RESEARCH - Lipids and inflammation: serial measurements of the lipid profile of blood donors who later developed RA

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Published Online First: 7 June 2006. doi:10.1136/ard.2006.051672

ls of the Rheumatic Diseases 2007;66:184-188

Copyright © 2007 BMJ Publishing Group Ltd & European League Against

Rheumatism

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EXTENDED REPORT

Lipids and inflammation: serial measurements of the lipid profile of blood

donors who later developed rheumatoid arthritis

1 Department of Rheumatology, VU University Medical Centre, Amsterdam, The

Netherlands

2 Department of Rheumatology, Jan van Breemen Institute, Amsterdam

3 Sanquin Bloodblank Northwest Region, Amsterdam

4 Department of Clinical Epidemiology and Biostatistics, VU University

Medical Centre

Background: Rheumatoid arthritis is characterised by inflammation and an

increased cardiovascular risk. It was recently shown that active early

rheumatoid arthritis is associated with dyslipidaemia, which may partially

explain the enhanced cardiovascular risk. However, it is unknown when this

dyslipidaemia starts.

Objective: To investigate the progression of the lipid profile over time and

the influence of inflammatory parameters on this lipid profile, in people

who later developed rheumatoid arthritis.

Methods: Levels of total cholesterol, high-density lipoprotein cholesterol

(HDLc), triglycerides, apolipoprotein AI (apo AI), apolipoprotein B (apo

and lipoprotein(a) (Lp(a)) were determined in 1078 stored, deep-frozen,

serial blood bank samples, collected between 1984 and 1999, of 79 blood

donors who later developed rheumatoid arthritis. These samples were compared

with 1071 control samples of unselected blood donors, matched for age, sex

and storage time.

Results: Samples of patients who later developed rheumatoid arthritis

showed, on average, 4% higher total cholesterol, 9% lower HDLc, 17% higher

triglyceride and 6% higher apo B levels than matched controls (p0.05).

The magnitude of the differences in lipid levels between groups, explained

by C reactive protein (CRP), was limited. For example, only 3.6% of the

difference in HDLc levels between the groups was explained by the CRP

concentrations.

Conclusion: Patients who later develop rheumatoid arthritis have a

considerably more atherogenic lipid profile than matched blood donors at

least 10 years before onset of symptoms. As inflammation only marginally

explains the differences between the two groups, a modulating effect of

lipids on inflammatory processes is hypothesised.

http://ard.bmj.com/cgi/content/abstract/66/2/184?etoc

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