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- DOI: 10.1177/0003319710373749
- PMID: 20682616
- UKPMCID: 20682616
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Are Lipid Ratios Less Susceptible to Change With Systemic Inflammation Than Individual Lipid Components in Patients With Rheumatoid Arthritis?
Toms, Tracey E; Panoulas, Vasileios F; Douglas, Karen M J; Nightingale, Peter; Smith, Jacquleine P; Griffiths, Helen; Sattar, Naveed; Symmons, Deborah P M; Kitas, George D
Angiology. 2011;62(2):167-175.
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Full-text held externally
- DOI: 10.1177/0003319710373749
- PMID: 20682616
- UKPMCID: 20682616
Abstract
Rheumatoid arthritis (RA) associates with excess cardiovascular risk and there is a need to assess that risk. However, individual lipid levels may be influenced by disease activity and drug use, whereas lipid ratios may be more robust. A cross-sectional cohort of 400 consecutive patients was used to establish factors that influenced individual lipid levels and lipid ratios in RA, using multiple regression models. A further longitudinal cohort of 550 patients with RA was used to confirm these findings, using generalized estimating equations. Cross-sectionally, higher C-reactive protein (CRP) levels correlated with lower levels of total cholesterol (TC), low-density lipoprotein-cholesterol (LDL-C), and high-density lipoprotein-cholesterol ([HDL-C] P </= .015), whereas lipid ratios did not correlate with CRP. The findings were broadly replicated in the longitudinal data. In summary, the effects of inflammation on individual lipid levels may underestimate lipid-associated cardiovascular disease (CVD) risk in RA, thus lipid ratios may be more appropriate for CVD risk stratification in RA.