Influence of inflammation and the presence of amyloid on lipid metabolism in patients with rheumatoid arthritis

Introduction: Patients with rheumatoid arthritis (RA) display an accelerated atherosclerosis that is related in part to lipid metabolism disorders associated with the inflammatory process, which includes serum amyloid protein A. Objective: To evaluate the lipid profile in treated RA patients and its relationship to inflammatory activity and the presence of secondary amyloidosis. Methods: Seventy-eight female patients with RA were studied. Blood samples were obtained from all patients, to analyze the lipid profile (total cholesterol, HDL-c, HDL3-c, HDL2-c, LDL-c, triglycerides, lipoprotein (a) and apolipoproteins AI and B), an abdominal fat pad aspirate was performed to determinate the presence of amyloid, and the activity of the disease by clinical and laboratory parameters was evaluated. The control group was selected from a population-based study. Results: The RA patients had significantly higher concentrations of HDL-c and lower of apolipoprotein B than selected general population. Amyloid deposition was detected in 11%, and compared to patients without amyloidosis, significant differences in HDL-c concentrations was not observed, although the HDL3-c was higher, with differences near to statistical significance (p = 0.087). Inflammatory activity correlated negatively with HDL-c, HDL3-c and apolipoprotein AI in RA patients. Conclusions: There is a significant negative correlation between cardioprotective lipid parameters and inflammatory activity in women with treated RA, that is not related with the presence of amyloid deposits. (C) 2012 Elsevier Espana, S.L. and SEA. All rights reserved.