Background/Purpose: In contrast to high evidence of HDL inflammatory function in cardiovascular risk in rheumatoid arthritis (RA) patients, there is scarce data about the total HDL levels as a marker of RA disease activity.

Methods: A cross-sectional study in Rheumatology department of Hospital Almenara EsSalud. Lima Perú. Subjects were recruited consecutively from our RA cohort. RA was defined with ACR 87/ACR EULAR 2010 RA criteria, without overlap syndromes except Sjögren, current infections or pregnancy. For these analyses hospitalized patients, with recent medical/surgical procedures or severe anemia (less than 7 g/dL) were excluded. Clinical interview, chart review, physical examination (included 28 joint count), health questionnaires, Visual analogue scales and laboratory sampling including a complete lipid profile were performed in the same day. A univariable and multivariable linear regression models were performed in order to determine if HDL levels were associated with disease activity (DAS 28 or CDAI) independently of disease duration, gender, age at diagnosis, socioeconomic status, use of conventional DMARDs, biologics, current corticosteroid dose, CRP, anti CCP, RF, and metabolic syndrome.

Results:

Results: Two hundred and seventy-eight patients were included, all Mestizos, 92.8% were female, disease duration was 15.16 (11.92) and age at diagnosis 44.08 (13.92) years. The most frequent socioeconomic statuses were low: 30.9%, middle 33.1% and high 33.8%. Current prednisone dose was 4.50 mg/d (3.30). Patients with current convectional DMARD use were 97.1 % and 6.1 % with biologic agent; RF level was 290.39 (474, 17) UI/ml and anti CCP 544, 98 (132.37) U/ml. Level of HDL was 56.98 (1326, 37) mg/dL and LDL 120.76 (33.00) mg/L. One hundred and three patients (37.1 %) had metabolic syndrome. DAS 28 media score was 4.69 (1.22) and CRP level 11.76 (21.41) mg/dL. In the multivariate analysis HDL cholesterol level was associated with DAS 28 score (B= -0.016: CI: -0.26 – -0.01; p=0.04) independently of other variables. HDL cholesterol level was also independently associated with CDAI score (B -0.14 CI -0.24 – -0.04 p= 0.009)

Conclusion: Low HDL cholesterol level was associated with higher disease activity in RA patients, independently of other known classical factors. A more careful evaluation of active disease could be performed in patients with this potential marker, in clinical practice.

« Back to 2017 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/low-hdl-level-as-a-clinical-marker-of-disease-activity-in-rheumatoid-arthritis-patients/