The Differential Influence of Immunological Process of Autoimmune Disease on Lipid Metabolism: A Study on RA and SLE
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Metabolic parameters like uric acid, lipids and homocysteine are influenced by immunopathological mechanisms underlying the autoimmune disease processes. The current study examined the differences in these parameters and the correlation between inflammatory and metabolic variables in rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) patients. The cross-sectional prospective study included 24 treatment-naïve patients with moderate to severe diseases-15 subjects had RA and 9 had SLE. Atherogenic index of plasma (AIP) was used to assess the cardiovascular risk of the patients. Spearman’s correlation was performed to verify the relationship between inflammatory and metabolic parameters. A two-tailed P < 0.05 was considered statistically significant for all the analysis. SLE patients had higher uric acid levels, very low density lipoprotein-cholesterol, total cholesterol/high density lipoprotein-cholesterol ratio (TC/HDL-C) and logarithmic ratio of triglycerides to HDL-cholesterol (log[TG/HDL-C]) than RA. Whereas, reduced total lymphocyte count, lipoprotein(a), and low density lipoprotein cholesterol were noted in the former than latter group. Majority of the SLE patients had increased risk of cardiovascular diseases (> 0.24 AIP score) and RA patients in comparison had lower risk. Correlation among serum uric acid, lipid profile constituents and AIP was noted. The immunological process of SLE has greater impact on the metabolic parameters. Higher uric acid levels are suggestive of dysfunctional lipid profile. Understanding the implications of risk factors and its inflammatory role in autoimmune processes may assist in disease management.
KeywordsAtherogenic index Autoimmune diseases Immunopathologic process Inflammatory process Lipid metabolism Serum uric acid
We acknowledge the help of www.research-assist.com for editing the manuscript. We thank the ChanRe Diagnostic laboratory, Bengaluru, for blood sample analysis and providing details of reports. The study was approved by the hospital Institutional Ethics Committee (IEC-CRICR/077/14).
This work was supported by the Immunology and Arthritis Research and Education trust (IARET), Bangalore, an independent trust supporting research in arthritis and education.
Chandrashekara S conceptualized and monitored the study, Sachin Vithalrao Dhote patient recruitment and data cleaning, and Anupama K R conducted the statistical analysis and interpretation of the data. All the authors had access to anonymous data. All authors contributed for preparation of the manuscript and approved the finalized manuscript.
Compliance with Ethical Standards
Conflict of interest
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
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