RESEARCH - Proinflammatory HDL as a biomarker for atherosclerosis in patients with SLE and RA

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Arthritis Rheum. 2006 Jul 25;54(8):2541-2549 [Epub ahead of print]

Proinflammatory high-density lipoprotein as a biomarker for atherosclerosis

in patients with systemic lupus erythematosus and rheumatoid arthritis.

McMahon M, Grossman J, Fitzgerald J, Dahlin-Lee E, Wallace DJ, Thong BY,

Badsha H, Kalunian K, C, Navab M, Fogelman AM, Hahn BH.

University of California at Los Angeles Geffen School of Medicine.

OBJECTIVE: Women with systemic lupus erythematosus (SLE) have a 7-50-fold

increased risk of coronary artery disease (CAD). In the general population,

oxidized low-density lipoprotein (ox-LDL) increases the risk for CAD. Normal

high-density lipoproteins (HDLs) protect LDL from oxidation; proinflammatory

HDLs do not. This study was undertaken to determine whether patients with

SLE, who have chronic inflammation that causes oxidative damage, have more

proinflammatory HDL and higher levels of ox-LDL, thus predisposing them to

atherosclerosis. METHODS: One hundred fifty-four women with SLE, 48 women

with rheumatoid arthritis (RA), and 72 healthy controls were studied. The

ability of the patients' HDL to prevent oxidation of normal LDL was

measured. Values >1.0 (the value assigned for LDL oxidation in the absence

of HDL) after the addition of HDL indicated proinflammatory HDL. Plasma

ox-LDL levels were measured as the amount of oxidation produced by the

patient's LDL after the removal of HDL. RESULTS: SLE patients had more

proinflammatory HDL (mean +/- SD score 1.02 +/- 0.57, versus 0.68 +/- 0.28

in controls [P < 0.0001] and 0.81 +/- 0.22 in RA patients [P = 0.001 versus

SLE patients]). A higher proportion of SLE patients had proinflammatory HDL:

44.7% of SLE patients versus 4.1% of controls and 20.1% of RA patients had

scores >1.0 (P < 0.006 between all groups). Levels of ox-LDL correlated with

levels of proinflammatory HDL (r = 0.37, P < 0.001). SLE patients with CAD

had significantly higher proinflammatory HDL scores than patients without

CAD (P < 0.001).

CONCLUSION: HDLs are proinflammatory in a significant proportion of SLE

patients and are associated with elevated levels of ox-LDL. Abnormal HDLs

impair the ability to prevent LDL oxidation and may predispose to

atherosclerosis.

PMID: 16868975

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_uids=1\

6868975

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Mayo Clinic in Rochester

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s Hopkins Medicine

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