High density lipoprotein in rheumatoid arthritis: emerging role in predicting inflammation level and osteoporosis...

Area of Science:

• Rheumatology
• Endocrinology
• Cardiovascular Medicine

Background:

• Dyslipidemia is prevalent in rheumatoid arthritis (RA) patients, affecting disease progression.
• Understanding lipid profiles, particularly high-density lipoprotein (HDL), is crucial for managing RA complications.

Purpose of the Study:

• To investigate the clinical significance of HDL in Chinese RA patients.
• To analyze the association between HDL levels and osteoporosis (OP) in RA.
• To explore the relationship between HDL levels and disease activity, organ involvement, and cardiovascular disease (CVD) incidence in RA.

Main Methods:

• Retrospective study analyzing serum lipid profiles (TC, TG, HDL, LDL) in RA patients with and without OP.
• Logistic regression and ROC curve analysis to determine HDL's association with OP.
• Comparison of inflammatory markers (CRP, ESR), disease activity scores (DAS28), and complication rates across different HDL levels.

Main Results:

• RA patients with OP had significantly higher HDL levels (1.2 ± 0.3 mmol/L) compared to those without OP.
• HDL was identified as a significant risk factor for OP in RA patients (OR: 10.2; 95% CI: 4.5-23.0) after adjusting for covariates.
• Lower HDL levels (≤ 1.04 mmol/L) in RA patients were associated with higher CRP, ESR, DAS28, and CVD incidence, but a lower incidence of OP.

Conclusions:

• HDL levels play a significant role in the pathogenesis of RA-related osteoporosis.
• HDL may serve as a valuable predictive biomarker for disease complications, including OP and CVD, in RA patients.