Lipids in RA: Is Less Not Necessarily More?

Current Rheumatology Reports
Jorge Plutzky, Katherine P Liao

Abstract

In rheumatoid arthritis (RA), lipid levels are dynamic and can fluctuate along with changes in inflammation. A reduction in inflammation, most commonly as a result of disease-modifying anti-rheumatic drug (DMARD) therapy, is associated with increases in total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C). In this review, we discuss new evidence shedding light on the potential mechanism underlying changes in lipid levels observed with changes in inflammation. Measured lipid levels in the blood are a result of a balance between synthesis and catabolism or absorption. Recent human studies in active RA show that the catabolic rates of lipids are higher than expected compared to expected rates in the general population. DMARD therapy appears to allow a return to baseline lower catabolic rates, resulting in an apparent increase in lipids. Increases in lipids observed with control of inflammation and RA treatment suggest a return to homeostasis. Studies are underway to understand the overall impact on cardiovascular risk in RA when lipid levels increase as a result of controlling inflammation.

References

Jun 1, 1997·Journal of Clinical Epidemiology·M A WinklebyD M Murray
Mar 12, 2003·Circulation·Daniel H SolomonGary C Curhan
Nov 11, 2008·The New England Journal of Medicine·Paul M RidkerUNKNOWN JUPITER Study Group
Oct 27, 2009·Annals of the Rheumatic Diseases·Elena MyasoedovaSherine E Gabriel
Oct 19, 2010·The Journal of Rheumatology·Jasvinder A SinghMaria Angeles Lopez-Olivo
Mar 20, 2012·Annals of the Rheumatic Diseases·Juan Antonio Avina-ZubietaDiane Lacaille
Aug 9, 2013·Arthritis Care & Research·Katherine P LiaoElizabeth W Karlson
May 23, 2014·Annals of the Rheumatic Diseases·Inmaculada Del RincónAgustín Escalante
Nov 19, 2014·The New England Journal of Medicine·Anand RohatgiPhilip W Shaul
Mar 18, 2015·Arthritis & Rheumatology·D H SolomonJ D Greenberg
Jun 7, 2015·The Journal of Endocrinology·A Margot Umpleby
Mar 19, 2016·Arthritis & Rheumatology·Michelle J OrmsethUNKNOWN TETRAD Investigators
Aug 29, 2017·The New England Journal of Medicine·Paul M RidkerUNKNOWN CANTOS Trial Group

❮ Previous
Next ❯

Related Concepts

Related Feeds

Cardiovascular Inflammation

Inflammation plays a significant role in the development of cardiovascular diseases, an understanding of these endogenous processes is critical for evaluating the risks and potential treatment strategies. Discover the latest research on cardiovascular inflammation here.

ApoE, Lipids & Cholesterol

Serum cholesterol, triglycerides, apolipoprotein B (APOB)-containing lipoproteins (very low-density lipoprotein (VLDL), immediate-density lipoprotein (IDL), and low-density lipoprotein (LDL), lipoprotein A (LPA)) and the total cholesterol/high-density lipoprotein (HDL) cholesterol ratio are all connected in diseases. Here is the latest research.