e\n \u003cp\u003e0.088\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.803921568627452%\"\u003e\n \u003cp\u003e0.242\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" width=\"10.294117647058824%\"\u003e\n \u003cp\u003e0.009\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.294117647058824%\"\u003e\n \u003cp\u003e0.885\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.620915032679738%\"\u003e\n \u003cp\u003e-0.079\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.967320261437909%\"\u003e\n \u003cp\u003e0.215\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"19.444444444444443%\"\u003e\n \u003cp\u003e\u003cstrong\u003eLDL-c/HDL-c\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.823529411764707%\"\u003e\n \u003cp\u003e0.144\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.620915032679738%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.040\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.130718954248366%\"\u003e\n \u003cp\u003e0.093\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.803921568627452%\"\u003e\n \u003cp\u003e0.216\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" width=\"10.294117647058824%\"\u003e\n \u003cp\u003e0.225\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.294117647058824%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.620915032679738%\"\u003e\n \u003cp\u003e0.209\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.967320261437909%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"19.444444444444443%\"\u003e\n \u003cp\u003e\u003cstrong\u003eCRP (mg/L)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.823529411764707%\"\u003e\n \u003cp\u003e0.257\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.620915032679738%\"\u003e\n \u003cp\u003e\u003cstrong\u003e＜\u003c/strong\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.130718954248366%\"\u003e\n \u003cp\u003e0.310\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.803921568627452%\"\u003e\n \u003cp\u003e\u003cstrong\u003e＜\u003c/strong\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" width=\"10.294117647058824%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.294117647058824%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.620915032679738%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.746\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.967320261437909%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"19.444444444444443%\"\u003e\n \u003cp\u003e\u003cstrong\u003eESR (mm/h)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.823529411764707%\"\u003e\n \u003cp\u003e0.257\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.620915032679738%\"\u003e\n \u003cp\u003e\u003cstrong\u003e＜\u003c/strong\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.130718954248366%\"\u003e\n \u003cp\u003e0.296\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.803921568627452%\"\u003e\n \u003cp\u003e\u003cstrong\u003e＜\u003c/strong\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" width=\"10.294117647058824%\"\u003e\n \u003cp\u003e0.746\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.294117647058824%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.620915032679738%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.967320261437909%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eTC, total cholesterol; TG, triglycerides; HDL-c, high-density lipoprotein cholesterol; TC/HDL-c,\u0026nbsp;total cholesterol-high-density lipoprotein cholesterol ratio; TG/HDL-c, triglycerides-high-density lipoprotein cholesterol ratio; LDL-c/HDL-c, low-density lipoprotein cholesterol-high-density lipoprotein cholesterol ratio; ESR, erythrocyte sedimentation rate; CRP, C-reactive protein; BASDAI, Bath Ankylosing Spondylitis Disease Activity Index; BASFI, Bath Ankylosing Spondylitis Functional Index\u003c/p\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 4. Comparison of serum lipid parameters between axSpA of active group and remission group\u003c/strong\u003e\u003c/p\u003e\n\u003cdiv align=\"left\"\u003e\n \u003ctable border=\"1\" cellpadding=\"0\" cellspacing=\"0\" width=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.837662337662337%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.33116883116883%\"\u003e\n \u003cp\u003e\u003cstrong\u003eRemission axSpA (n=122)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.844155844155843%\"\u003e\n \u003cp\u003e\u003cstrong\u003eActive axSpA\u003c/strong\u003e\u003cstrong\u003e（\u003c/strong\u003e\u003cstrong\u003en=83\u003c/strong\u003e\u003cstrong\u003e）\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.987012987012987%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eP\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"24.837662337662337%\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge(years)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"31.33116883116883%\"\u003e\n \u003cp\u003e29.50(24.00,35.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"30.844155844155843%\"\u003e\n \u003cp\u003e30.00(25.00,37.