Background In the past decade, it is well recognized that patients with rheumatoid arthritis (RA) have increased morbidity and mortality from premature atherosclerosis. There is 1.5 fold increase in mortality due to cardiovascular events compared to general population. Both, traditional and nontraditional factors, such as systemic inflammation and immune dysregulation contribute to this. There are considerable variations between different studies regarding lipid profile and its role in patients with RA.
Objectives Objective of our study was to investigate relationship between systemic inflammation and lipid profile in RA patients.
Methods 90 RA patients (84,33% female, mean age 53,92±12,83 years) who fulfilled 1987. ACR criteria for RA and 40 age-matched controls with osteoarthritis were enrolled in the study. Group of RA patients consisted from 50 patients treated with Methotrexate (MTX group), mean disease duration 9,27±4,78 years and from 40 patients with early RA (less than 1 year duration) not treated with DMARDs (ERA group). Patients with known cardiovascular, cerebrovascular and peripheral vascular diseases were excluded as well as patients with diabetes, familiar dyslipidemia and those on hypolipemic therapy. Erythrocyte sedimentation rate (ESR), CRP, total cholesterol, LDL, HDL and triglyceride were determined to all subjects.
Results Patients in ERA and MTX groups had, as expected, increased markers of inflammation : ESR (64,36±28,91 mm and 41,44±18,68 mm respectively) and CRP (48,48±63,16 mg/L and 11,44±21,77 mg/L respectively) which was significantly higher than in control group (ESR 12,79±6,7 mm and CRP 1,81±0,35 mg/L, p<0,05). There were no significant differences in mean values of lipid components between ERA, MTX and control group. There were neither positive nor negative correlation between ESR and CRP with any of the lipid components in MTX or in control group. In spite of this, ERA group total cholesterol negatively correlated with ESR (r=-0,32, p<0,05) as well as with CRP (r=-0,43, p<0,01), LDL negatively correlated only with CRP (r=-0,31, p<0,05), HDL strongly negatively correlated with both ESR (r=-0,59, p<0,01) and with CRP (r=-0,44, p<0,01) while triglyceride showed no correlation with ESR and CRP.
Conclusions Patients with active untreated RA have tendency to have reduced total cholesterol, LDL and HDL. Low levels of HDL are most prominent aterogenic factor in these patients mostly influenced by systemic inflammation.
Disclosure of Interest None Declared
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