Background/Purpose: Patients with systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) are characterized by an increased frequency of cardiovascular diseases (CVD). Early diagnosis of these complications can reduce morbidity and mortality. Atherogenic index of plasma (AIP) is a new parameter in assessing the CVD risk¹. Previous work supports the utility of AIP and demonstrates that it is more closely associated with CVD risk than individual cardio-metabolic factors. However, no research yet has evaluated the relationship between AIP and the long term CVD risk in SLE and RA patients. The purpose of this study was to investigate whether AIP is associated with long term CVD risk among women with SLE and RA and to further determine its predictive value.

Methods: This was a cross-sectional study of 59 SLE and 99 RA women diagnosed according to the ACR criterion and carried out in the rheumatology department. For each patient, long-term risk of CVD was calculated using the Framingham risk score (FRS); AIP was derived according to the logarithmic (triglycerides/high-density lipoproteins cholesterol). At the same time, clinical, and biochemical data were obtained and disease activities were calculated. The relationship between FRS as a dependent variable and the AIP as an independent one was examined using linear regression analysis.

Results: The mean age of the SLE patients was 36.7±9.1 years and of the RA was 47.9±8.8 years. The mean disease duration for SLE and RA was 5.2±3.8 and 8.4±7.8 years, respectively. The mean body mass index for both groups was over 27.8 kg/m². Nearly 70% of SLE patients were using prednisone with a mean daily dose of 9.1 mg; 29% of RA patients were receiving prednisone with a mean daily dose of 5.1 mg. The mean FRS% in SLE was 4.8±4.5, while in RA women was 6.4±5.6. 8.6% of SLE and 23.2% of RA patients were at a moderate to high risk of CVD. In SLE, mean AIP was 0.02±0.27 while in RA it was 0.00±0.4. Among SLE patients, AIP showed significant association with FRS (r=0.45; p<0.01), triglyceride (r=0.46; p<0.01) and mild positive association with disease activity score (r=0.29; p=0.03), while FRS was significantly linked to uric acid level (r=0.49; p<0.01). In RA, AIP was associated with FRS (r=0.26; p=0.01), waist circumference (r=0.27; p<0.01), triglyceride and total cholesterol (r=0.66, p<0.01 and r=0.38, p<0.01; respectively). Serum uric acid was significantly associated with both FRS (r=0.43; p<0.01) and AIP (r=0.27; p<0.01) in women with RA. In multivariate regression analysis, an independent relationship between AIP and risk of CVD in both SLE (β =6.0, 95% CI: 1.87–10.13; p<0.01) and in RA (β=1.64, 95% CI: -0.64–3.93; p=0.01) was detected. SUA remained significant CVD predictor in both SLE and RA (p=0.03 and p=0.01; respectively).

Conclusion: Higher atherogenic index of plasma was potentially and strongly associated with risk of long term CVD risk among women with SLE and RA patients. AIP level can be a good marker for the CVD risk, thus control and monitor of AIP can improve the outcome in these populations.

Reference:

1- Joob B, Wiwanitkit V. Atherogenic Index of Plasma for the Assessment of Cardiovascular Risk Factors. Annals of African Medicine. 2017;16(3):148.

« Back to 2018 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/atherogenic-index-of-plasma-in-women-with-systemic-lupus-erythematosus-and-rheumatoid-arthritis-a-10-year-potential-predictor-of-cardiovascular-disease/