RESEARCH - Conventional lipid profile and lipoprotein(a) concentrations in treated patients with RA

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J Rheumatol. 2009 Apr 15.

Conventional Lipid Profile and Lipoprotein(a) Concentrations in

Treated Patients with Rheumatoid Arthritis.

García-Gómez C, Nolla JM, Valverde J, Gómez-Gerique JA, Castro MJ, Pintó X.

From the Rheumatology Unit, Department of Internal Medicine, Consorci

Sanitari de Terrassa, Terrassa, Barcelona; Department of Rheumatology,

IDIBELL-Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat,

Barcelona; Department of Biochemistry, Hospital Marqués de Valdecilla,

Santander; Department of Biochemistry, Hospital Universitari de

Bellvitge, L'Hospitalet de Llobregat, Barcelona; and Lipid Unit,

Department of Internal Medicine, IDIBELL-Hospital Universitari de

Bellvitge, L'Hospitalet de Llobregat, Fipec, Barcelona, Spain.

OBJECTIVE: Patients with rheumatoid arthritis (RA) have an increased

cardiovascular risk not completely explained by traditional

cardiovascular risk factors. If the proatherogenic lipid profile

observed in active and untreated RA improves by effectively treating

RA without the use of a lipid-lowering agent, other nonconventional

cardiovascular lipid risk factors may be implicated.We evaluated

conventional lipid risk factors and lipoprotein(a) in treated patients

with RA.

METHODS: This cross-sectional study was conducted in 122 patients with

RA. Lipid profiles of patients were compared with a control group,

consisting of a population-based study cohort (DRECE study), matched

for sex, age, menopausal status, and body mass index. Excess

lipoprotein( a) was defined by a serum concentration > 0.3 g/l.

RESULTS: High-density lipoprotein cholesterol (HDL-c) concentrations

were higher in pre- and postmenopausal women with RA than in controls

(p = 0.023 and p </= 0.001, respectively). All RA patients had

significantly lower levels of apolipoprotein B and apolipoprotein

B/apolipoprotein A-I ratio, and postmenopausal women with RA also had

significantly lower low-density lipoprotein cholesterol and total

cholesterol levels than their respective controls. No differences were

observed in serum levels of apolipoproteinA-I and triglyceride.All RA

patients had higher lipoprotein(a) values than controls. Fourteen men

(56%) and 10 (53%) and 42 (54%) pre- and postmenopausal women with RA,

respectively, had hyperlipoproteinemia(a).

CONCLUSION: RA patients undergoing antirheumatic therapy display a

nonatherogenic conventional lipid profile, i.e., high HDL-c, low

apolipoprotein B concentrations, and low apolipoprotein

B/apolipoprotein A-I ratio. This may be counteracted by the high

prevalence of hyperlipoproteinemia( a) observed in these patients.

PMID: 19369465

http://www.ncbi.nlm.nih.gov/pubmed/19369465

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