RESEARCH - Total cholesterol and LDL levels decrease before RA

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Ann Rheum Dis. Published Online First: 23 October 2009.

doi:10.1136/ard.2009.122374

Total cholesterol and LDL levels decrease before rheumatoid arthritis

Elena Myasoedova, S Crowson, Hilal Maradit-Kremers, D

J Fitz-Gibbon, Terry M Therneau, Sherine E *

Mayo Clinic, United States

ABSTRACT

Objectives: To compare lipid profiles in patients with rheumatoid

arthritis (RA) and non-RA subjects during the 5 years before and 5

years after RA incidence/index date.

Methods: Lipid measures were abstracted in a population-based incident

cohort of RA patients (1987 ACR criteria) first diagnosed between

1/1/1988 and 1/1/2008 and in non-RA subjects. Random effects models

adjusting for age, sex and calendar year were used to examine trends

in lipid profiles, accounting for multiple measurements per subject.

Results: Study population included a cohort of 577 RA patients (a

total of 3,088 lipid measurements) and 540 non-RA subjects (a total of

3,048 lipid measurements). There were significant decreases in total

[TCh] and low-density cholesterol [LDL] levels in the RA cohort during

the 5 years before RA, compared to the non-RA cohort (p<0.001). Trends

in other lipid measures (triglycerides and high-density cholesterol)

were similar in RA and non-RA cohorts during the 5 years before and 5

years after RA incidence/index date. During the 5 years before RA

incidence/index date, the proportion of RA patients with elevated TCh

or LDL measures, but not with abnormal HDL and TG measures,

significantly decreased compared to non-RA subjects. Lipid-lowering

drugs (statins in particular) were less often (p=0.02) prescribed to

RA patients than to non-RA subjects.

Conclusion: TCh and LDL levels and the prevalence of abnormal TCh or

LDL measures decreased significantly during the 5 years before RA

incidence/index date in RA patients as compared to non-RA cohort.

These trends in lipid profile in RA are unlikely to be solely due to

lipid-lowering therapy.

http://ard.bmj.com/cgi/content/abstract/ard.2009.122374v1?papetoc

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