Affiliation:
1. Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, Boston, MA
2. NIH Heart, Blood and Lung Institute, Bethesda, MD
Abstract
Background
Potent anti‐inflammatory rheumatoid arthritis (RA) treatments are associated with reduced cardiovascular risk as well as increases in low‐density lipoprotein (
LDL
) cholesterol. This apparent paradox may be explained by favorable changes in other lipid measurements. The objective of this study was to determine the longitudinal association between changes in inflammation with advanced lipoprotein measurements and high‐density lipoprotein (
HDL
) cholesterol efflux capacity.
Methods and Results
We conducted this study in a longitudinal
RA
cohort from a large academic center, including subjects with high‐sensitivity C‐reactive protein (hs‐
CRP
) reduction ≥10 mg/L at 2 time points 1 year apart. Subjects receiving statins during the study period or preceding 6 months were excluded. We compared total cholesterol,
LDL
cholesterol, HDL cholesterol, apolipoprotein B, and apolipoprotein A1 levels and
HDL
cholesterol efflux capacity at baseline and 1‐year follow‐up by using the paired
t
test. We also assessed the correlations between reductions in hs‐
CRP
with percentage change in lipid parameters. We studied 90
RA
subjects (mean age 57 years, 89% female), all of whom were receiving disease‐modifying antirheumatic drugs. We observed a 7.2% increase in
LDL
cholesterol levels (
P
=0.02) and improvement in efflux capacity by 5.7% (
P
=0.002) between baseline and follow‐up, with a median hs‐
CRP
reduction of 23.5 mg/L. We observed significant correlations between reductions in hs‐
CRP
with increases in apolipoprotein A1 (
r
=0.27,
P
=0.01) and
HDL
cholesterol efflux capacity (
r
=0.24,
P
=0.02).
Conclusion
Among
RA
subjects experiencing reductions in hs‐
CRP
, we observed increased
LDL
cholesterol levels and concomitant improvements in
HDL
cholesterol efflux capacity. These findings provide further insight into lipid modulation and the beneficial effect of reduction in inflammation on lipids in vivo.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Subject
Cardiology and Cardiovascular Medicine
Cited by
107 articles.
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