Inflammation
Systemic sclerosis patients have higher Lp(a) and triglycerides but lower HDL-C than healthy controls, meta-analysis of over 2,500 participants finds (Rheumatol Int 2025)
Original title: Classic lipid profile and lipoprotein(a) in systemic sclerosis: a systematic review and meta-analysis of case-control studies
This systematic review and meta-analysis (registered CRD42024607564) searched PubMed and Cochrane Library through November 2024 for case-control studies comparing lipid profiles and Lp(a) between patients with systemic sclerosis (SSc), a systemic autoimmune disease marked by fibrosis and vascular abnormalities, and healthy controls. Twenty-seven eligible studies covered 2,503 participants (1,114 SSc patients, 1,389 controls). Pooled analysis found SSc patients had significantly lower HDL-C (mean difference -5.61 mg/dL, 95% CI -8.22 to -3.00), significantly higher triglycerides (MD 16.98 mg/dL, 95% CI 8.28-25.68), and significantly higher Lp(a) (MD 15.66 mg/dL, 95% CI 6.77-24.55, from 3 studies covering 131 SSc patients and 206 controls), while total cholesterol and LDL-C did not differ significantly between groups. The authors conclude this altered lipid profile, elevated Lp(a) and triglycerides alongside depressed HDL-C, may have implications for cardiovascular risk assessment specifically in patients with systemic sclerosis.
Original abstract
Background And Aims: Systemic sclerosis (SSc) is a systemic autoimmune disease characterized by fibrosis, vascular abnormalities, and immune dysfunction. Whether patients with SSc exhibit lipid profile abnormalities, which may increase cardiovascular risk, remains uncertain. Our aim was to systematically investigate whether total cholesterol (TCHOL), triglycerides (TRG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and Lipoprotein (a) [Lp(a)] are affected in SSc patients.
Methods: PubMed and Cochrane library databases were systematically searched up to 30 November 2024 for studies reporting on lipid profile (TCHOL, TRG, HDL-C, LDL-C) and Lp(a) in patients with SSc. Qualitative and quantitative syntheses of data from published prospective and retrospective studies was performed.
Results: Literature search identified 27 eligible trials including 2503 participants, of whom 1114 were SSc patients and 1389 were healthy controls (HC). The pooled analysis from 24 studies (1001 SSc patients and 1254 HC) demonstrated that SSc patients had significantly lower HDL-C levels compared with the HC group (MD:- 5.61 mg/dl, 95% CI- 8.22,- 3.00, I2 = 83%). Regarding TRGs, pooled analysis from 24 studies (1016 SSc patients and 1246 HC) showed significantly higher levels in SSc compared with HC (MD: 16.98 mg/dl, 95% CI 8.28, 25.68, I2 = 68%). Similarly, the pooled analysis from 3 studies (131 SSc patients and 206 HC) showed significantly higher Lp(a) levels in SSc compared with HC (MD: 15.66 mg/dl, 95% CI 6.77, 24.55, I2 = 5%). No significant differences were observed in TCHOL (MD: 0.94 mg/dl, 95% CI- 10.23, 12.10, I2 = 93%), and LDL-C (MD:- 6.12 mg/dl, 95% CI- 16.00, 3.77, I2 = 95%) levels between SSc and HC groups.
Conclusions: HDL-C levels are decreased in SSc, contrary to TRG and Lp(a) levels, which are increased. These findings may have implications in assessing cardiovascular risk in patients with SSc.
Trail Registry: CRD42024607564.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 17 August 2026. Methods.