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"12.987012987012987%\"\u003e\n \u003cp\u003e0.350\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"24.837662337662337%\"\u003e\n \u003cp\u003e\u003cstrong\u003eSex(male/female)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"31.33116883116883%\"\u003e\n \u003cp\u003e103/19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"30.844155844155843%\"\u003e\n \u003cp\u003e67/16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"12.987012987012987%\"\u003e\n \u003cp\u003e0.489\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"24.837662337662337%\"\u003e\n \u003cp\u003e\u003cstrong\u003eTC (mmol/L)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"31.33116883116883%\"\u003e\n \u003cp\u003e3.98(3.53,4.66)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"30.844155844155843%\"\u003e\n \u003cp\u003e4.00(3.58,4.61)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"12.987012987012987%\"\u003e\n \u003cp\u003e0.853\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"24.837662337662337%\"\u003e\n \u003cp\u003e\u003cstrong\u003eTG (mmol/L)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"31.33116883116883%\"\u003e\n \u003cp\u003e0.88(0.61,1.24)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"30.844155844155843%\"\u003e\n \u003cp\u003e0.80(0.63,1.18)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"12.987012987012987%\"\u003e\n \u003cp\u003e0.752\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"24.837662337662337%\"\u003e\n \u003cp\u003e\u003cstrong\u003eLDL-c(mmol/L)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"31.33116883116883%\"\u003e\n \u003cp\u003e2.39(1.90,2.96)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"30.844155844155843%\"\u003e\n \u003cp\u003e2.37(2.03,2.82)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"12.987012987012987%\"\u003e\n \u003cp\u003e0.601\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"24.837662337662337%\"\u003e\n \u003cp\u003e\u003cstrong\u003eHDL-c(mmol/L)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"31.33116883116883%\"\u003e\n \u003cp\u003e1.04(0.93,1.22)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"30.844155844155843%\"\u003e\n \u003cp\u003e0.99(0.86,1.17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"12.987012987012987%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.042\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"24.837662337662337%\"\u003e\n \u003cp\u003e\u003cstrong\u003eTC/HDL-c\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"31.33116883116883%\"\u003e\n \u003cp\u003e3.84\u0026plusmn;0.92\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"30.844155844155843%\"\u003e\n \u003cp\u003e4.20\u0026plusmn;0.75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"12.987012987012987%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.003\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"24.837662337662337%\"\u003e\n \u003cp\u003e\u003cstrong\u003eTG/HDL-c\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"31.33116883116883%\"\u003e\n \u003cp\u003e0.86(0.58,1.17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"30.844155844155843%\"\u003e\n \u003cp\u003e0.84(0.66,1.18)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"12.987012987012987%\"\u003e\n \u003cp\u003e0.487\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"24.837662337662337%\"\u003e\n \u003cp\u003e\u003cstrong\u003eLDL-c/HDL-c\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"31.33116883116883%\"\u003e\n \u003cp\u003e2.25\u0026plusmn;0.76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"30.844155844155843%\"\u003e\n \u003cp\u003e2.51\u0026plusmn;0.68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"12.987012987012987%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.011\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"24.837662337662337%\"\u003e\n \u003cp\u003e\u003cstrong\u003eCRP (mg/L)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"31.33116883116883%\"\u003e\n \u003cp\u003e7.83(3.14,23.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"30.844155844155843%\"\u003e\n \u003cp\u003e18.30(6.55,32.25)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"12.987012987012987%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"24.837662337662337%\"\u003e\n \u003cp\u003e\u003cstrong\u003eESR (mm/L)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"31.33116883116883%\"\u003e\n \u003cp\u003e20.00(10.00,40.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"30.844155844155843%\"\u003e\n \u003cp\u003e31.00(16.50,50.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"12.987012987012987%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.006\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"24.837662337662337%\"\u003e\n \u003cp\u003e\u003cstrong\u003eBASDAI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"31.33116883116883%\"\u003e\n \u003cp\u003e2.00(1.00,3.