Full Papers
Glycolipid metabolic changes during remission induction in ANCA-associated vasculitis: a retrospective study of the lipid paradox
B. Cao1, X. Yan2, Y. Zhu3, H. Zhang4, W. Hao5, F. Dong6, R. Liu7, N. Zhang8, W. Li9
- Department of Blood Transfusion, The Second Xiangya Hospital of Central South University, Changsha, Hunan Province; and Department of Transfusion Medicine, Huashan Hospital, Fudan University, Shanghai, China.
- The Second Hospital of Changsha, West Branch of Changsha Hospital for Maternal & Child Health Care, Changsha, Hunan Province, China.
- Department of Blood Transfusion, The Second Xiangya Hospital of Central South University, Changsha, Hunan Province, China.
- The 14th Five-Year Plan Application Characteristic Discipline of Hunan Province, Clinical Medicine; Hunan Provincial Key Laboratory of the Traditional Chinese Medicine Agricultural Biogenomics, Department of Basic Medical Sciences, Changsha Medical University, Changsha, China.
- Department of Rheumatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China.
- Department of Rheumatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China.
- Department of Rheumatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China.
- Department of Blood Transfusion, The Second Xiangya Hospital of Central South University, Changsha, Hunan Province, China. znj_123188@csu.edu.cn
- Department of Rheumatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China. libuwei2011@163.com
CER19839
Full Papers
PMID: 43001864 [PubMed]
Received: 24/02/2026
Accepted : 04/08/2026
In Press: 29/10/2026
Abstract
OBJECTIVES:
To investigate dynamic changes in glycolipid metabolism in patients with antineutrophil cytoplasmic antibody-associated vasculitis (AAV) during remission induction and to explore their associations with inflammatory markers, treatment and ANCA antigen specificity.
METHODS:
In this retrospective cohort study of 973 patients with AAV, baseline glycolipid profiles and the prevalence of dyslipidaemia were assessed. Paired baseline and post-remission induction glycolipid parameters were compared in the longitudinal cohort. Multivariable models were used to evaluate factors associated with baseline dyslipidaemia and exploratory associations with metabolic changes. Additional analyses compared patients with and without longitudinal data and assessed the relationship between changes in inflammatory markers and metabolic parameters.
RESULTS:
Dyslipidaemia was highly prevalent at baseline. Inflammatory markers, including erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), were associated with dyslipidaemia. During remission induction, triglyceride, total cholesterol and LDL-C levels increased, whereas fasting glucose and the TC/HDL-C ratio decreased, consistent with a lipid-paradox pattern. Additional analyses suggested potential selection bias in the longitudinal cohort.
CONCLUSIONS:
Patients with AAV show a high burden of baseline dyslipidaemia and dynamic glycolipid metabolic changes during remission induction. The observed increase in lipid concentrations together with decreases in fasting glucose and the TC/HDL-C ratio suggests a lipid-paradox pattern and a close relationship between inflammation and metabolic status. Further prospective studies with standardised treatment exposure and cardiovascular outcome assessment are needed to clarify the clinical significance of these metabolic trajectories.
