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Rheumatology International

, Volume 25, Issue 4, pp 241–245 | Cite as

Lp(a) lipoprotein and lipids in patients with rheumatoid arthritis: serum levels and relationship to inflammation

  • Dursun Dursunoğlu
  • Harun Evrengül
  • Bülent Polat
  • Halil Tanrıverdi
  • Veli Çobankara
  • Asuman Kaftan
  • Mustafa Kılıç
Original Article

Abstract

Objectives

Changes in lipid profiles, Lp(a) lipoprotein, and acute phase reactants are associated with early atherosclerosis in rheumatoid arthritis (RA). The associations of Lp(a) levels with atherosclerotic disorders, diabetes, RA, and renal diseases suggest that Lp(a) might be involved in autoimmune reactions.

Methods

Eighty-seven women with RA diagnosed according to American Rheumatism Association criteria (mean age 45.4±9.4 years) were recruited and 50 healthy women (mean age 44±10.7 years) included as a control group. Serum Lp(a), total cholesterol (TC), triglyceride (TG), LDL cholesterol (LDL-C), HDL cholesterol (HDL-C), and C-reactive protein levels were analyzed.

Results

In the RA and C groups, serum Lp(a) levels were 39.2±20.6 mg/dl and 14.8±9.7 mg/dl, respectively (P<0.001). The TC levels were 188.4±41.8 mg/dl and 185.3±19.3 mg/dl (P>0.05), TG levels were 124.5±50.1 mg/dl and 94.6±24.9 mg/dl (P<0.01), HDL-C levels were 40.0±7.4 mg/dl and 52.8±4.8 mg/dl (P<0.01), and LDL-C levels were 123.4±24.6 mg/dl and 113.3±21.1 mg/dl (P>0.05). While serum CRP levels showed a positive correlation with Lp(a), they correlated negatively with HDL-C levels (r=0.83 and P<0.0001, r=−0.49 and P<0.0001, respectively). It was meaningful that Lp(a) correlated negatively with serum HDL-C level (r=−0.36, P<0.001).

Conclusions

It is suggested that higher serum Lp(a), lower HDL-C, higher TG level, and a high ratio of TC/HDL-C might show high risk of atherosclerosis. Inflammation in RA may cause changes in HDL-C and Lp(a) metabolisms.

