Total cholesterol and LDL levels decrease before rheumatoid arthritis

Department of Health Sciences Research, Mayo Foundation, 200 First Street SW, Rochester, MN 55905, USA.
Annals of the rheumatic diseases (Impact Factor: 10.38). 10/2009; 69(7):1310-4. DOI: 10.1136/ard.2009.122374
Source: PubMed


To compare lipid profiles in patients with rheumatoid arthritis (RA) and in non-RA subjects during the 5 years before and 5 years after the RA incidence/index date.
Lipid measures were abstracted in a population-based incident cohort of patients with RA (1987 American College of Rheumatology criteria) first diagnosed between 1 January 1988 and 1 January 2008 and in non-RA subjects. Random-effects models adjusting for age, sex and calendar year were used to examine trends in lipid profiles, accounting for multiple measurements for each subject.
The study population included a cohort of 577 patients with RA (a total of 3088 lipid measurements) and 540 non-RA subjects (a total of 3048 lipid measurements). There were significant decreases in total (TC) and low-density lipoprotein cholesterol (LDL) levels in the RA cohort during the 5 years before RA, compared with the non-RA cohort (p<0.001). Decreases of 0.58 mmol/l for TC and 0.61 mmol/l for LDL were noted in RA compared with decreases of 0.09 mmol/l for TC and 0.22 mmol/l for LDL in the non-RA cohort. Trends in other lipid measures (triglycerides (TGs) and high-density lipoprotein cholesterol (HDL)) were similar in RA and non-RA cohorts during the 5 years before and 5 years after the RA incidence/index date. During the 5 years before the RA incidence/index date, the proportion of patients with RA with elevated TC or LDL measures, but not with abnormal HDL and TG measures, significantly decreased compared with non-RA subjects. Lipid-lowering drugs (statins in particular) were less often prescribed to patients with RA than to non-RA subjects (34% vs 41%; p=0.02).
TC and LDL levels and the prevalence of abnormal TC or LDL measures decreased significantly during the 5 years before the RA incidence/index date in patients with RA as compared with the non-RA cohort. These trends in lipid profile in RA are unlikely to be solely due to lipid-lowering treatment.


Available from: Hilal Maradit Kremers, Nov 26, 2014
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    • "Quanto ao IMC, resultados de estudo alemão com 551 pacientes que identificou valores de 26,7 ± 5,1 corroboram nossos resultados de 27,6 ± 4,94. Nossos resultados foram semelhantes aos de Myasoedova et al. (2010), 33 que relataram que 3/4 dos pacientes com AR apresentaram IMC acima do índice de normalidade. 34 Além disso, essa proporção de pacientes com sobrepeso e obesidade determinados a partir do IMC, segundo os critérios para população geral, pode estar subestimada, pois tem sido demonstrado que para uma dada quantidade de gordura corporal os pacientes com AR têm dois quilos/m 2 a menos do que controles normais. "
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    ABSTRACT: Objective: To identify risk factors for cardiovascular disease in patients with Rheumatoid Arthritis (RA). Material and methods: A descriptive cross-sectional study with 71 patients with established RA. The instruments used were: DAS-28, HAQ and SF-36, and the following parameters were determined: the erythrocyte sedimentation rate, capillary blood glucose; total cholesterol (TC) and its fractions, thyroid hormones, antinuclear antibodies (ANA), rheumatoid factor (RF) and antibodies against citrullinated proteins (ACPAs). Patients were classified into groups HAQ ≤ 1 (mild dysfunction) and HAQ > 1 (moderate and severe dysfunction) and, according to the HAQ scores, in groups treated with corticosteroids (CS) and without CS. Results: 9 patients were male and 62 female with mean age and duration of disease of 53.45 (± 10.7) and 9.9 (± 8.6), respectively. RF was positive in 52 (76%), ACPAs in 54 (76.1%) and ANA in 12 (16.9%). Thirty-six patients (50.7%) had systemic hypertension, 9 (12.68%) diabetes mellitus, 16 (22.5%) hypothyroidism, 33 (46.5%) dyslipidemia and 8 (11.27%) were smokers. The results of TC >240 were found in 53.8% for group HAQ >1 (26) and in 24.4% for group HAQ ≤ 1 (45) (p=0.020). These groups did not differ as to presence of comorbidities or drug treatment. Triglyceride levels >200 for the group with CS (42.4%) versus without CS (18.42%) were significant (p=0.025). Conclusion: An association of increased TC and triglycerides with results of HAQ ≤ 1 and with CS use was noted, reinforcing the importance of screening risk factors associated with cardiovascular disease in RA.
    Revista Brasileira de Reumatologia 09/2015; 365. DOI:10.1016/j.rbr.2015.02.001 · 1.09 Impact Factor
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    • "Such an autoimmune “pattern” has been reported in the TARF study [12, 27]. Reduced levels of LDL-cholesterol have been reported to similarly precede the clinical onset of rheumatoid arthritis [28]. Epidemiological data showing paradoxical inverse association of lipid levels with cardiovascular disease risk in rheumatoid arthritis patients have been reviewed [29]. "
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    BMC Nephrology 10/2014; 15(1):160. DOI:10.1186/1471-2369-15-160 · 1.69 Impact Factor
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    • ". 9. A precipitous decline in serum levels of total and LDL cholesterol was reported to precede the incidence of clinical rheumatoid arthritis [4]. Excess cardiovascular risk in rheumatoid arthritis also seems to be preceded by a lowering of total cholesterol and is followed by immune processes typically illustrated by positivity of rheumatoid factor [5]. 10. "
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    Current pharmaceutical design 04/2013; 20(4). DOI:10.2174/138161282004140213145551 · 3.45 Impact Factor
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