REVIEW - Interpreting lipid levels in the context of high-grade inflammatory states with a focus on RA

[Guest guest]

Ann Rheum Dis. 2009 Apr;68(4):460-9.

Interpreting lipid levels in the context of high-grade inflammatory

states with a focus on rheumatoid arthritis: a challenge to

conventional cardiovascular risk actions.

Choy E, Sattar N.

Sir Alfred Baring Garrod Clinical Trials Unit, Academic Department of

Rheumatology, King's College, London, UK.

In severe untreated rheumatoid arthritis (RA), reductions in

high-density lipoprotein-cholesterol, low-density

lipoprotein-cholesterol and total cholesterol have been noted; this is

in line with findings in other pathologies/conditions associated with

inflammation or infection, such as sepsis, cancer, trauma or the

postoperative period. Although the precise mechanisms remain to be

established, cytokine-induced activation of the reticuloendothelial

system is potentially critical to such changes. Consequently,

dampening of inflammation in severe RA-as occurs with several

biologics-may lead to increases, not only in high-density

lipoprotein-cholesterol, but also with other lipid moieties, including

total and low-density lipoprotein-cholesterol and, perhaps,

triglycerides. This concept is consistent with findings following

antitumour necrosis factor treatment and interleukin-6 receptor

inhibition in patients with RA. At the same time, it is increasingly

apparent that potent dampening of inflammation, however achieved,

broadly reduces the risk of cardiovascular disease in RA. Therefore,

changes in lipid profiles, particularly increases in cholesterol and

triglycerides that occur with treatments for severe inflammation, may

not represent increased cardiovascular risk as in the usual

understanding of lipid-level elevations in individuals without

significant inflammation. Rather, changes in lipid levels, in part or

largely, may represent a predictable response to attenuation of

inflammation. These observations are increasingly important clinically

and should aid in the understanding and interpretation of lipid

changes under inflammatory conditions, as well as in the context of

potent anti-inflammatory interventions.

PMID: 19286905

http://www.ncbi.nlm.nih.gov/pubmed/19286905

Not an MD

[Guest guest]

Hi ,

Would you or anyone know of any correlation between RA and short term memory

depletion?  Post menopause.

 

Best wishes

From: <Rheumatoid.Arthritis.Support@...>

Subject: [ ] REVIEW - Interpreting lipid levels in the context of

high-grade inflammatory states with a focus on RA

" " < >

Date: Wednesday, 25 March, 2009, 11:11 PM

Ann Rheum Dis. 2009 Apr;68(4):460- 9.

Interpreting lipid levels in the context of high-grade inflammatory

states with a focus on rheumatoid arthritis: a challenge to

conventional cardiovascular risk actions.

Choy E, Sattar N.

Sir Alfred Baring Garrod Clinical Trials Unit, Academic Department of

Rheumatology, King's College, London, UK.

In severe untreated rheumatoid arthritis (RA), reductions in

high-density lipoprotein- cholesterol, low-density

lipoprotein- cholesterol and total cholesterol have been noted; this is

in line with findings in other pathologies/ conditions associated with

inflammation or infection, such as sepsis, cancer, trauma or the

postoperative period. Although the precise mechanisms remain to be

established, cytokine-induced activation of the reticuloendothelial

system is potentially critical to such changes. Consequently,

dampening of inflammation in severe RA-as occurs with several

biologics-may lead to increases, not only in high-density

lipoprotein- cholesterol, but also with other lipid moieties, including

total and low-density lipoprotein- cholesterol and, perhaps,

triglycerides. This concept is consistent with findings following

antitumour necrosis factor treatment and interleukin- 6 receptor

inhibition in patients with RA. At the same time, it is increasingly

apparent that potent dampening of inflammation, however achieved,

broadly reduces the risk of cardiovascular disease in RA. Therefore,

changes in lipid profiles, particularly increases in cholesterol and

triglycerides that occur with treatments for severe inflammation, may

not represent increased cardiovascular risk as in the usual

understanding of lipid-level elevations in individuals without

significant inflammation. Rather, changes in lipid levels, in part or

largely, may represent a predictable response to attenuation of

inflammation. These observations are increasingly important clinically

and should aid in the understanding and interpretation of lipid

changes under inflammatory conditions, as well as in the context of

potent anti-inflammatory interventions.

PMID: 19286905

http://www.ncbi. nlm.nih.gov/ pubmed/19286905

Not an MD

[Guest guest]

So maybe this explains why it's so hard to get my triglycerides under

100. Last time my cholesterol was checked, they were 101, down from

what they were previously.

I do take a mild statin, and my total cholesterol is good, about 150

last blood work. But I had no idea that Enbrel could affect cholesterol.

Sue

On Mar 25, 2009, at 7:11 PM, wrote:

>

> Consequently,

> dampening of inflammation in severe RA-as occurs with several

> biologics-may lead to increases, not only in high-density

> lipoprotein-cholesterol, but also with other lipid moieties, including

> total and low-density lipoprotein-cholesterol and, perhaps,

> triglycerides. This concept is consistent with findings following

> antitumour necrosis factor treatment and interleukin-6 receptor

> inhibition in patients with RA.