ASSOCIATION BETWEEN LIPID PROFILE AND RISK OF INCIDENT SYSTEMIC SCLEROSIS: A NATIONWIDE POPULATION-BASED STUDY

O. C. Kwon, K. D. Han, M. C. ParkYonsei University College of Medicine, Department of Internal Medicine, Seoul, Korea, Rep. of (South Korea) Soongsil University, Department of Statistics and Actuarial Science, Seoul, Korea, Rep. of (South Korea)  Background Lipid metabolism is altered in patients with systemic sclerosis (SSc), mediating activation of immune cells and fibroblasts. However, it is unclear whether altered lipid profile in individuals without SSc is associated with a risk of future development of SSc. Objectives To assess the association between lipid profile and future development of SSc. Methods Individuals without SSc who underwent national health check-ups in 2009 were selected and followed up through 2019 from a nationwide database of the Korean National Health Insurance Service. Serum levels of total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglyceride, measured on the date of health check-up in 2009, were each categorized into quartiles (Q1 [lowest], Q2, Q3, and Q4 [highest]). Individuals who developed SSc during follow-up were identified. Cox regression analyses adjusted for multiple covariates were performed to estimate the adjusted hazard ratios (aHRs), and 95% confidence intervals (CIs) according to the quartiles of levels of TC, HDL-C-, LDL-C, and triglyceride, respectively, using Q1 as the reference. Results Of the 9,894,996 individuals selected, 1,355 individuals developed SSc during a mean follow-up of 9.2 years, accounting for an incidence rate of 1.49 per 100,000 person-years. Compared with Q1 levels, Q4 levels of TC (aHR 0.691, 95% CI 0.592–0.806), HDL-C (aHR 0.611, 95% CI 0.521–0.716), and LDL-C (aHR 0.735, 95% CI 0.630–0.856) were associated with a lower risk of incident SSc, while Q4 levels of triglyceride (aHR 1.060, 95% CI 0.896–1.254) were not. Higher quartiles of TC (p for trend<0.001), HDL-C (p for trend<0.001), and LDL-C (p for trend=0.001) were associated with a larger effect size. Conclusion Serum levels of TC, HDL-C, and LDL-C were inversely associated with the risk of incident SSc. Our findings provide new insights that altered lipid profile could be considered a risk factor for incident SSc. Reference None. Table 1. Risk of incident systemic sclerosis according to lipid profile Cut-off(mg/dL) N SSc Duration (pyrs) IR/100,000 pyrs Model 1 Model 2 TC Q1 ≤139 2,485,033 373 22,670,953.05 1.65 1 (Ref.) 1 (Ref.) Q2 170–192 2,487,413 345 22,832,305.38 1.51 0.918(0.793–1.063) 0.874(0.754–1.012) Q3 193–217 2,450,733 317 22,517,096.31 1.41 0.855(0.736–0.993) 0.773(0.664–0.900) Q4 ≥218 2,471,817 320 22,690,097.63 1.41 0.857(0.738–0.995) 0.691(0.592–0.806) HDL -C Q1 ≤45 2,599,835 367 23,703,987.10 1.55 1 (Ref.) 1 (Ref.) Q2 46–53 2,406,259 336 22,083,139.89 1.52 0.982(0.847–1.139) 0.847(0.730–0.983) Q3 54–63 2,507,100 352 23,041,299.39 1.53 0.986(0.852–1.142) 0.760(0.654–0.882) Q4 ≥64 2,381,802 300 21,882,025.99 1.37 0.885(0.760–1.031) 0.611(0.521–0.716) LDL –C Q1 ≤90 2,508,966 362 22,891,074.64 1.58 1 (Ref.) 1 (Ref.) Q2 91–111 2,485,047 322 22,808,239.53 1.41 0.892(0.768–1.037) 0.829(0.713–0.964) Q3 112–134 2,467,601 336 22,667,147.88 1.48 0.937(0.807–1.087) 0.826(0.710–0.961) Q4 ≥135 2,433,382 335 22,343,990.32 1.50 0.947(0.816–1.099) 0.735(0.630–0.856) Triglyceride Q1 ≤74 2,446,904 381 22,542,116.72 1.69 1 (Ref.) 1 (Ref.) Q2 75–109 2,521,143 320 23,103,563.15 1.39 0.820(0.706–0.951) 0.867(0.745–1.009) Q3 110–163 2,458,085 367 22,478,344.97 1.63 0.966(0.837–1.115) 1.109(0.953–1.292) Q4 ≥164 2,468,864 287 22,586,427.53 1.27 0.752(0.645–0.876) 1.060(0.896–1.254) Model 1: Crude model. Model 2: Adjusted for age, sex, BMI, residence, income, smoking status, alcohol consumption, physical activity, hypertension, type 2 diabetes, CKD, and lipid-lowering agents. BMI, body mass index; CKD, chronic kidney disease; HDL-C, high-density lipoprotein cholesterol; IR, incidence rate; LDL-C, low-density lipoprotein cholesterol; pyrs, person-years; SSc, systemic sclerosis; TC, total cholesterol. Acknowledgements: NIL. Disclosure of Interests None Declared. Keywords: Epidemiology, Systemic sclerosis, Real-world evidence DOI: 10.1136/annrheumdis-2023-eular.2532Citation: , volume 82, supplement 1, year 2023, page 1017Session: Scleroderma, myositis and related syndromes (Poster View)