Immune thrombocytopenia (ITP) is an autoimmune hemorrhagic disease characterized by increased platelet destruction and impaired thrombopoiesis. The changes in platelet indices depend on the morphology and volume of platelets. Serum lipids have been found to affect platelet formation and activity in certain diseases, thus inducing the corresponding variation of platelet indices. Mendelian randomization (MR) analysis was performed based on databases. The clinical data from 457 ITP patients were retrospectively collected and analyzed, including platelet indices, serum lipids, hemorrhages and therapeutic responses. MR analysis showed low high-density-lipoprotein-cholesterol (HDL-C), low apolipoprotein A-1, high triglyceride (TG) and high apolipoprotein B (ApoB) caused high platelet distribution width (PDW); high low-density-lipoprotein-cholesterol (LDL-C) increased mean platelet volume (MPV). In ITP, there were positive correlations between platelet count with TG, PDW with HDL-C and ApoB, and plateletcrit with TG and non-esterified fatty acid, and the correlation had gender differences. Bleeding scores were negatively correlated with cholesterol and LDL-C. LDL-C and homocysteine were risk factors for therapeutic responses. Serum lipids, especially cholesterol were tightly correlated with platelet indices, hemorrhage and therapeutic effects in ITP patients. These results provide clinical references for the management of serum lipids, and highlight the necessity to further explore the relationship between lipids and pathogenesis of ITP. No: NCT05095896, October 14, 2021, retrospectively registered.

中文翻译：

---

免疫性血小板减少症的血脂谱：孟德尔随机分析和回顾性研究

免疫性血小板减少症（ITP）是一种自身免疫性出血性疾病，其特征是血小板破坏增加和血小板生成受损。血小板指数的变化取决于血小板的形态和​​体积。已发现血清脂质会影响某些疾病中的血小板形成和活性，从而引起血小板指数的相应变化。基于数据库进行孟德尔随机化（MR）分析。回顾性收集和分析457例ITP患者的临床资料，包括血小板指数、血脂、出血和治疗反应。MR分析显示低高密度脂蛋白胆固醇（HDL-C）、低载脂蛋白A-1、高甘油三酯（TG）和高载脂蛋白B（ApoB）导致血小板分布宽度（PDW）高；高低密度脂蛋白胆固醇（LDL-C）增加平均血小板体积（MPV）。在ITP中，血小板计数与TG、PDW与HDL-C和ApoB、血小板压积与TG和非酯化脂肪酸呈正相关，且相关性存在性别差异。出血评分与胆固醇和低密度脂蛋白胆固醇呈负相关。LDL-C 和同型半胱氨酸是治疗反应的危险因素。ITP患者血脂尤其是胆固醇与血小板指数、出血量及治疗效果密切相关。这些结果为血脂的管理提供了临床参考，并强调了进一步探讨血脂与ITP发病机制之间关系的必要性。编号：NCT05095896，2021年10月14日，追溯注册。