Lipid profile and its relationship with endothelial dysfunction and disease activity in patients of early Rheumatoid Arthritis

Abstract

BackgroundLipid profile derangements in patients with early rheumatoid arthritis (RA) have been described. These may predispose to premature atherosclerosis and early cardiovascular events. However data from India is sparse. ObjectiveTo evaluate the serum lipid profiles in patients of early RA, and assess the inter-relationship between serum lipid profile, endothelial dysfunction, disease activity and inflammatory markers. Materials and methods50 patients of early RA and 50 age and sex matched healthy controls were included in the study. Fasting lipid profiles and brachial artery flow mediated vasodilatation (FMV%) were estimated, along with other disease activity parameters in the RA group. ResultEarly RA patients showed an atherogenic lipid profile characterized by an increase in the Total Cholesterol (TC) (180.12 ± 16.50 versus 141.30 ± 9.57; p value < 0.0001) and Low Density Lipoprotein-Cholesterol (LDL-C) (126.82 ± 17.49 versus 79.36 ± 10.04; p value < 0.0001) and a reduction in the High Density Lipoprotein-Cholesterol (HDL-C) (37.92 ± 3.85 versus 44.42 ± 4.38; p value < 0.0001) as compared with their age and sex matched healthy controls. Mean FMV% in early RA patients (3.87 ± 1.70) was less than the controls (8.7 ± 1.58). Patients of early RA showed an atherogenic lipid profile with high atherogenic ratios of TC/HDL and LDL/HDL thus suggesting that these patients are at higher risk of developing atherosclerosis. There was significant correlation between lipoprotein levels, disease activity, endothelial dysfunction and inflammation. ConclusionPatients of early rheumatoid arthritis have an atherogenic lipid profile and impaired FMV%, which correlates with disease activity and inflammation.