High-density lipoprotein cholesterol subfractions HDL2 and HDL3 are reduced in women with rheumatoid arthritis and may augment the cardiovascular risk of women with RA: a cross-sectional studyReportar como inadecuado




High-density lipoprotein cholesterol subfractions HDL2 and HDL3 are reduced in women with rheumatoid arthritis and may augment the cardiovascular risk of women with RA: a cross-sectional study - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

Arthritis Research and Therapy

, 14:R116

First Online: 14 May 2012Received: 16 December 2011Revised: 18 April 2012Accepted: 14 May 2012

Abstract

IntroductionHigher levels of high density lipoprotein HDL subfractions HDL3-chol and particularly HDL2-chol protect against cardiovascular disease CVD, but inflammation reduces the HDL level and may impair its anti-atherogenic effect. Changed HDL composition through the impact of inflammation on HDL subfractions may contribute to the excess risk of CVD in rheumatoid arthritis RA. In this study, we investigated whether HDL2-chol and HDL3-chol concentrations differ between RA patients and healthy controls, and whether these levels are related to the level of RA disease activity.

MethodsNon-fasting blood samples were collected from 45 RA patients and 45 healthy controls. None of the participants had a history of CVD, diabetes, or used lipid-lowering drugs. HDL2-chol and HDL3-chol concentrations were obtained by ultracentrifugation. Regression modeling was used to compare HDL subfraction levels between RA patients and healthy controls, and to analyze the effect of disease activity on HDL2-chol and HDL3-chol.

ResultsHDL2-chol and HDL3-chol were significantly lower in RA patients compared to healthy controls P = 0.01, P = 0.005, respectively. The HDL2:HDL3 ratio was significantly lower in patients compared to controls P = 0.04. Reduced HDL2-chol and HDL3-chol levels were primarily present in female RA patients and not in male RA patients. A modest effect of the disease activity score in 28 joins DAS28 on HDL2-chol concentrations was found, after correction for disease duration, glucocorticosteroid use and body mass index BMI, with a 0.06 mmol-L decrease with every point increase in DAS28 P = 0.05. DAS28 did not significantly affect HDL3-chol concentrations P = 0.186.

ConclusionsBoth HDL subfractions but particularly HDL2-chol concentrations were decreased in RA, primarily in women. This seems to be associated with disease activity and is of clinical relevance. The reduction of the HDL subfraction concentrations, particularly the supposedly beneficial HDL2-chol, may negatively impact the cardiovascular risk profile of women with RA.

AbbreviationsApoA-Iapolipoprotein A-I

Apo-Bapolipoprotein B

BMIbody mass index

CETPcholesterylester transfer protein

CIconfidence interval

CRPC-reactive protein

CVDcardiovascular disease

DAS28disease activity score 28 joints

DMARDdisease-modifying anti-rheumatic drugs

ESRerythrocyte sedimentation rate

HDL-cholhigh-density-lipoprotein cholesterol

HDL2-cholhigh-density-lipoprotein 2 cholesterol

HDL3-cholhigh-density-lipoprotein 3 cholesterol

LDL-chollow-density-lipoprotein cholesterol

RArheumatoid arthritis

RCTreversed cholesterol transport

SDstandard deviation

TCtotal cholesterol

TGtriglycerides.

Electronic supplementary materialThe online version of this article doi:10.1186-ar3842 contains supplementary material, which is available to authorized users.

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Autor: Elke Arts - Jaap Fransen - Heidi Lemmers - Anton Stalenhoef - Leo Joosten - Piet van Riel - Calin D Popa

Fuente: https://link.springer.com/







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