RESEARCH - Rheumatoid cachexia is associated with dyslipidemia and low levels of anti-PC but not with dietary fat

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Arthritis Research & Therapy 2009, 11:R37doi:10.1186/ar2643

Published: 10 March 2009

Rheumatoid cachexia is associated with dyslipidemia and low levels of

atheroprotective natural antibodies against phosphorylcholine but not

with dietary fat in patients with rheumatoid arthritis: a cross

sectional study

Ann-Charlotte Elkan , Niclas Hakansson , Johan Frostegard , Tommy

Cederholm and Ingiald Hafstrom

Abstract (provisional)

Introduction

Patients with rheumatoid arthritis (RA) have an increase risk for

cardiovascular disease (CVD) independent of traditional risk factors.

The aim of this study was to analyse the associations between diet,

body composition, lipids and atheroprotective natural antibodies

against phosphorylcholine (anti-PC) in patients with RA.

Methods

Eighty RA patients (76% women), mean age (SD) 61.4 (12) years and

median disease duration of 6 years, were assessed by food frequency

questionnaire (FFQ), fatty acid profile in adipose tissue and

whole-body dual-energy X-ray absorptiometry (DXA). Rheumatoid cachexia

was defined as fat free mass index below the 25th percentile and fat

mass index above the 50th percentile of a reference population. Blood

lipids, oxidized low-density lipoprotein (oxLDL) and anti-PC were

determined.

Results

Mean body mass index for the women and men was 25.0 and 27.0,

respectively. Central obesity was found in 57% of the women (waist

circumference >80 cm) and in 89% of the men (waist circumference >94

cm). Eighteen percent of the women and 26% of the men had rheumatoid

cachexia. These patients had significantly higher total cholesterol

(P<0.033), LDL (P<0.029), and trendwise oxLDL (P=0.056) as well as

lower anti-PC IgM (P=0.040), higher frequency of hypertension (69%)

and metabolic syndrome (25%) than those without. The patients reported

a high dietary intake of saturated fat, which partly correlated with

fatty acid composition in adipose tissue and significantly with

disease activity. However, patients with or without cachexia did not

differ with respect to dietary fat intake or intake of mediterranean

like diet. Patients on mediterranean like diet though had high levels

of anti-PC (P<0.001).

Conclusions

About one of five patients with low-active RA displayed rheumatoid

cachexia. This condition was associated with high levels of LDL

cholesterol, low levels of atheroprotective anti-PC and high frequency

of hypertension, which is of interest in the context of CVD in RA. The

cachexia could not be related to diet fat intake. Patients on

mediterranean like diet though had high anti-PC levels in spite of

similar frequency of cachexia. High anti-PC levels may provide some

protection against CVD.

http://arthritis-research.com/content/pdf/ar2643.pdf

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