Lipid profiles in untreated patients with rheumatoid arthritis

Objective. To investigate lipid profiles in patients with untreated active rheumatoid arthritis (RA) and to assess the relationship of the inflammatory condition of RA with lipid profiles. Methods. Forty-two patients with RA and 42 age and sex matched healthy controls were studied. Patients with RA had not been treated with corticosteroid or disease modifying antirheumatic drugs prior to the study. Total cholesterol, triglyceride, HDL- cholesterol, LDL-cholesterol, apolipoprotein A1 (apo A1), apolipoprotein B (apo B), lipoprotein(a) [Lp(a)], and C-reactive protein (CRP) were measured in both groups. Results. The levels of apo A1 and HDL-cholesterol were significantly lower in patients than in controls (128.5 vs 151.8 mg/dl, 41.2 vs 54.9 mg/dl, respectively). The level of Lp(a) was significantly higher in patients than in controls (27.1 vs 18.0 mg/dl). The ratios of apo B/apo A1, total cholesterol/HDL-cholesterol, and LDL-cholesterol/HDL-cholesterol were significantly higher in patients than in controls (0.82 vs 0.67, 4.4 vs 3.4, 2.8 vs 1.9, respectively). CRP showed a significant correlation with apo A1 (r = -0.44, p < 0.01) and HDL-cholesterol (r = -0.35, p < 0.05). Conclusion. Our study suggests that patients with untreated active RA have altered lipoprotein and apolipoprotein patterns that may possibly expose them to higher risk of atherosclerosis. The inflammatory condition of RA may affect the metabolism of HDL-cholesterol and apo A1.