Mild lipid abnormalities common before arthritis

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During the years leading up to the onset of rheumatoid arthritis, levels of cholesterol and other blood fats are often abnormal, investigators in the Netherlands report

People with rheumatoid arthritis run an increased risk of developing cardiovascular disease, and for a long time it was believed that inflammation was responsible for this. Now, in the Annals of the Rheumatic Diseases, Dr. M. T. Nurmohamed and colleagues report findings suggesting that these patients have a worse lipid pattern than individuals who do not develop rheumatoid arthritis.

This analysis was possible because an Amsterdam blood bank has been storing samples from all donors since 1984. Using the donor information and data from a network of rheumatology clinics, the researchers identified 79 subjects who had routinely donated blood and were diagnosed with rheumatoid arthritis. These were matched to similar donors who had not developed arthritis and served as a control group.

Nurmohamed, from VU University Medical Centre in Amsterdam, and the team found that the first blood donations were obtained an average of 7.5 years before onset of arthritis symptom. The investigators analyzed 1078 samples from arthritis patients and 1071 from control subjects.

This showed that before the diagnosis of rheumatoid arthritis, levels of total cholesterol, triglycerides and apolipoprotein B were somewhat higher than in controls, and HDL ("good") cholesterol levels were lower. The researchers note that “the differences between patients and controls were mainly constant over time.”

When the researchers factored in markers of inflammation such as C-reactive protein, this had little effect on the likelihood of developing arthritis.

Nurmohamed’s group suggests that “the marginally deteriorated lipid profile might render a person more susceptible to inflammation or inflammatory diseases.”

They also propose that the poorer lipid profiles may be related to the development of rheumatoid arthritis by a common background, such as socioeconomic status or genetics.

SOURCE: Annals of the Rheumatic Diseases, June 5, 2006.

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