Atherogenic lipid profiles in rheumatoid arthritis

Rheumatoid arthritis is associated with an excess mortality from cardiovascular disease, and this may be related to an atherogenic lipid profile. We set out to identify whether there was a correlation between disease activity and levels of different lipid fractions in a stable population of patients with rheumatoid arthritis on disease-modifying therapy.

Patients with rheumatoid arthritis were selected from our database and requested to have inflammatory markers and a fasting lipid profile taken at their next visit for monitoring of their disease modifying therapy.

204 patients were recruited for the study. A statistically significant relationship exists between reduced HDL and elevated CRP (p=0.01) and ESR (p=0.041). Elevated ESR, but not elevated CRP, was associated with raised LDL cholesterol (p=0.014). Fourteen patients (6.8%) were receiving statin therapy and 71 (34.8%) were taking prednisone. Use of prednisone, independent of dose, was associated with elevated triglyceride levels (p=0.041).

This study supports previous work showing that rheumatoid arthritis is associated with an adverse lipid profile. While good disease control is clearly important, we should not neglect management of traditional cardiovascular risk factors.