Postprandial Hyperlipidemia: Association with Inflammation and Subclinical Atherosclerosis in Patients with Rheumatoid Arthritis.

Natalia Mena-Vázquez,Laura Cano-García,Marta Rojas-Gimenez,José Rioja,Antonio Fernández-Nebro,Pedro Valdivielso,Rocío Redondo-Rodríguez,Francisco Gabriel Jimenez-Nuñez,Jose Manuel Lisbona-Montañez,Sara Manrique-Arija,Inmaculada Ureña

doi:10.3390/biomedicines10010133

Abstract

Objective: To describe postprandial lipidemia in patients with rheumatoid arthritis (RA) and to analyze its association with subclinical atherosclerosis and inflammatory activity. Methods: Observational study of 80 cases of RA and 80 sex- and age-matched controls. We excluded individuals with dyslipidemia. Postprandial hyperlipidemia (PPHL) was defined as postprandial triglycerides >220 mg/dL and/or postprandial ApoB48 levels >75th percentile (>p75). Plasma lipids, cholesterol, triglycerides, ApoB48, and total ApoB were evaluated at baseline and after a meal. Other variables analyzed included subclinical atherosclerosis (defined as presence of carotid atheromatous plaque), inflammatory activity (disease activity score (DAS28-ESR)), cytokines, apolipoproteins, and physical activity. A multivariate analysis was performed to identify factors associated with PPHL in patients with RA. Results: A total of 75 patients with RA and 67 healthy controls fulfilled the inclusion criteria. PPHL was more frequent in patients with RA than controls (No. (%), 29 (38.70) vs. 15 (22.40); p = 0.036), as was subclinical atherosclerosis (No. (%), 22 (30.10) vs. 10 (14.90); p = 0.032). PPHL in patients with RA was associated with subclinical atherosclerosis (OR (95% CI) 4.69 (1.09–12.11); p = 0.037), TNF-α (OR (95% CI) 2.00 (1.00–3.98); p = 0.048), high-sensitivity C-reactive protein (OR (95% CI) 1.10 (1.01–1.19); p = 0.027), and baseline triglycerides (OR (95% CI) 1.02 (1.00–1.04); p = 0.049). Conclusion: PPHL was more frequent in patients with RA than in controls. PPHL in patients with RA was associated with inflammation and subclinical atherosclerosis.

Highlights

Introduction distributed under the terms andRheumatoid arthritis (RA) is a chronic inflammatory disease characterized by persistent sinusitis, bone erosion, and functional incapacity
This approach showed that patients with rheumatoid arthritis (RA) had fasting triglyceride and ApoB48 values that were similar to those of controls, postprandial hyperlipidemia (PPHL) was more frequent in patients with RA (p = 0.036)
Postprandial hyperlipidemia values are higher in patients with RA than in controls, even though fasting triglycerides were similar in both groups

Summary

Introduction

Introduction distributed under the terms andRheumatoid arthritis (RA) is a chronic inflammatory disease characterized by persistent sinusitis, bone erosion, and functional incapacity. RA is associated with premature death and multiple morbidities [1], mainly because the associated cardiovascular risk is similar to that of patients with type 2 diabetes mellitus [2] This increased risk can be conditions of the Creative Commons. Interest in triglycerides as a cardiovascular risk factor is growing, since elevated postprandial lipidemia was recently shown to be an independent predictor of the risk of arteriosclerosis in the general population [8,9]. This triglyceride intolerance syndrome results from difficulty processing triglyceride-rich lipoproteins, which in turn increase the risk of atherosclerosis [10,11].

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