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"30.844155844155843%\"\u003e\n \u003cp\u003e4.80(4.40,5.70)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"12.987012987012987%\"\u003e\n \u003cp\u003e\u003cstrong\u003e＜\u003c/strong\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"24.837662337662337%\"\u003e\n \u003cp\u003e\u003cstrong\u003eBASFI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"31.33116883116883%\"\u003e\n \u003cp\u003e0.30(0.00,1.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"30.844155844155843%\"\u003e\n \u003cp\u003e2.20(0.80,3.40)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"12.987012987012987%\"\u003e\n \u003cp\u003e\u003cstrong\u003e＜\u003c/strong\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eTC, total cholesterol; TG, triglycerides; HDL-c, high-density lipoprotein cholesterol; TC/HDL-c,\u0026nbsp;total cholesterol-high-density lipoprotein cholesterol ratio; TG/HDL-c, triglycerides-high-density lipoprotein cholesterol ratio; LDL-c/HDL-c, low-density lipoprotein cholesterol-high-density lipoprotein cholesterol ratio; ESR, erythrocyte sedimentation rate; CRP, C-reactive protein; BASDAI, Bath Ankylosing Spondylitis Disease Activity Index; BASFI, Bath Ankylosing Spondylitis Functional Index\u003c/p\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 5. The diagnostic value of serum lipid parameters, CRP and ESR for axSpA of active group using ROC cures\u003c/strong\u003e\u003c/p\u003e\n\u003cdiv align=\"left\"\u003e\n \u003ctable border=\"1\" cellpadding=\"0\" cellspacing=\"0\" width=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"16.44736842105263%\"\u003e\n \u003cp\u003e\u003cstrong\u003eParameters\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" width=\"20.723684210526315%\"\u003e\n \u003cp\u003e\u003cstrong\u003eAUC(CI95%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" width=\"9.210526315789474%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eP\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" width=\"15.460526315789474%\"\u003e\n \u003cp\u003e\u003cstrong\u003eOptimal cut off value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" width=\"10.855263157894736%\"\u003e\n \u003cp\u003e\u003cstrong\u003eYouden index\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" width=\"13.980263157894736%\"\u003e\n \u003cp\u003e\u003cstrong\u003eSensitivity\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" width=\"13.322368421052632%\"\u003e\n \u003cp\u003e\u003cstrong\u003eSpecificity\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" width=\"18.555008210180624%\"\u003e\n \u003cp\u003e\u003cstrong\u003eTC (mmol/L)\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eTG (mmol/L)\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eLDL-c(mmol/L)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" width=\"21.67487684729064%\"\u003e\n \u003cp\u003e0.616(0.539,0.694)\u003c/p\u003e\n \u003cp\u003e0.513(0.432-0.594)\u003c/p\u003e\n \u003cp\u003e0.522(0.441-0.602)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" width=\"10.344827586206897%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.005\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e0.752\u003c/p\u003e\n \u003cp\u003e0.601\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" width=\"12.479474548440066%\"\u003e\n \u003cp\u003e5.70\u003c/p\u003e\n \u003cp\u003e0.795\u003c/p\u003e\n \u003cp\u003e1.805\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" width=\"10.344827586206897%\"\u003e\n \u003cp\u003e0.071\u003c/p\u003e\n \u003cp\u003e0.101\u003c/p\u003e\n \u003cp\u003e0.084\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" width=\"13.793103448275861%\"\u003e\n \u003cp\u003e9.60%\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;49.4%\u003c/p\u003e\n \u003cp\u003e90.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"12.807881773399014%\"\u003e\n \u003cp\u003e97.5%\u003c/p\u003e\n \u003cp\u003e60.7%\u003c/p\u003e\n \u003cp\u003e18.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" width=\"18.555008210180624%\"\u003e\n \u003cp\u003e\u003cstrong\u003eHDL-c(mmol/L)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" width=\"21.67487684729064%\"\u003e\n \u003cp\u003e0.584(0.503-0.664)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" width=\"10.344827586206897%\"\u003e\n \u003cp\u003e0.420\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" width=\"12.479474548440066%\"\u003e\n \u003cp\u003e0.955\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" width=\"10.344827586206897%\"\u003e\n \u003cp\u003e0.162\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" width=\"13.793103448275861%\"\u003e\n \u003cp\u003e\u0026nbsp;48.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"12.807881773399014%\"\u003e\n \u003cp\u003e68.