Abstract
ObjectiveIt 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.MethodsCross-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.ResultsThe 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.ConclusionSSc patients show an abnormal lipid profile with respect to controls including CEC. Skin thickness is independent and inversely associated with CEC in SSc patients.
Highlights
The high-density lipoprotein (HDL) particle has multiple potentially antiatherogenic properties
It has been demonstrated that cholesterol efflux capacity” (CEC) is disrupted in patients with rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) [5], a finding associated with an increased subclinical atherosclerosis in both diseases [6, 7]
Many differences were found in the lipid profiles between patients and controls
Summary
The HDL particle has multiple potentially antiatherogenic properties Much of this beneficial effect is thought to be mediated by its participation in the removal of cholesterol from macrophages in atherosclerotic plaques during a well-known anti-atherogenic process [1] termed “cholesterol efflux capacity” (CEC) [2]. Limited cutaneous SSc has been linked to low high-density lipoprotein (HDL) and total cholesterol serum levels [10] compared to controls. In another report, encompassing both limited and diffuse SSc, patients exhibited low serum levels of HDL cholesterol and high total cholesterol [11]. The atherogenic ratio LDL (low-density lipoprotein):HDL was significantly higher among SSc patients versus controls [11]. Lipoprotein A serum levels have been found to be higher in patients with SSc compared to controls [12]. CEC has not been explored with respect to controls in this disease
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