Altered Lipid Levels in Untreated Patients with Early Polymyositis

Abstract

BackgroundLittle is known so far on the lipid profile in polymyositis (PM) patients. Our aim is to identify lipid profiles in untreated patients with early PM, to assess the association between lipid profiles and C-reactive protein (a sensitive marker of inflammation) in these patients.Methods and FindingsThis work was conducted as a case-control study. Sixty untreated patients with PM and 60 age- and sex-matched healthy controls were included. The duration of PM was less than six months, and none of them had received intermittent or regular corticosteroids or disease-modifying antirheumatic drugs or biological agents prior to the study. Triglyceride (TG), total cholesterol (TC), LDL-cholesterol (LDL-C), and HDL-cholesterol (HDL-C), and C-reactive protein (CRP) were assessed using standard techniques. Thirty patients (50%) had a decreased level of HDL-C and 47% had an increased level of TG. The levels of HDL-C, LDL-C, and TC in PM were significantly lower than in controls (P<0.001, P<0.01, P<0.001, respectively). The level of TG was significantly higher in PM than in controls (P<0.001). The level of very low LDL-cholesterol (VLDL-C), and the ratios of VLDL-C/LDL-C, TC/HDL-C, and LDL-C/HDL-C were significantly higher than in controls (all P<0.001). Serum CRP levels correlated negatively with HDL-C (r = −0.352, P = 0.006) and TC (r = −0.262, P = 0.043). After adjustment for age, gender, smoking, drinking, body mass index, and pulmonary fibrosis/infection, linear regression model demonstrated that CRP is associated with HDL-C among PM patients (P = 0.028).ConclusionsDyslipidemia is a common feature in patients with PM that is characterized by a decrease in HDL-C and an increase in TG, suggesting a high risk of atherosclerosis. The Inflammatory condition in PM may account for the metabolism of HDL-C.

Coronary Heart Disease and Cardiovascular Risk Factors in Patients With Idiopathic Inflammatory Myopathies: A Systemic Review and Meta-Analysis

“…For example, the study by Antovic et al (26) and the study by Moshtaghi-Svensson et al (27) used the same databases (the Swedish National Patient Register Database and the Swedish Population Register Database), but the latter reported the most comprehensive results, thus, we only included the study by Moshtaghi-Svensson et al in the current review. Finally, seven articles focused on CHD risk and nine articles focused on cardiovascular risk factors met the inclusion criteria and were included in this meta-analysis (11)(12)(13)(14)(15)(16)(17)(27)(28)(29)(30)(31)(32)(33)(34). Moreover, the majority of eligible studies in the current review were about patients with DM/PM, but these studies did not describe the different subtypes of PM or DM in detail.…”

Cardiac involvement in adult and juvenile idiopathic inflammatory myopathies

“…Increasing evidence suggests that traditional CV risk factors (including diabetes, hypertension, dyslipidaemia, obesity and smoking) are more prevalent in adult onset IIM than in the general population ( table 1 ); this has especially been found for abdominal obesity. 22 36 37 Increased prevalence of hypertension and dyslipidaemia has also been shown in untreated patients with IIM, 38 39 which indicates an effect of the disease per se in addition to a possible effect of long-term glucocorticoid treatment. Also in JDM, hypertension and dyslipidaemia have been demonstrated ( table 1 ).…”

“…Different mechanisms are suspected in the development of cardiac involvement in IIM. Recently, Wang et al found dyslipidaemia in newly diagnosed, untreated patients with PM 39 and with DM, 38 with lower high-density lipoprotein cholesterol (HDL-c) and higher triglycerides and total-/HDL cholesterol (TC/HDL) ratio than matched controls. High TC/HDL ratio is a predictor of ischaemic heart disease, superior to other lipid parameters such as TC and HDL/low-density lipoprotein (LDL).…”

Targeted lipidomics analysis identified altered serum lipid profiles in patients with polymyositis and dermatomyositis

“…Information on lipid profiles in patients with PM or DM is very limited. A few reports suggest altered serum levels of low-density lipoprotein (LDL)-cholesterol, high-density lipoprotein (HDL)-cholesterol, total cholesterol and triglycerides indicating changes in lipid metabolism in these diseases [ 24 – 26 ]. The dyslipidemia was associated with disease activity in one study and may reflect an interaction between inflammation and lipid metabolism [ 26 ].…”