Title: A Comparative Study of Lipid Profile and Atherogenic Index of Plasma among Women with Rheumatoid Arthritis and without Rheumatoid Arthritis

Authors: Dr Silpa Thota, Dr Madhavi Kondeti, Dr Palla Nagadasaiah, Dr Pasupurekula Laxmi

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i8.72

Abstract

The clinical association between Rheumatoid arthritis (RA) and cardiovascular diseases (CVD) is important as the patients with rheumatoid arthritis are more prone to cardiovascular morbidity and mortality. Dyslipidemia appears to be present very early in the RA disease process which contributes to accelerated atherosclerosis among these individuals. Female gender is considered as risk factor for rheumatic diseases. So, this study aims at comparing the lipid profile levels and Atherogenic index of plasma (AIP) among women with RA and women without RA. This observational study was conducted totally on 80 women in the age group of 30 to 60 years. Among them 40 women were clinically diagnosed with RA (as per 1987 ACR criteria) who are taken as group 1 and 40 women were without RA who are taken as group 2. Serum lipid profiles parameters were estimated and Atherogenic index of plasma was calculated. These values were expressed in mean±  standard deviation. The values are compared among both the groups and statistical significance was observed. Serum total cholesterol(TC), triglycerides(TAG), low density lipoprotein(LDL), very low density lipoproteins(VLDL) and Atherogenic index of plasma were significantly increased in women with RA  and high density lipoprotein(HDL)  was  significantly decreased in women with RA when compared with women without RA. Women with RA are characterized by atherogenic lipid profile in comparison with women without RA. Early diagnosis and treatment of RA along with screening of hyperlipidemias can reduce cardiovascular related mortality and morbidity in these patients.

Keywords: Atherogenic index of plasma; Cardiovascular risk; Lipid profile; Lipoproteins; Rheumatoid arthritis.

References

  1. Gravallese EM: Bone destruction in arthritis. Ann rheum Dis.2002, 61(Suppl2):ii84-ii86.
  2. Dohert M, Lanyon P, Ralston SH. Inflammarotry Joint Disease.In:Christopher H, Edwin RC, Nicholas AB, Nicki RC, editors. Davidson‟s Principles and Practice Of Medicine.19th ed.Edinburgh:Churchill Livingstone;2002.p.1002-07.
  3. C Turesson, R L McClelland, T J H Christianson, E L Matteson. Severe extra articular disease manifestations are associated with an increased risk of first ever cardiovascular events in patients with rheumatoid arthritis. Ann Rheum Dis. 2007; 66:70-75.
  4. Rho YH, Chung CP, Oeser A, et al. Inflammatory mediators and premature coronary atherosclerosis in rheumatoid arthritis. Arthritis Rheum. 2009;61:1580-5.
  5. Gerli R, Bocci EB, Sherer Y, et al. Association of anti-cyclic citrullinated peptide antibodies with subclinical atherosclerosis in patients with rheumatoid arthritis. Ann Rheum Dis. 2008;67:724-5.
  6. Role of inflammation in atherosclerosis associated with rheumatoid arthritis, Am J Med,  2008, vol. 121 Suppl 1(pg. S21-31).
  7. Susanti E. Donosepoetro M. Patellong I. Arif M. Differences between several atherogenic parameters in patients with controlled and uncontrolled type 2 diabetes mellitus. Med J Indones.2010;19:103-8.
  8. Kavitha G. Ramani G. Dhass PK. Aruna RM. Oxidative stress, interleukin-6 (IL-6) and atherogenic index of plasma in diabetic nephropathy. IJABPT. 2011; 2(2): 211-217.
  9. Kalidhas P. Kanniyappan D. Gandhi K. Aruna RM. Coronary artery disease risk factors in type 2 diabetes mellitus with metabolic syndrome in the Urban South Indian population. Journal of Clinical and Diagnostic Research .2011; 5(3):516-518.
  10. Arnett FC. Edworthy SM, Bloch DA, McShane DJ, Fries JF, Cooper NS et al. The American Rheumatism Association 1987. Revised Criteria for Classification of Rheumatoid Arthritis. Arth Rheum 1988; 31:315-24.
  11. Dobiasova M. Frohlich J. The plasma parameter log (TG/ HDL-c) as an atherogenic index : correlation with lipoprotein particle size and esterification rate in apo B-lipoprotein- depleted plasma (FERNDL). Clin Biochem. 2001; 34: 583-588.
  12. Ledwozym A, Michalak J, Stepien A, Kadziolka A. The relationship between plasma triglycerides,cholesterol, total lipids and lipid peroxidation products during human atherosclerosis, Clin ChemActa, 1983; 155: 275–284.
  13. McEntegart A, Capell HA, Creran D, Rumley A, Woodward M, Lowe GD. Cardiovascular risk factors, including thrombotic variables, in a population with rheumatoid arthritis. Rheumatology (Oxford). 2001;40:640‑
  14. Khovidhunkit W, Memon RA, Feingold KR, Grunfeld C. Infection and inflammation-induced proatherogenic changes of lipoproteins. J Infect Dis.2000; 181(suppl 3):S462-S472.
  15. 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 Res Ther. 2006; 8(3):R82.
  16. Kowsalya R, Sreekantha, Vinod Chandran, Remya. Dyslipedemia with altered oxidant –antioxidant status in Rheumatoid arthritis. Int J of pharma and Biosciences.2011;2 (1): B424-B428.
  17. Situnayake R, Kitas G: Dyslipidemia and rheumatoid arthritis. Ann Rheum Dis 1997, 56:341-342.
  18. Dessein PH, Stanwix AE, Joffe BI: Cardiovascular risk in rheumatoid arthritis versus osteoarthritis: acute phase response related decreased insulin sensitivity and high-density lipoprotein cholesterol as well as clustering of metabolic syndrome features in rheumatoid arthritis. Arthritis Res 2002, 4:R5.
  19. Munro R, Morrison E, McDonald AG, Hunter JA, Madhok R, Capell HA: Effect of disease modifying agents on the lipid profiles of patients with rheumatoid arthritis. Ann Rheum Dis 1997,56:374-377.
  20. Zeinab M. A. R., Eiman A.A., Layla K.A., Noorhan K.S., Interleukin-33 in Iraqi‟s Rheumatoid Arthritis patients prone to Atherosclerosis. Medical Journal of Babylon-Vol. 10- No. 4 -2013.

Corresponding Author

Dr Silpa Thota

Address: Flat no 403, Brindavanam Apartments, Thimminaidu palem, Karkambadi Road, Tirupati

Andhra Pradesh 517507, India

Email: This email address is being protected from spambots. You need JavaScript enabled to view it., Phone NO- 9493031608; 0877-2970021