Are lipid ratios less susceptible to change with systemic inflammation than individual lipid components in patients with rheumatoid arthritis?

Tracey E. Toms, Vasileios F. Panoulas, Karen M.J. Douglas, Peter Nightingale, Jacqueline P. Smith, Helen Griffiths, Naveed Sattar, Deborah P.M. Symmons, George D. Kitas

Research output: Contribution to journalArticlepeer-review

Abstract

Rheumatoid arthritis (RA) associates with excess cardiovascular risk and there is a need to assess that risk. However, individual lipid levels may be influenced by disease activity and drug use, whereas lipid ratios may be more robust. A cross-sectional cohort of 400 consecutive patients was used to establish factors that influenced individual lipid levels and lipid ratios in RA, using multiple regression models. A further longitudinal cohort of 550 patients with RA was used to confirm these findings, using generalized estimating equations. Cross-sectionally, higher C-reactive protein (CRP) levels correlated with lower levels of total cholesterol (TC), low-density lipoprotein-cholesterol (LDL-C), and high-density lipoprotein-cholesterol ([HDL-C] P = .015), whereas lipid ratios did not correlate with CRP. The findings were broadly replicated in the longitudinal data. In summary, the effects of inflammation on individual lipid levels may underestimate lipid-associated cardiovascular disease (CVD) risk in RA, thus lipid ratios may be more appropriate for CVD risk stratification in RA.
Original languageEnglish
Pages (from-to)167-175
Number of pages9
JournalAngiology
Volume62
Issue number2
Early online date3 Aug 2010
DOIs
Publication statusPublished - Feb 2011

Keywords

  • aged
  • anti-inflammatory agents
  • antirheumatic agents
  • rheumatoid arthritis
  • c-reactive protein
  • cohort studies
  • cross-sectional studies
  • dyslipidemias
  • female
  • humans
  • lipids
  • male
  • middle aged
  • retrospective studies
  • risk factors

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