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" width=\"18.555008210180624%\"\u003e\n \u003cp\u003e\u003cstrong\u003eTC/HDL-c\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eTG/HDL-c\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" width=\"21.67487684729064%\"\u003e\n \u003cp\u003e0.616(0.539-0.694)\u003c/p\u003e\n \u003cp\u003e0.529(0.449-0.608)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" width=\"10.344827586206897%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.005\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e0.487\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" width=\"12.479474548440066%\"\u003e\n \u003cp\u003e4.218\u003c/p\u003e\n \u003cp\u003e0.528\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" width=\"10.344827586206897%\"\u003e\n \u003cp\u003e0.195\u003c/p\u003e\n \u003cp\u003e0.117\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" width=\"13.793103448275861%\"\u003e\n \u003cp\u003e\u0026nbsp;50.6%\u003c/p\u003e\n \u003cp\u003e90.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"12.807881773399014%\"\u003e\n \u003cp\u003e68.9%\u003c/p\u003e\n \u003cp\u003e21.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" width=\"18.555008210180624%\"\u003e\n \u003cp\u003e\u003cstrong\u003eLDL-c/HDL-c\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" width=\"21.67487684729064%\"\u003e\n \u003cp\u003e0.600(0.523-0.678)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" width=\"10.344827586206897%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.015\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" width=\"12.479474548440066%\"\u003e\n \u003cp\u003e2.371\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" width=\"10.344827586206897%\"\u003e\n \u003cp\u003e0.192\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" width=\"13.793103448275861%\"\u003e\n \u003cp\u003e\u0026nbsp;60.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"12.807881773399014%\"\u003e\n \u003cp\u003e59.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" width=\"18.555008210180624%\"\u003e\n \u003cp\u003e\u003cstrong\u003eCRP\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" width=\"21.67487684729064%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.632(0.554-0.710)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" width=\"10.344827586206897%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" width=\"12.479474548440066%\"\u003e\n \u003cp\u003e11.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" width=\"10.344827586206897%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.285\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" width=\"13.793103448275861%\"\u003e\n \u003cp\u003e\u0026nbsp;71.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"12.807881773399014%\"\u003e\n \u003cp\u003e57.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" width=\"18.555008210180624%\"\u003e\n \u003cp\u003e\u003cstrong\u003eESR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" width=\"21.67487684729064%\"\u003e\n \u003cp\u003e0.614(0.537,0.690)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" width=\"10.344827586206897%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.006\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" width=\"12.479474548440066%\"\u003e\n \u003cp\u003e14.500\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" width=\"10.344827586206897%\"\u003e\n \u003cp\u003e0.236\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" width=\"13.793103448275861%\"\u003e\n \u003cp\u003e\u0026nbsp;84.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"12.807881773399014%\"\u003e\n \u003cp\u003e39.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eTC, total cholesterol; TG, triglycerides; HDL-c, high-density lipoprotein cholesterol; TC/HDL-c,\u0026nbsp;total cholesterol-high-density lipoprotein cholesterol ratio; TG/HDL-c, triglycerides-high-density lipoprotein cholesterol ratio; LDL-c/HDL-c, low-density lipoprotein cholesterol-high-density lipoprotein cholesterol ratio; ESR, erythrocyte sedimentation rate; CRP, C-reactive protein\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 6. Logistic regression analysis of independent indicator for axSpA disease activity\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\"\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd width=\"24.297520661157026%\"\u003e\n\u003cp\u003e\u003cstrong\u003eRisk factor\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"49.421487603305785%\"\u003e\n\u003cp\u003e\u003cstrong\u003eOR(CI95%)\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"26.28099173553719%\"\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eP\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;value\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"24.297520661157026%\"\u003e\n\u003cp\u003e\u003cstrong\u003eTC\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"49.421487603305785%\"\u003e\n\u003cp\u003e-\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"26.28099173553719%\"\u003e\n\u003cp\u003e0.991\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"24.297520661157026%\"\u003e\n\u003cp\u003e\u003cstrong\u003eTG\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"49.421487603305785%\"\u003e\n\u003cp\u003e-\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"26.28099173553719%\"\u003e\n\u003cp\u003e0.821\