LIPID PROFILES AND MATRIX METALLOPROTEINASE-3 IN PATIENTS WITH RHEUMATOID ARTHRITIS

Abstract

TOPIC: Cardiovascular Disease TYPE: Original Investigations PURPOSE: Rheumatoid arthritis (RA) is associated with an unexplained increased cardiovascular risk. Matrix metalloproteinase-3 (MMP-3) is the most important protease involved in RA inflammation which may play a role in the development of cardiovascular events. Specific role of MMP-3 in cardiac pathology in RA patients (pts) is not well investigated.OBJECTIVE: To compare levels lipid profiles and MMP-3 in patients (pts) with active RA and healthy people. METHODS: Thirty nine RA pts (33 women and 6 men, median age 56,5 [49; 65] years), with active arthritis (mean disease duration 96 [48; 190] months; DAS28 5,8 [5,3;6,3]; HAQ 1,8 [1,3; 2,2]) were enrolled in the study. Twenty three pts (59%) received methotrexate, 5 (13%) – the combination of methotrexate with oral glucocorticoids, 10 (26%) - oral glucocorticoids monotherapy. The control group consisted of 29 volunteers (21 women and 8 men, median age 58,5 [53; 62] years). The concentration of total cholesterol (TC) and triglycerides (TG) in the blood determined colorimetrically, low density lipoprotein cholesterol (LDL-C) – homogeneous enzymatic colorimetric method, high density lipoprotein cholesterol (HDL-C) – quantitative photometric method. Atherogenic index (AI) calculated by the formula: IA = (HC – HDL-C)/HDL-C. Serum MMP-3 were measured by enzyme-linked immunosorbent assay (ELISA). RESULTS: Rates of dyslipidemia were similar in RA pts (23/39 (59%) and control group subjects (15/29 (52%). Concentrations of lipids were also similar in both groups and were as follows: total cholesterol was 5,2 [4,9; 6,2]mmol/l in RA pts and 6,3[5,1; 6,6]mmol/l in the control group; HDL cholesterol - 1,7 [1,4; 2,0]mmol/l and 1,7[1,5; 2,1]mmol/l,LDL cholesterol - 3,3 [2,8; 4,0]mmol/l and 3,6[3,0; 4,0]mmol/l, triglycerides - 1,3 [1,0; 1,6]mmol/l and 1,4[1,1; 1,8]mmol/l, the atherogenic index of plasma - 2,4 [1,8; 2,8] and 2,4 [1,9; 3,0], respectively. Elevated MMP-3 levels were detected more frequently in RA pts (31/39 (79%)) vs healthy controls (2/29 (7%), p<0,0001). MMP-3 concentrations were higher in RA pts (57,0 [36,6; 114,3ng/ml), than in the control group subjects (13,4 [9,9; 20,4]mg/ml, p <0,0001). In RA pts and in healthy controls, MMP-3 levels demonstrated significant correlation with erythrocyte sedimentation rate (ESR) (r =0,64, p < 0,05) and C-reactive protein (CRP) (r =0,52, p < 0,05) values. In the RA group, concentrations of HDL cholesterol were negatively correlated with MMP-3 (r = -0,5, p < 0,05), CRP (r = -0,53, p< 0,05), and DAS28 (r = -0,4, p< 0,05). Showed no correlation between the levels of lipids and MMP-3 in control group. CONCLUSIONS: RA pts exhibited higher serum MMP-3 levels than healthy individuals. Obtained results suggest that MMP-3 and CRP may produce a negative impact on HDL-Cl levels in pts with active RA. CLINICAL IMPLICATIONS: Control over RA activity probably avoids the development of dyslipidemia in RA pts. DISCLOSURES: No relevant relationships by Maria Cherkasova, source=Web Response No relevant relationships by Elena Gerasimova, source=Web Response No relevant relationships by Tatiana Popkova, source=Web Response