The relationship between serum levels of lipid profile and activity of rheumatoid arthritis

Document Type : Original Article


Department of Rheumatology and Rehabilitation, Sohag Faculty of Medicine, Sohag University


Introduction: Rheumatoid arthritis (RA) is a chronic inflammatory disease of unknown etiology marked by a symmetric, peripheral polyarthritis. It is the most common form of chronic inflammatory arthritis and often results in joint damage and physical disability. As it is a systemic disease, it may result in variety of extra-articular manifestations, including fatigue, subcutaneous nodules, lung involvement, pericarditis, peripheral neuropathy, vasculitis, and hematologic abnormalities.
Aim of the work: Show changes of serum lipid profile in patients with rheumatoid arthritis.
Patients and Methods: Fifty patients with rheumatoid arthritis who diagnosed according to (EULAR/ ACR2010) criteria  for rheumatoid arthritis, 47 females and 3 males with a mean age of 36.80 ±6.03 years. Fifty control healthy subjects included 43 females and 7 males with a mean age of 36.14 ±7.73 years were examined for their lipid profile parameters and disease activity. Lipid profile parameters (total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol and atherogenic index ratio), erythrocyte sedimentation rate and C-reactive protein; all were determined for both the patients and control groups.
Results: The results of the present study revealed that rheumatoid arthritis patients exhibited a highly significant increase in total cholesterol and low-density lipoprotein cholesterol (p=0.0001), with a significant increase in high-density lipoprotein cholesterol (p= 0.002). As a consequence, the atherogenic index ratio was significantly higher (p=0.0001). The rheumatoid factor, CRP and ESR were higher in patients with RA than in control group with very highly significant difference (p=0.0001). There is a significant correlation between disease activity score (DAS 28) and different parameters of lipid profile which was a highly significant with LDL and TC/HDL (0.9-0.8) respectively and was less significant with other parameters. The disease duration for rheumatoid arthritis patients was significantly correlated with Das28 score (p=0.01).
Conclusion: Rheumatoid arthritis patients are characterized by an atherogenic lipid profile in comparison with the healthy controls. Recognition and treatment of early rheumatoid arthritis and reduction of cardiac risk factor has greater impact on the course of the disease.


1.         Kaplan MJ. Cardiovascular disease in rheumatoid arthritis. Current opinion in rheumatology. 2006;18(3):289-97.
2.         Toms TE, Panoulas VF, Douglas KM, Nightingale P, Smith JP, Griffiths H, et al. Are lipid ratios less susceptible to change with systemic inflammation than individual lipid components in patients with rheumatoid arthritis? Angiology. 2011;62(2):167-75.
3.         Nakken B, Szodoray P. Accelerated atherosclerosis in rheumatoid arthritis: rationale for mannose-binding lectins? The Journal of rheumatology. 2010;37(3):482-4.
4.         Georgiadis AN, Papavasiliou EC, Lourida ES, Alamanos Y, Kostara C, Tselepis AD, et al. Atherogenic lipid profile is a feature characteristic of patients with early rheumatoid arthritis: effect of early treatment--a prospective, controlled study. Arthritis research & therapy. 2006;8(3):R82.
5.         Aletaha D, Neogi T, Silman AJ, Funovits J, Felson DT, Bingham CO, 3rd, et al. 2010 Rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Arthritis and rheumatism. 2010;62(9):2569-81.
6.         Puszczewicz M, Iwaszkiewicz C. Role of anti-citrullinated protein antibodies in diagnosis and prognosis of rheumatoid arthritis. Archives of medical science : AMS. 2011;7(2):189-94.
7.         Myasoedova E, Crowson CS, Kremers HM, Roger VL, Fitz-Gibbon PD, Therneau TM, et al. Lipid paradox in rheumatoid arthritis: the impact of serum lipid measures and systemic inflammation on the risk of cardiovascular disease. Annals of the rheumatic diseases. 2011;70(3):482-7.
8.         Lakatos J, Harsagyi A. Serum total, HDL, LDL cholesterol, and triglyceride levels in patients with rheumatoid arthritis. Clinical biochemistry. 1988;21(2):93-6.
9.         Makinodan T, Kay MM. Age influence on the immune system. Advances in immunology. 1980;29:287-330.
10.       Westhoff G, Rau R, Zink A. Radiographic joint damage in early rheumatoid arthritis is highly dependent on body mass index. Arthritis and rheumatism. 2007;56(11):3575-82.
11.       van Zeben D, Hazes JM, Zwinderman AH, Cats A, van der Voort EA, Breedveld FC. Clinical significance of rheumatoid factors in early rheumatoid arthritis: results of a follow up study. Annals of the rheumatic diseases. 1992;51(9):1029-35.
12.       Arts EE, Popa CD, Smith JP, Arntz OJ, van de Loo FA, Donders R, et al. Serum samples that have been stored long-term (>10 years) can be used as a suitable data source for developing cardiovascular risk prediction models in large observational rheumatoid arthritis cohorts. BioMed research international. 2014;2014:930925.
13.       Nurmohamed MT. Atherogenic lipid profiles and its management in patients with rheumatoid arthritis. Vascular health and risk management. 2007;3(6):845-52.
14.       Vijayakumar D, Suresh K, Manoharan S. Altered pattern of lipids in plasma and erythrocyte membranes of rheumatoid arthritis patients. Indian journal of clinical biochemistry : IJCB. 2005;20(1):52-5.
15.       Peters MJ, Symmons DP, McCarey D, Dijkmans BA, Nicola P, Kvien TK, et al. EULAR evidence-based recommendations for cardiovascular risk management in patients with rheumatoid arthritis and other forms of inflammatory arthritis. Annals of the rheumatic diseases. 2010;69(2):325-31.