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Atherogenic dyslipidaemia in rheumatoid arthritis

Emerging data suggest a link between triglyceride-rich lipoproteins, inflammation and atherogenesis. This study adds to this, suggesting that increased number of triglyceride-rich lipoproteins and dysfunctional high-density lipoproteins (HDL) may represent the missing link between inflammation and lipids in rheumatoid arthritis.
This prospective study measured inflammatory mediators, paraoxonase-1 (PON1) activity, and serum total antioxidant capacity in 113 patients with rheumatoid arthritis, 113 healthy controls, and 27 dyslipidaemic subjects. Overall, 26% (29/113) rheumatoid arthritis patients had atherogenic dyslipidaemia, characterised by high fasting triglycerides and low HDL-C. These patients also had significantly increased serum levels of inflammatory mediators (including tumour necrosis factor alpha and monocyte chemotactic protein, both p=0.004), and leptin, p <0.001) but decreased PON1 and antioxidant activity. Moreover, the high triglycerides/low HDL-C profile was also associated with poor clinical response to tumour necrosis factor-? blockade.
These data suggest the importance of atherogenic dyslipidaemia beyond the setting of residual cardiovascular risk, to also include management of inflammatory disease such as rheumatoid arthritis.
High triglycerides and low high-density lipoprotein cholesterol lipid profile in rheumatoid arthritis: A potential link among inflammation, oxidative status, and dysfunctional high-density lipoprotein.

Rodríguez-Carrio J, Alperi-López M, López P, López-Mejías R, Alonso-Castro S, Abal Fet al.