Abstract

Introduction: Rheumatod Arthritis (RA) is the most common autoimmune arthritis, associated with accelerated atherogenesis and increased cardiovascular mortality. An apparent lipid paradox exists in RA. Active RA with high burden of inflammatory markers leads to low levels of LDL-C, Total cholesterol, HDL-C and vice versa in inactive disease. The current study was aimed to assess the relationship between inflammatory markers and lipid components in RA patients.

Methods: The study was conducted at a Rheumatology clinic of a Tertiary care hospital and included 203 RA patients. Fasting blood samples were drawn for lipid analysis and inflammatory markers (ESR/CRP). Relationship between the two was assessed using Pearson’s correlation method.

Results: Out of 203 patients, 180 were female (89%) and 23 were males (11%). Mean duration of disease was 2.55 ± 2.09 years and mean age was 47 ± 10.9 years. The mean total cholesterol, HDL-C, LDL-C and triglycerides were 198.6 ± 43.6 mg/ dl, 41 ± 8.2 mg/dl, 109 ± 28 mg/dl and 224.8 ± 89 mg/dl respectively. Mean ESR was 37mm in 1st hour and mean CRP was 9.6 mg/dl. A statistically significant negative correlation was found between CRP and total cholesterol (p<0.001), CRP and HDL-cholesterol (P<0.001), CRP and LDL-cholesterol (P<0.001). Similarly, a negative correlation was found between ESR and HDL-cholesterol (p<0.001). However, no significant correlation was found between ESR and total cholesterol and/or LDL-cholesterol. Triglycerides and VLDL-cholesterol were found to have no significant correlation with inflammatory markers in our study.

Conclusion: RA is a disease with lipid paradox. A high inflammatory burden is associated with low level of HDL-C, LDL-C and Total cholesterol.