Glycolipid metabolic changes during remission induction in ANCA-associated vasculitis: a retrospective study of the lipid paradox.

Authors

Bowei Cao, Xianghong Yan, Yuanpei Zhu, Hui Zhang, Weiwei Hao, Fang Dong, Rui Liu, Ningjie Zhang, Wei Li

Published in

Clinical and experimental rheumatology. Oct 29, 2026. Epub Oct 29, 2026.

Abstract

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.
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.
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.
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.

PMID:
43001864
Bibliographic data and abstract were imported from PubMed on 09 Nov 2026.

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