Background Arteriosclerosis is a risk factor for mortality among patients with rheumatoid arthritis (RA) and it is associated with changes in lipid profiles. Therefore, the present prospective cohort study evaluates risk factors and lipid profiles associated with disease activity in patients with RA (TOMORROW study; TOtal Management Of Risk factors in Rheumatoid arthritis patients to lOWer morbidity and mortality, clinical trial registration number: UMIN000003876).
Methods Lipid profiles and serum levels of adipocytokines such as adiponectin or leptin were prospectively evaluated relative to disease activity in 202 consecutive patients with RA (109 of whom were treated with biological agents) and 202 age- and sex-matched healthy volunteers (HV). The mean age of the 341 females and 61 males was 57.9 (20.9 - 79.3) years.
Results The following were lower in patients with RA than in HV at baseline: serum total cholesterol, 210 vs. 222 mg/dL (p<0.01); high-density lipoprotein (HDL) cholesterol, 65.4 vs. 69.1 mg/dL (p<0.05) and low-density lipoprotein (LDL) cholesterol, 120 vs. 126 mg/dL (p<0.05). However, serum levels of both leptin and adiponectin and ratio of body fat were higher in patients with RA than in HV (7.5 vs. 5.6 μg/mL, p<0.001, 12.2 vs. 11.2 μg/mL, p<0.05 and 29.4 vs. 27.2%, p<0.001 respectively). Changes in all three cholesterol values after one year inversely correlated with those in disease activity score (DAS) 28 (Table 1).Serum adiponectin was associated with DAS28 at baseline (r =0.248; p=0.003), but changes in these values did not correlate with DAS28 scores after one year (Table 1).
Conclusions Improvements in disease activity increased lipid levels but did not change plasma levels of adiponectin after one year in patients with RA.
Disclosure of Interest Y. Sugioka: None Declared, T. Koike Grant/Research support from: Takeda Pharmaceutical, Mitsubishi Tanabe Pharma Corporation, Chugai Pharmaceutical, Eisai, Abbott Japan, Teijin Pharma, Banyu Pharmaceutical and Ono Pharmaceutical, K. Mamoto: None Declared, T. Okano: None Declared, M. Tada: None Declared, S. Wakitani: None Declared, H. Nakamura Grant/Research support from: Chugai Pharmaceutical, Astellas, Speakers Bureau: Ono