Patterns of serum lipids derangements and cardiovascular risk assessment in patients with primary biliary cholangitis

Introduction and objectives: Primary biliary cholangitis (PBC) is a chronic cholestatic autoimmune disease that disrupts the cholesterol metabolism. Our aim was to investigate the frequency of dyslipidemias and to evaluate the risk of cardiovascular events in a historic cohort of patients with PBC. Patients: All patients attended from 2000 to 2009 with histological diagnosis of PBC were included and were compared with healthy controls. The 10-year cardiovascular risk was estimated by the Framingham risk score. Results: Fifty four patients with PBC were included and compared to 106 controls. Differences in total cholesterol (263.8 +/- 123.9 mg/dl vs. 199.6 +/- 40, p = 0.0001), LDL-cholesterol (179.3 +/- 114.8 vs. 126.8 +/- 34.7, p = 0.0001), HDL-cholesterol (62.4 +/- 36.2 mg/l vs. 47.3 +/- 12.3, p = 0.0001) and triglycerides (149.1 +/- 59.1 mg/dl vs. 126.4 +/- 55.4,p = 0.001) were found. Hypercholesterolemia (>240 mg/dl) was found in 52.4% of the patients with PBC vs. 11% in the control group, high LDL-cholesterol (160-189 mg/dl) in 45.2% of the patients with PBC vs. 10% in controls and hyperalphalipoproteinemia (HDL-cholesterol >60 mg/dl) in 45.2% of the patients with PBC vs. 16% in controls. The 10-year cardiovascular risk was 5.3% +/- 5.9 in the patients with PBC and 4.1% +/- 5.7 in the control group (p = 0.723, IC 95% = 0.637-1.104). Only one cardiovascular event (stroke) in a patient with PBC was registered in a mean follow up time of 57.9 +/- 36.5 months. Conclusions: Marked derangements in serum lipids and a high frequency of dyslipidemias are found in patients with PBC, however, these do not increase the risk of cardiovascular events. (C) 2019 Published by Elsevier Espana, S.L.U. on behalf of Fundacion Clinica Medica Sur, A.C.