Keywords

Inflammation Lipids Lp(a) lipoprotein Rheumatoid arthritis 

References

  1. 1.
    Isomaki HA, Mutru O, Koota K (1975) Death rate and causes of death in patients with rheumatoid arthritis. Scand J Rheumatol 4:205–208PubMedGoogle Scholar
  2. 2.
    Abruzzo JL (1982) Rheumatoid arthritis and mortality. Arthritis Rheum 25:1020–1023PubMedGoogle Scholar
  3. 3.
    Prior P, Symmons DPM, Scott DL, Brown R, Hawkins CF (1984) Causes of death in rheumatoid arthritis. Br J Rheumatol 23:92–99PubMedGoogle Scholar
  4. 4.
    Mutro O, Laakso M, Isomaki H, Koota K (1985) Ten year mortality and causes of death in patients with rheumatoid arthritis. BMJ 290:1811–1813PubMedGoogle Scholar
  5. 5.
    Wallberg-Jonsson S, Cederfelt M, Rantapää-Dahlqvist S (2000) Hemostatic factors and cardiovascular disease in active rheumatoid arthritis: an 8 year follow up study. J Rheumatol 27:71–75PubMedGoogle Scholar
  6. 6.
    Scanu AM (1992) Lipoprotein (a): a genetic risk factor for premature coronary heart disease. JAMA 267:3326–3329CrossRefPubMedGoogle Scholar
  7. 7.
    Gordon T, Castelli WP, Hjortland MC, Kannel WB, Dawber TR (1977) High density lipoprotein as a protective factor against coronary heart disease. Am J Med 62:707–714CrossRefPubMedGoogle Scholar
  8. 8.
    Rantapää-Dahlqvist S, Wallberg-Jonsson S, Dahlen G (1991) Lipoprotein (a), lipids and lipoproteins in patients with rheumatoid arthritis. Ann Rheum Dis 50:366–368PubMedGoogle Scholar
  9. 9.
    Arnett FC, Edworthy SM, Bloch DA, McShane DJ, Fries JF, Cooper NS, Healey LA, Kaplan SR, Liang MH, Luthra HS et al (1988) The American Rheumatism Association 1987 revised criteria for classification of rheumatoid arthritis. Arthritis Rheum 31:315–324PubMedGoogle Scholar
  10. 10.
    Assmann G, Schulte H, Cullen P (1997) New and classical risk factors-the Munster Heart study (PROCAM). Eur J Med Res 2:237–242PubMedGoogle Scholar
  11. 11.
    Lakatos J, Harsagyi A (1988) Serum total HDL, LDL cholesterol and triglyceride levels in patients with rheumatoid arthritis. Clin Biochem 21:93–96PubMedGoogle Scholar
  12. 12.
    Svensson K, Lithel H, Hallgren R, Selinus I, Vesby B (1987) Serum lipoprotein in active rheumatoid arthritis and other chronic inflammatory arthritides: I. Relativity to inflammatory activity. Arch Intern Med 147:1912–1916CrossRefPubMedGoogle Scholar
  13. 13.
    Lorber M, Aviram M, Linn S, Scharf Y, Brook JG (1985) Hypocholesterolemia and abnormal high density lipoprotein in rheumatoid arthritis. Br J Rheumatol 24:250–255PubMedGoogle Scholar
  14. 14.
    Park YB, Lee SK, Lee WK, Suh CH, Lee CW, Lee CH, Song CH, Lee J (1999) Lipid profiles in untreated patients with rheumatoid arthritis. J Rheumatol 26:1701–1704PubMedGoogle Scholar
  15. 15.
    Asanuma Y, Kawai S, Aoshima H, Kaburaki J, Mizushima Y (1999) Serum lipoprotein(a) and apolipoprotein(a) phenotypes in patients with rheumatoid arthritis. Arthritis Rheum 42:443–447CrossRefPubMedGoogle Scholar
  16. 16.
    Seriolo B, Accardo S, Cutolo M (1996) Lipoprotein (a) and other risk factors for thrombosis in rheumatoid arthritis. J Rheumatol 23:194–196Google Scholar
  17. 17.
    Seriolo B, Accardo S, Fasciolo D, Bertolini S, Cutolo M (1996) Lipoproteins, anticardiolipin antibodies and thrombotic events in rheumatoid arthritis. Clin Exp Rheumatol 14:593–599PubMedGoogle Scholar
  18. 18.
    Seriolo B, Accardo S, Fasciolo D, Sulli A, Bertolini S, Cutolo M (1995) Lipoprotein (a) and anticardiolipin antibodies as risk factors for vascular disease in rheumatoid arthritis. Thromb Haemost 74:799–800PubMedGoogle Scholar
  19. 19.
    Dahlen GH, Boman J, Birgander LS, Lindblom B (1995) Lp(a) lipoprotein, IgG, IgA and IgM antibodies to Chlamydia pneumoniae and HLA class II genotype in early coronary artery disease. Atherosclerosis 114:165–174CrossRefPubMedGoogle Scholar
  20. 20.
    Dahlen GH (1994) Indications of an autoimmune component in Lp(a) associated disorders. Eur J Immunogenet 21:301–312PubMedGoogle Scholar
  21. 21.
    Lee YH, Choi SJ, Ji JD, Seo HS, Song GG (2000) Lipoprotein (a) and lipids in relation to inflammation in rheumatoid arthritis. Clin Rheumatol 19:324–325CrossRefPubMedGoogle Scholar
  22. 22.
    Banks MJ, Kitas GD (1999) Lipoprotein (a) levels and atherosclerosis in rheumatoid arthritis: comment on the article by Asanuma et al. Arthritis Rheum 42:2491–2492CrossRefGoogle Scholar
  23. 23.
    Wallberg-Jonsson S, Uddhammar A, Dahlen G, Rantapää-Dahlqvist S (1995) Lipoprotein (a) in relation to acute phase reaction in patients with rheumatoid arthritis and polymyalgia rheumatica. Scand J Clin Lab Invest 55:309–315PubMedGoogle Scholar
  24. 24.
    Dahlen GH (1994) Lp (a) lipoprotein in cardiovascular disease. Atherosclerosis 108:111–126PubMedGoogle Scholar
  25. 25.
    Ehnholm C, Garoff H, Renkonen O, Simons K (1972) Protein and carbohydrate composition of Lp(a) lipoprotein from human plasma. Biochemistry 11:3229PubMedGoogle Scholar
  26. 26.
    Ross R (1999) Atherosclerosis: an inflammatory disease. N Engl J Med 340:115–126CrossRefPubMedGoogle Scholar
  27. 27.
    Magaro M, Altomonte L, Zoli A, Mirone L, Ruffini MP (1991) Serum lipid pattern and apolipoproteins (A-I and B-100) in active rheumatoid arthritis. Z Rheumatol 50:168–170PubMedGoogle Scholar
  28. 28.
    Gianturco SH, Bradley WA (1994) Atherosclerosis: cell biology and lipoproteins. Curr Opin Lipidol 5:313–315PubMedGoogle Scholar
  29. 29.
    Svensson K, Lithell H, Hallgren R, Selinus I, Vessby B (1987) Altered serum lipoproteins and enhanced lipoprotein elimination in patients with rheumatoid arthritis and other chronic inflammatory arthritides. I. Relationship to the inflammatory activity. Arch Intern Med 147:1912–1916CrossRefPubMedGoogle Scholar
  30. 30.
    Hansson GK (2001) Immune mechanisms in atherosclerosis. Arterioscler Thromb Vasc Biol 21:1876–1890PubMedGoogle Scholar
  31. 31.
    Rossner S, Lofmark C (1977) Dyslipoproteinemia in patients with active chronic polyarthritis: a study on serum lipoproteins and triglycerides clearance (intravenous fat tolerance test). Atherosclerosis 28:41–52PubMedGoogle Scholar
  32. 32.
    Lazarevic MB, Vitic J, Myones BL, Mladenovic V, Nanusevic N, Skosey JL, Swedler WI (1993) Antilipoprotein antibodies in rheumatoid arthritis. Semin Arthritis Rheum 22:385–391PubMedGoogle Scholar
  33. 33.
    Wallberg-Jonsson S, Dahlen GH, Nilsson TK, Ranby M, Rantapää-Dahlqvist S (1993) Tissue plasminogen activator, plasminogen activator inhibitor-1 and von Willebrand factor in rheumatoid arthritis. Clin Rheumatol 12:318–324PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • Dursun Dursunoğlu
    • 1
    • 3
  • Harun Evrengül
    • 1
  • Bülent Polat
    • 1
  • Halil Tanrıverdi
    • 1
  • Veli Çobankara
    • 2
  • Asuman Kaftan
    • 1
  • Mustafa Kılıç
    • 1
  1. 1.Department of CardiologyPamukkale University Medical FacultyDenizliTurkey
  2. 2.Department of Internal MedicinePamukkale University Medical FacultyDenizliTurkey
  3. 3.Yunus Emre Mah. 6402 sk. No: 12DenizliTurkey

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