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. 2023 Aug 25:15:1759720X231187191.
doi: 10.1177/1759720X231187191. eCollection 2023.

Dysfunctional high-density lipoprotein in chronic inflammatory rheumatic diseases

Sabina Waldecker-Gall  1 , Felix Seibert  2 , Sebastian Bertram  2 , Adrian Doevelaar  2 , Jürgen Braun  1 , Xenofon Baraliakos  1 , Nina Babel  3 , Christoph Waldecker  4 , Linda Scharow  5 , Nikolaos Pagonas  5 , Timm H Westhoff  6
Affiliations

Dysfunctional high-density lipoprotein in chronic inflammatory rheumatic diseases

Sabina Waldecker-Gall et al. Ther Adv Musculoskelet Dis. .

Abstract

Background: The mechanism explaining low cholesterol concentrations in chronic inflammatory rheumatic disease (CIRD) is incompletely understood. We hypothesized that chronic inflammation impairs the functionality of high-density lipoprotein (HDL), for example, by oxidative processes.

Objectives: Assessment of oxidized HDL (HDLox), a marker of dysfunctional HDL, in newly diagnosed patients with CIRD before and after initiation of immunosuppressive therapy and comparison of HDLox values of patients with CIRD to non-CIRD controls.

Design: Prospective observational trial.

Methods: The study was conducted on 44 newly diagnosed CIRD patients, who were initiated on immunosuppressive therapy (baseline). A total of 136 patients without CIRD served as control. Lipid profiles including HDLox levels and C-reactive protein (CRP) were measured in both groups at baseline. In CIRD patients, measurements were repeated 12 weeks after baseline. Validated outcome tools for disease activity and function were assessed at baseline and 12 weeks.

Results: A total of 33 (75%) patients with rheumatoid arthritis, 7(16%) with axial spondyloarthritis, and 4 (9%) with systemic lupus erythematosus were included. Groups were comparable for age and BMI. CIRD patients had higher HDLox concentrations (1.57 versus 0.78, p = 0.02) and tended to have lower low-density lipoprotein cholesterol, HDL cholesterol, and cholesterol concentrations compared to controls. HDLox (1.57 versus 1.4, p = 0.26) and CRP levels (2.1 versus 0.7 mg/dl, p < 0.01) decreased in CIRD patients from baseline to follow-up.

Conclusion: CIRD is associated with an impairment of the anti-inflammatory properties of HDL as reflected by an increase in HDLox concentrations. This effect may contribute to the increased cardiovascular risk in chronic inflammatory diseases.

Keywords: axial spondyloarthritis; cardiovascular risk; inflammation; oxidized high-density lipoprotein; rheumatic disease; rheumatoid arthritis.

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Conflict of interest statement

The authors declare that there is no conflict of interest.

Figures

Figure 1.
Figure 1.
Comparison of HDLox and CRP between CIRD and non-CIRD patients.
Figure 2.
Figure 2.
Comparison of HDLox and CRP between baseline and follow-up in CIRD patients.
Figure 3.
Figure 3.
Serum lipid profile at baseline and follow-up in CIRD patients.
See this image and copyright information in PMC

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