Lower total cholesterol and HDL-C levels are associated with increased risk of Behçet’s disease in a prospective nationwide Korean study

This study explores the relationship between Behçet's disease (BD) and serum lipid levels, focusing on a large cohort to understand the correlation between lipid profile variations and BD. Utilizing data from the Korean National Healthcare Insurance Service, it encompasses 9,914,049 individuals who participated in health screenings in 2009. The research identifies patients diagnosed with BD during a follow-up period and analyzes their lipid profiles, categorized into quartiles of total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglycerides (TG). The study calculates adjusted hazard ratios (aHR) considering age, gender, smoking history, alcohol consumption, exercise habits, income, body mass index, hypertension, and diabetes, to evaluate the impact of lipid concentrations on BD development. Results show a significant increase in BD incidence among those with lower TC and HDL-C levels (aHR for lowest vs. highest TC quartile: 1.57, 95% CI 1.40-1.76, p < 0.0001; aHR for lowest vs. highest HDL-C quartile: 1.66, 95% CI 1.48-1.86, p < 0.0001), while LDL-C and TG levels did not exhibit a statistically significant association with BD risk. Additionally, the risk of BD does not escalate in the low HDL group using lipid-lowering agents (aHR: 1.33, 95% CI 0.93-1.90, p = 0.8496). The study concludes that lower TC and HDL-C levels are associated with an increased risk of developing BD.