3 Results
The patients with active RA were given 99Tc-MDP or and oral glucocorticoids for a course, the disease activities were apparently attenuated in the two groups of 99Tc and99Tc & GC. The inflammatory markers (ESR and CRP) went down, tender joint counts and swollen joint counts were reduced, in turn, DAS28ESR and DAS28CRP were decreased (Figure1 and Supplementary Table2). Comparison of treatment between before and after, the differences are significant in both groups (P < 0.05). These results demonstrated that99Tc-MDP or and oral glucocorticoids are efficacious against inflammation in RA in short run. Thus, we investigated changes of lipid profiles in the two groups between post-treatment and before.
In the two groups of the patients with active RA, the lipid profiles were detected before treatment and after 10-day treatment enclosed TC, TG, and HDL-C, LDL-C, and ApoA1, ApoB. According to the above lipids, the ratio of ApoB/ApoA1 and atherogenic index have been calculated. It is significant with P < 0.05 comparing of lipid profiles after treatment (as treated) and before (as baseline) in the patients with active RA (Figure2 & Table2). TG and ApoA1 were increased after treatment of 99Tc-MDP in the group of99Tc (P < 0.05). The ratio of ApoB/ApoA1was decreased significantly after therapy (P = 0.0036). However, atherogenic index was also decreased, but the difference did not reach statistical significance (P = 0.0856). In the group of 99Tc & GC, most of lipids were changed after the combined therapy except LDL-C and ApoB. The levels of TC, TG, and HDL-C, ApoA1 were elevated significantly, while the ratio of ApoB/ApoA1 and atherogenic index were both reduced, their P values < 0.05.
The correlation of between inflammation markers and lipid profile were computed by non-parameter Spearman correlation analysis and line regression analysis when the changes of lipid profiles were detected after treatment of 99Tc-MDP or and glucocorticoids (Figure3 & Supplementary Table3). The data showed that disease activity scores (DAS28CRP or ESR) were inversely correlated with CHO, LDL-C and ApoB (P < 0.05) in the group of99Tc. In a word, there is a correlation between DAS28 decrease and partial lipids of TC, LDL-C and ApoB increases. The results were concordance in forementioned both of analysis methods. However, the results of between ESR and LDL-C were different in two analysis methods. That is, ESR was inversely related to LDL-C in non-parameter Spearman correlation analysis (r = -0.4237, P = 0.0276) (Supplementary Table3), while not in line regression analysis (r = -0.3460, P = 0.0771). It possibly caused by methodological difference. There was no correlation of between CRP and lipid profiles. The possible reason is that sample size is too small. These results needed a large scale of samples to be addressed.
In the group of 99Tc & GC, CRP was negatively correlated with ApoA1, while positively correlated with the ratio of ApoB/ApoA1 and atherogenic index (P < 0.05). Also, there were correlation between ESR and partial lipids including HDL-C, ApoA1, and ratio of ApoB/ApoA1(P < 0.05). ESR were inversely related to HDL-C, ApoA1, while positively related to ratio of ApoB/ApoA1. DAS28CRP or ESR were inversely correlated with TG, whereas positively correlated with atherogenic index. Moreover, DAS28CRP was also positively related to LDL-C (Figure4). These results are similar using two statistical analysis methods (Figure4 and Supplementary Table4). However, there were three exceptions which were significantly correlation using non parameter Spearman analysis (P < 0.05) while not using line regression between DAS28CRP or ESRand the ratio of ApoB/ApoA1, DAS28ESR and LDL-C (Supplementary Table4).