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Updated: Nov 16, 2025
Cholesterol Efflux Assay
Published on: March 6, 2012
HDL cholesterol efflux capacity and lipid profile in patients with systemic sclerosis
Iván Ferraz-Amaro1, Esmeralda Delgado-Frías1, Vanesa Hernández-Hernández1
1Servicio de Reumatología, Hospital Universitario de Canarias, C/Ofra s/n, 38320, Santa Cruz de Tenerife, Spain.
Insights
Systemic sclerosis patients exhibit altered lipid profiles and reduced cholesterol efflux capacity (CEC). Skin thickness in these patients is inversely linked to CEC, highlighting a potential cardiovascular risk factor.
Area of Science:
- Cardiovascular disease research
- Lipid metabolism and atherosclerosis
- Rheumatology and autoimmune diseases
Background:
- Systemic sclerosis (SSc) is associated with disrupted lipid profiles and increased cardiovascular risk.
- Cholesterol efflux capacity (CEC), mediated by high-density lipoprotein (HDL), is a key factor in cardiovascular health.
- Impaired CEC may contribute to the heightened cardiovascular risk observed in SSc patients.
Purpose of the Study:
- To investigate whether CEC and lipid profiles are impaired in SSc patients compared to healthy controls.
- To determine if SSc-related factors are associated with alterations in CEC and lipid profiles.
Main Methods:
- A cross-sectional study involving 73 SSc patients and 115 controls.
- Assessment of in vitro CEC and serum lipoprotein concentrations.
- Multivariable analysis to identify differences and associations between SSc patients and controls, considering disease-related data.
Main Results:
- SSc patients demonstrated significantly different lipid profiles, including total cholesterol, triglycerides, and lipoprotein A, compared to controls.
- Cholesterol efflux capacity (CEC) was significantly lower in SSc patients.
- Increased skin thickness, measured by the modified Rodnan skin score, was independently associated with reduced CEC in SSc patients.
Conclusions:
- Systemic sclerosis patients present with an abnormal lipid profile and impaired cholesterol efflux capacity (CEC) compared to controls.
- Skin thickness is an independent factor inversely associated with CEC in SSc patients.
- These findings suggest that CEC and lipid abnormalities in SSc may be linked to disease characteristics, impacting cardiovascular risk.
Objective:
It is well established that patients with systemic sclerosis (SSc) have a disrupted lipid profile and an increased cardiovascular risk. Cholesterol efflux capacity (CEC), the ability of high-density lipoprotein (HDL)-cholesterol to accept cholesterol from macrophages, has been linked to cardiovascular events. The aim of this study was to establish whether CEC and lipid profile were impaired in SSc patients with respect to controls and whether these changes were associated with disease-related data.
Methods:
Cross-sectional study encompassed 188 individuals: 73 SSc patients and 115 controls. CEC, using an in vitro assay, and lipoprotein serum concentrations were assessed in patients and controls. A multivariable analysis was performed to study the differences in CEC between patients and controls, and if SSc-related data could explain such differences.
Results:
The multivariable analysis adjusted for demographic characteristics, cardiovascular risk factors, and lipid-related molecules showed that total cholesterol (beta coefficient: - 22 [95%CI - 37 to - 7], p = 0.004), triglycerides (beta coefficient: 24 [95%CI 2-47], p = 0.033), lipoprotein A (beta coefficient: 22 [95%CI 2-43], p = 0.033), and CEC (beta coefficient: - 6 [95%CI - 10 to - 2]%,p = 0.002) were significantly different between patients and controls. Skin thickness, as assessed by modified Rodnan skin score, was independently associated with a lower CEC (beta coefficient: - 0.21 [95%CI - 0.37 to - 0.05]%, p = 0.011) after multivariable adjustment.
Conclusion:
SSc patients show an abnormal lipid profile with respect to controls including CEC. Skin thickness is independent and inversely associated with CEC in SSc patients.
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