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Dysfunctional high-density lipoprotein in chronic inflammatory rheumatic diseases

Sabina Waldecker-Gall1, Felix Seibert2, Sebastian Bertram2

  • 1Rheumazentrum Ruhrgebiet, Ruhr-University Bochum, Germany.

Therapeutic Advances in Musculoskeletal Disease
|August 30, 2023
PubMed

Insights

Chronic inflammatory rheumatic disease (CIRD) is linked to higher oxidized high-density lipoprotein (HDLox), indicating impaired HDL function. Treatment reduced HDLox, suggesting improved cardiovascular health in CIRD patients.

Area of Science:

  • Rheumatology
  • Cardiovascular Disease
  • Lipid Metabolism

Background:

  • The mechanisms behind low cholesterol in chronic inflammatory rheumatic diseases (CIRD) are not fully understood.
  • Chronic inflammation may impair high-density lipoprotein (HDL) functionality through oxidative processes.

Purpose of the Study:

  • To assess oxidized HDL (HDLox), a marker of HDL dysfunction, in newly diagnosed CIRD patients.
  • To compare HDLox levels in CIRD patients before and after immunosuppressive therapy with non-CIRD controls.

Main Methods:

  • A prospective observational trial involving 44 newly diagnosed CIRD patients and 136 controls.
  • Measurements included lipid profiles, HDLox, and C-reactive protein (CRP) at baseline and 12 weeks for CIRD patients.
  • Disease activity and function were assessed using validated tools.

Main Results:

  • CIRD patients exhibited significantly higher HDLox concentrations compared to controls (1.57 vs. 0.78, p=0.02).
  • CIRD patients showed trends towards lower LDL, HDL, and total cholesterol levels.
  • HDLox and CRP levels decreased in CIRD patients after 12 weeks of immunosuppressive therapy.

Conclusions:

  • CIRD is associated with impaired HDL anti-inflammatory properties, evidenced by increased HDLox.
  • Elevated HDLox may contribute to the heightened cardiovascular risk observed in chronic inflammatory diseases.
Abstract

Keywords:
axial spondyloarthritiscardiovascular riskinflammationoxidized high-density lipoproteinrheumatic diseaserheumatoid arthritis

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