Evaluation of dysfunctional high‐density lipoprotein levels with myeloperoxidase/paraoxonase‐1 ratio in rheumatoid arthritis

Abstract

Background:The aim of this study is to evaluate dysfunctional high-density lipoprotein cholesterol (HDL) by measuring myeloperoxidase (MPO)/paraoxonase 1 (PON1) ratio in patients with rheumatoid arthritis (RA) and to investigate the relationship between dysfunctional HDL and cardiovascular disease (CVD) in RA patients.Methods: Sixty-seven healthy individuals and 130 RA patients were included in the study. Routine lipid panels (triglyceride (TG), low-density lipoprotein cholesterol (LDL), HDL, total cholesterol (TC), PON1 and MPO levels were measured. Disease activity scores-28 (DAS28) of RA patients were calculated. Cardiological examination records of the patients were assessed to detect patients who also have CVD.Results: There were no significant differences between RA and control groups in routine lipid profiles (P > .05 for all). MPO/PON1 ratios were significantly elevated in the RA group compared with the control group (P < .001). MPO/PON1 ratios were higher in RA patients with CVD history compared with those without CVD (P < .05).MPO/PON1 ratios were correlated with DAS28 scores (rho: 0.357, P < .001). Conclusion:HDL dysfunction determined by the MPO/PON1 ratio may be associated with the pathophysiology of increased CVD in RA. Thus, evaluating dysfunctional HDL levels by measuring the MPO/PON1 ratio in RA patients may allow more detailed patient follow-up, as well as the reduction of CVD events in RA patients with therapeutic agents aiming to increase the functional properties of HDL by decreasing this ratio.

Association between Paraoxonase/Arylesterase Activity of Serum PON-1 Enzyme and Rheumatoid Arthritis: A Systematic Review and Meta-Analysis

“…We excluded 707 studies as they were irrelevant or duplicates, and five because of missing data (one), duplicate data (two), or different study design (not a case-control study, two). Thus, we included 20 studies in the meta-analysis ( Figure 1 ) [ 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 ].…”

“…Serum PON-1 values were described in 17 studies [ 29 , 30 , 31 , 32 , 34 , 35 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 45 , 46 , 47 , 48 ] ( Figure 2 ), while ARE serum activity was reported in ten [ 31 , 32 , 33 , 34 , 35 , 36 , 38 , 40 , 44 , 47 ] ( Figure 3 ).…”

“…Seventeen studies with a total of 1144 RA patients (mean age 49 years, 25% males) and 797 healthy controls (mean age 49 years, 31% males) were assessed [ 29 , 30 , 31 , 32 , 34 , 35 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 45 , 46 , 47 , 48 ]. Ten studies were performed in Asia [ 29 , 30 , 31 , 32 , 34 , 35 , 37 , 38 , 43 , 48 ], five in Europe [ 39 , 41 , 42 , 46 , 47 ], one in America [ 40 ], and one in Africa [ 45 ].…”

“…The risk of bias was estimated to be low in 10 studies [ 30 , 34 , 35 , 37 , 39 , 40 , 41 , 45 , 46 , 47 ], moderate in six [ 29 , 31 , 32 , 38 , 43 , 48 ], and high in one [ 42 ] ( Supplementary Table S3 ).…”

Improvements in High-Density Lipoprotein Quantity and Quality Contribute to the Cardiovascular Benefits by Anti-tumor Necrosis Factor Therapies in Rheumatoid Arthritis: A Systemic Review and Meta-Analysis

“…Induced by oxidative stress and inflammation, MPO promoted the development of arthritis in an experimental mouse model (80). In the patients with RA, MPO/PON1 ratio was elevated, positively correlated with DAS28, and higher in the patients with a history of CVDs compared to the patients without a history of CVDs (81). Higher plasma MPO activity and increased MPO-oxidized HDL in RA are also associated with decreased antioxidant and cholesterol efflux capacity of HDL (82,83).…”