LOW-LEVELS OF HIGH-DENSITY-LIPOPROTEIN CHOLESTEROL IN PATIENTS WITH ACTIVE SARCOIDOSIS

Objective: To determine lipoprotein abnormalities in patients diagnose d with sarcoidosis and their relation to disease activity. Methods: We studied 90 patients with biopsy-proven sarcoidosis who had not been t reated with corticosteroids (44 with active disease and 46 with inacti ve disease) and 147 control subjects. Sarcoidosis activity was evaluat ed by means of clinical, chest X-ray, gallium-67 scan, serum angiotens in converting enzyme (peptidyl-dipeptidase A) values, and pulmonary fu nction tests. Analysis of lipoprotein metabolism included: serum chole sterol, low density lipoprotein (LDL)-cholesterol, high density lipopr otein (HDL)cholesterol, HDL2-cholesterol, HDL3-cholesterol, apolipopro tein A-I, apolipoprotein B, and triglyceride concentrations. Results: Patients with active sarcoidosis had significantly low HDL-cholesterol concentrations (1.15 +/- 0.27 mmol/l) as compared with inactive sarco id patients (1.40 +/- 0.34 mmol/l) and with the healthy control subjec ts (1.49 +/- 0.34 mmol/l) (p = 0.00001). The decrease in the HDL-chole sterol concentrations seen in patients with active disease was due mai nly to the cholesterol bound to HDL, subfraction. Apolipoprotein A-I c oncentrations were significantly reduced in the patients with active d isease (1.18 +/- 0.32 g/l) compared to the healthy controls (1.38 +/- 0.27 g/l) (p = 0.003). There were no significant differences in choles terol, triglyceride, LDL-cholesterol or apolipoprotein B values among the three groups. Multivariate logistic regression analysis showed tha t HDL-cholesterol was the only variable independently associated with disease activity (Regression Coefficient b = -0.03; S.E. = 0.008; p = 0.0005). Conclusion: The decrease in HDL-cholesterol that is observed in patients with sarcoidosis is limited to those with active disease. (C) 1998 Elsevier Science Ireland Ltd.