Retrospective analysis of serum lipids in the diagnosis of neuromyelitis optica spectrum disorders

Objective　To investigate the diagnostic efficacy of serum lipids in patients with neuromyelitis optica spectrum disorders (NMOSD), and to analyze the relationship between serum lipids and clinical features of NMOSD. Methods　The clinical and laboratory diagnosis information of 324 patients with NMOSD (NMOSD group), 147 patients with multiple sclerosis (MS, MS group) and 252 healthy controls (HCs, HCs group) were collected from the First Medical Center of PLA General Hospital from January 2018 to July 2020. Logistic regression analysis was used to control the age, gender, disease duration, affected sites and the interaction of various serum lipid indexes. The differences of serum total cholesterol (TC), triglyceride (TG), Apolipoprotein A1 (Apo A1), Apolipoprotein B (Apo B), high-density lipoprotein (HDL) and low-density lipoprotein (LDL) in three groups of patients were analyzed, and the concentration differences of each index in the acute stage, relapse stage and remission stage of NMOSD were also analyzed. According to the clinical features of NMOSD, such as AQP4 antibody titer and affected sites, the concentration difference of lipid index in different subgroups was analyzed. Results　The average disease duration in the NMOSD group was 20 months, and magnetic resonance imaging (MRI) showed that the most affected region is the optic nerve (198/324, 61.1%). In the MS group, the disease duration was longer (48 months) and multiple sites were affected (56/147, 38.1%). There were significant differences in TC, Apo A1, LDL, TG and Apo B between NMOSD group and MS group or HCs group (P<0.05). Subgroup analysis showed that only Apo B was significantly different in the acute stage, relapse stage and remission stage of NMOSD group (P<0.05). Further analysis on the subgroups of NMOSD showed that there were significant differences in TC, Apo A1, Apo B, HDL and LDL in different sites (P<0.05). The receiver operating characteristic (ROC) analysis showed that the combination of serum TC, Apo A1, Apo B and LDL could specifically diagnose NMOSD with the AUC of 0.732, sensitivity of 57.86% and specificity of 81.15%. Conclusion　The combination of serum TC, Apo A1, Apo B and LDL can specifically diagnose NMOSD, and Apo A1 and Apo B can be used as indicators of affected sites and disease activity of NMOSD respectively. DOI: 10.11855/j.issn.0577-7402.2021.04.09