Background Over the past decades many reports have demonstrated the association between RA and dyslipidemia, the unfavourable lipid profiles having been observed >10 years before disease onset. Some have reported an association between disease activity and low HDL cholesterol levels, however in other studies no associations between disease duration or activity and lipid spectrum abnormalities could be found. Also, after treatment with biologicals improvement, as well as deterioration of lipid profiles has been observed. Dislipidemia might contribute to the observed raised cardiovascular mortality in RA, therefore more data concerning lipid profiles in currently treated RA patients are needed.
Objectives To compare the lipid profiles of RA outpatients with the general population, and to investigate risk factors for an artherogenic lipid profile in RA.
Methods Comparison of lipid profiles, i.e. total cholesterol (TC), HDL cholesterol (HDL), and TC/HDL-ratio in a cohort of consecutive patients between 36 and 75 years of age attending the Arthritis Center Twente (ACT), a large rheumatology outpatient department in The Netherlands (n=546), and a sample of the general population (GP) from the same geographic region (n=4523). Multivariate analysis of the relationship between potential risk factors, i.e. disease activity (remission by DAS-28 or expert opinion), ESR, disease duration, biological use, and smoking and TC/HDL-ratio. Data were collected by direct measurements in 2009 (ACT), and from 2003 to 2007 (GP) respectively. Analyses were sex-specific and standardised by age.
Results The RA cohort consisted of 341 women and 205 men, mean age 56 years, and mean disease duration 81 months, 19% being treated with biologicals, and 69% being in remission of RA. Preliminary analyses show that RA patients had similar frequencies of hypercholesterolemia (TC>6.5 mmol/L and/or use of lipid lowering medication; GP 18%, ORACT 1.1, 95% CI 0.9-1.4) and lowered HDL<1.0 mmol/L; GP 7.2%, ORACT 1.0, 95% CI 0.7-1.4) compared to the GP. TC/HDL ratios were lower in RA patients (GP 4.2, RA 3.9, p<0.05). In RA patients non-smoking and biological use were associated with lower TC/HDL ratios (p<0.05), controlling for lipid lowering therapy.
Conclusions dislipidemia is not increased in low disease activity RA patients. Non-smoking and biological use are associated with lower TC/HDL ratios.
Disclosure of Interest None Declared