Disease activity and lipids in rheumatoid arthritis: a prospective study

Abstract

Background Atherosclerotic cardiovascular disease (CVD) is the major cause for mortality in rheumatoid arthritis (RA). Dyslipidemia is an important risk factor for CVD and is influenced by the disease activity of RA. There is paucity of data on this subject in Indian patients with RA. Objectives To study the lipid levels in patients with RA and their relation with disease activity. Method The prospective study was carried out at a tertiary care centre in northern India. Results The study population included 96 patients with RA. Using the “high” cut-off values of National Cholesterol Education Programme–Adult Treatment Panel (NCEP-ATP III) as many as 38.5% (37/96) of patients exhibited dyslipidemia. Low high-density lipoprotein cholesterol (HDL-C) was the commonest abnormality seen in 34.3% of (33/96) patients. Disease activity scores (DAS-28) were at baseline and on a follow-up visit after 3 months they were 4.9 (1.02) and 4.4 (0.9), respectively ( P = 0.003). With a decline in disease activity, a rising trend was observed for all lipids, statistically significant only for HDL. DAS-28 showed significant negative correlation with TC, r = 0.302 (0.003) and LDL-C, r = 0.274 (0.007). For HDL and TG, the correlation was not significant. Conclusion Lipid abnormalities are common in Indian patients with RA. Low HDL is the commonest abnormality. Disease activity is negatively related with lipids.