The Composition of the HDL Particle and Its Capacity to Remove Cellular Cholesterol Are Associated with a Reduced...

Area of Science:

• Cardiovascular Medicine
• Rheumatology
• Biochemistry

Background:

• Rheumatoid arthritis (RA) significantly increases cardiovascular death risk due to systemic inflammation and altered lipoprotein profiles.
• Understanding lipid changes in RA is crucial for managing associated cardiovascular complications.

Purpose of the Study:

• To investigate plasma lipid levels, lipid ratios, and high-density lipoprotein (HDL) composition and functionality in RA patients.
• To correlate these parameters with disease activity scores (DAS28) and identify predictors of active RA.

Main Methods:

• Analysis of plasma lipids (TC, TG) and HDL composition (HDLc, TG, PL, apoA-1, apoB) in 50 controls and 56 RA patients (13 remission, 43 active disease).
• Assessment of HDL-mediated cholesterol efflux and anti-inflammatory activity in macrophages.
• Statistical analysis using Mann-Whitney test and binary logistic regression.

Main Results:

• RA subjects had higher TC and TC/apoB ratio than controls.
• Active RA patients showed higher TG and TG/HDLc ratio, and lower HDLc, TG/apoB ratio, TC, and HDL apoA-1 compared to remission patients.
• Increased HDLc, TC/apoB, HDL TC, PL, and apoA-1 were associated with decreased active RA risk, while BMI and TG were positively associated.
• Reduced HDL cholesterol efflux increased active RA risk by 26.2%.

Conclusions:

• Plasma HDLc levels, HDL particle composition, and HDL functionality are linked to the inflammatory status in RA.
• These HDL-related factors may play a role in the heightened cardiovascular disease risk observed in RA patients.