A Study on the Relationship between Lipid Profile and Rheumatoid Arthritis Activity

Document Type : Original Article (s)

Authors

1 Assistant Professor, Department of Rheumatology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 Intern, Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

3 Researcher, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

4 Isfahan University of Medical Sciences

Abstract

Background: Rheumatoid arthritis (RA) is commonly associated with abnormalities in plasma lipoprotein levels, especially a significantly low level of high density lipoprotein (HDL). Most treatments for RA, particularly biological drugs, decrease atherogenic index. Improvement in lipoprotein profile has been found to be associated with decrease in inflammation in RA patients. This study was designed to survey the relationship between lipid profile and RA activity index.Methods: This cross-sectional study included a total of 200 randomly selected RA patients. After blood sampling, plasma levels of triglyceride (TG), cholesterol, low density lipoprotein (LDL), HDL were measured. The correlations between these indices and disease activity index were then evaluated using disease activity score calculator (DAS28). The collected data was statistically analyzed by SPSS18. Pierson and Spearman correlation coefficients were applied for data analysis. Multiple regression test and factorial model were used to control bias..Findings: Examination of the relation between LDL levels and RA criteria revealed a direct significant association of 0.13. A significant association of 0.17 was also found between pain intensity (based on visual analogue scale) and LDL levels. Moreover, LDL and tender joints were significantly associated (0.16). There were no statistically significant associations between LDL, joint swelling and erythrocyte sedimentation rate (ESR). HDL levels did not show significant relations with ESR, pain intensity and tender joints (P > 0.05). However, there was a significant reverse association between HDL levels and joint swelling (0.16).Conclusion: This study showed that lipid profile and RA were significantly related in many aspects. This finding was in accordance with the results of other similar studies. Therefore, it seems advisable to check the lipid profile of patients with chronic inflammatory diseases, especially RA, on a regular basis.

Keywords

References

  1. Steiner G, Urowitz MB. Lipid profiles in patients with rheumatoid arthritis: mechanisms and the impact of treatment. Semin Arthritis Rheum 2009; 38(5): 372-81.
  2. Shirinskii IV, Zheltova OI, Shirinskii VS, Kozlova VA. Relationship between blood lipid spectrum and activity of the disease in patients with rheumatoid arthritis. Klin Med (Mosk) 2008; 86(12): 40-3.
  3. Yoo WH. Dyslipoproteinemia in patients with active rheumatoid arthritis: effects of disease activity, sex, and menopausal status on lipid profiles. J Rheumatol 2004; 31(9): 1746-53.
  4. Pearson TA, Mensah GA, Alexander RW, Anderson JL, Cannon RO, III, Criqui M, et al. Markers of inflammation and cardiovascular disease: application to clinical and public health practice: A statement for healthcare professionals from the Centers for Disease Control and Prevention and the American Heart Association. Circulation 2003; 107(3): 499-511.
  5. Seriolo B, Paolino S, Sulli A, Fasciolo D, Cutolo M. Effects of anti-TNF-alpha treatment on lipid profile in patients with active rheumatoid arthritis. Ann N Y Acad Sci 2006; 1069: 414-9.
  6. Papanicolaou DA, Wilder RL, Manolagas SC, Chrousos GP. The pathophysiologic roles of interleukin-6 in human disease. Ann Intern Med 1998; 128(2): 127-37.
  7. Fernandez-Real JM, Broch M, Vendrell J, Richart C, Ricart W. Interleukin-6 gene polymorphism and lipid abnormalities in healthy subjects. J Clin Endocrinol Metab 2000; 85(3): 1334-9.
  8. Popa C, Netea MG, Radstake T, Van der Meer JW, Stalenhoef AF, van Riel PL, et al. Influence of anti-tumour necrosis factor therapy on cardiovascular risk factors in patients with active rheumatoid arthritis. Ann Rheum Dis 2005; 64(2): 303-5.
  9. Feingold KR, Soued M, Staprans I, Gavin LA, Donahue ME, Huang BJ, et al. Effect of tumor necrosis factor (TNF) on lipid metabolism in the diabetic rat. Evidence that inhibition of adipose tissue lipoprotein lipase activity is not required for TNF-induced hyperlipidemia. J Clin Invest 1989; 83(4): 1116-21.
  10. Choi HK, Seeger JD. Lipid profiles among US elderly with untreated rheumatoid arthritis--the Third National Health and Nutrition Examination Survey. J Rheumatol 2005; 32(12): 2311-6.
  11. Dursunoglu D, Evrengul H, Polat B, Tanriverdi H, Cobankara V, Kaftan A, et al. Lp(a) lipoprotein and lipids in patients with rheumatoid arthritis: serum levels and relationship to inflammation. Rheumatol Int 2005; 25(4): 241-5.
  12. Peters MJ, Vis M, van Halm VP, Wolbink GJ, Voskuyl AE, Lems WF, et al. Changes in lipid profile during infliximab and corticosteroid treatment in rheumatoid arthritis. Ann Rheum Dis 2007; 66(7): 958-61.
  13. Haruna Y, Morita Y, Yada T, Satoh M, Fox DA, Kashihara N. Fluvastatin reverses endothelial dysfunction and increased vascular oxidative stress in rat adjuvant-induced arthritis. Arthritis Rheum 2007; 56(6): 1827-35.
  14. ten CR, Nibbering PH, Bredius RG. Therapy-refractory systemic juvenile idiopathic arthritis successfully treated with statins. Rheumatology (Oxford) 2004; 43(7): 934-5.
  15. McCarey DW, McInnes IB, Madhok R, Hampson R, Scherbakov O, Ford I, et al. Trial of Atorvastatin in Rheumatoid Arthritis (TARA): double-blind, randomised placebo-controlled trial. Lancet 2004; 363(9426): 2015-21.
  16. Okamoto H, Kamatani N. Successful treatment with fenofibrate, a peroxisome proliferator activated receptor alpha ligand, for a patient with rheumatoid arthritis. Ann Rheum Dis 2004; 63(8): 1002-3.
  17. Georgiadis AN, Papavasiliou EC, Lourida ES, Alamanos Y, Kostara C, Tselepis AD, et al. Atherogenic lipid profile is a feature characteristic of patients with early rheumatoid arthritis: effect of early treatment--a prospective, controlled study. Arthritis Res Ther 2006; 8(3): R82.
  18. Park YB, Lee SK, Lee WK, Suh CH, Lee CW, Lee CH, et al. Lipid profiles in untreated patients with rheumatoid arthritis. J Rheumatol 1999; 26(8): 1701-4.
  19. Vis M, Nurmohamed MT, Wolbink G, Voskuyl AE, de KM, van de Stadt R, et al. Short term effects of infliximab on the lipid profile in patients with rheumatoid arthritis. J Rheumatol 2005; 32(2): 252-5.
  20. Kiortsis DN, Mavridis AK, Filippatos TD, Vasakos S, Nikas SN, Drosos AA. Effects of infliximab treatment on lipoprotein profile in patients with rheumatoid arthritis and ankylosing spondylitis. J Rheumatol 2006; 33(5): 921-3.
Journal of Isfahan Medical School
Volume 29, Issue 169 - Serial Number 169
November and December 2012
Pages 2620-2627

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History

  • Receive Date: 02 December 2011
  • Revise Date:
  • Accept Date: 06 April 2022

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