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"24.297520661157026%\"\u003e\n\u003cp\u003e\u003cstrong\u003eLDL-c\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"49.421487603305785%\"\u003e\n\u003cp\u003e\u003cstrong\u003e-\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"26.28099173553719%\"\u003e\n\u003cp\u003e0.557\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"24.297520661157026%\"\u003e\n\u003cp\u003e\u003cstrong\u003eHDL-c\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"49.421487603305785%\"\u003e\n\u003cp\u003e-\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"26.28099173553719%\"\u003e\n\u003cp\u003e0.587\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"24.297520661157026%\"\u003e\n\u003cp\u003e\u003cstrong\u003eTC/HDL-\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"49.421487603305785%\"\u003e\n\u003cp\u003e\u003cstrong\u003e1.626(1.128-2.343)\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"26.28099173553719%\"\u003e\n\u003cp\u003e\u003cstrong\u003e0.009\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"24.297520661157026%\"\u003e\n\u003cp\u003e\u003cstrong\u003eTG/HDL-c\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"49.421487603305785%\"\u003e\n\u003cp\u003e-\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"26.28099173553719%\"\u003e\n\u003cp\u003e0.672\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"24.297520661157026%\"\u003e\n\u003cp\u003e\u003cstrong\u003eLDL-C/HDL-c\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"49.421487603305785%\"\u003e\n\u003cp\u003e-\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"26.28099173553719%\"\u003e\n\u003cp\u003e0.599\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"24.297520661157026%\"\u003e\n\u003cp\u003e\u003cstrong\u003eCRP\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"49.421487603305785%\"\u003e\n\u003cp\u003e1.019(1.003-1.035)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"26.28099173553719%\"\u003e\n\u003cp\u003e\u003cstrong\u003e0.019\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"24.297520661157026%\"\u003e\n\u003cp\u003e\u003cstrong\u003eESR\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"49.421487603305785%\"\u003e\n\u003cp\u003e-\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"26.28099173553719%\"\u003e\n\u003cp\u003e0.637\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eTC, total cholesterol; TG, triglycerides; HDL-c, high-density lipoprotein cholesterol; TC/HDL-c, total cholesterol-high-density lipoprotein cholesterol ratio; TG/HDL-c, triglycerides-high-density lipoprotein cholesterol ratio; LDL-c/HDL-c, low-density lipoprotein cholesterol-high-density lipoprotein cholesterol ratio; ESR, erythrocyte sedimentation rate; CRP, C-reactive protein; BASDAI, Bath Ankylosing Spondylitis Disease Activity Index; BASFI, Bath Ankylosing Spondylitis Functional Index\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Axial Spondyloarthritis, total cholesterol to high-density lipoprotein cholesterol ratio, disease activity, biomarker ","lastPublishedDoi":"10.21203/rs.3.rs-960249/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-960249/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eObjectives:\u003c/strong\u003e 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.\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eMethods: \u003c/strong\u003eTwo 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.\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eResults: \u003c/strong\u003eTC, TG, LDL-c and HDL-c were lower in axSpA group, while LDL-c/HDL-c was higher (\u003cem\u003eP\u003c/em\u003e\u0026lt;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 (\u003cem\u003eP\u003c/em\u003e\u0026lt;0.05). TC/HDL-c was positively correlated with BASDAI, BASFI, CRP, and ESR (\u003cem\u003eP\u003c/em\u003e\u0026lt;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 (\u003cem\u003eP\u003c/em\u003e\u0026lt;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.\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eConclusions: \u003c/strong\u003eTC/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.\u003c/p\u003e","manuscriptTitle":"The Relationship Between TC/HDL-c and Disease Activity in Axial Spondyloarthritis Patients","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2021-10-20 16:30:13","doi":"10.21203/rs.3.rs-960249/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"d42fa24c-c743-4a54-b10b-0b4a0a71e990","owner":[],"postedDate":"October 20th, 2021","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":7980316,"name":"Cardiac \u0026 Cardiovascular Systems"},{"id":7980317,"name":"Endocrinology \u0026 Metabolism"}],"tags":[],"updatedAt":"2021-11-20T22:19:31+00:00","versionOfRecord":[],"versionCreatedAt":"2021-10-20 16:30:13","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-960249","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-960249","identity":"rs-960249","version":["v1"]},"buildId":"cBFmMYwuxLRRLfASyISRj","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}