HDL cholesterol efflux capacity in rheumatoid arthritis patients: contributing factors and relationship with subclinical atherosclerosis

Tejera-Segura, Beatriz; Macía-Díaz, María; Machado, José David; Vera-González, Antonia de; García-Dopico, José A.; Olmos, José M.; Hernández, José L.; Dı́az-González, Federico; González-Gay, Miguel Á.; Ferraz-Amaro, Iván

doi:10.1186/s13075-017-1311-3

Cited by 46 publications

(57 citation statements)

References 32 publications

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“…In addition, the fact that SSc display lower levels of total cholesterol and higher triglycerides than controls has also been previously described [10,11], although in smaller cohorts that lacked multivariate analysis. The lipid pro le differences between patients and controls found in our study are in accordance with the 'lipid paradox' [15] described in other in ammatory diseases like RA [6,16,17] or SLE [18]. This means that untreated in ammatory diseases are associated with lower levels of total cholesterol and LDL-cholesterol, and it is believed that this may stem from the lipid-lowering effects of systemic in ammation.…”

Section: Discussionsupporting

confidence: 90%

“…In a previous report by our group including 178 RA patients and 223 sex-matched control subjects, CEC was not signi cantly different between them, although patients exhibiting higher disease activity had lower levels of CEC than patients in remission. Moreover, greater CEC was independently associated with a lower risk for the presence of carotid plaques in patients with RA [6]. Similarly, Ronda et al evaluated CEC in 30 SLE patients and 30 healthy controls [5].…”

Section: Discussionmentioning

confidence: 99%

“…Evidence suggests that CEC has a strong inverse association with carotid intimamedia thickness (cIMT), the likelihood of angiographic coronary artery disease, independent of HDLcholesterol levels [3], and with the incidence of cardiovascular (CV) events in a population-based cohort [4]. Regarding to rheumatic diseases, it has been demonstrated that CEC is disrupted in patients with rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) [5], a nding associated with an increased subclinical atherosclerosis in both diseases [6,7].…”

Section: Introductionmentioning

confidence: 99%

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HDL-Cholesterol Efflux Capacity and Lipid Profile in Patients With Systemic Sclerosis

Ferraz‐Amaro

Delgado-Frías

Hernández-Hernández

et al. 2020

Preprint

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Objective. It is well established that patients with systemic sclerosis (SSc) have a disrupted lipid profile and an increased cardiovascular risk. Cholesterol efflux capacity (CEC), the ability of high-density lipoprotein (HDL)-cholesterol to accept cholesterol from macrophages has been linked to cardiovascular events. The aim of this study was to establish whether CEC and lipid profile were impaired in SSc patients respect to controls and whether these changes were associated with disease-related data.Methods. Cross-sectional study encompassed 188 individuals: 73 SSc patients and 115 controls. CEC, using an in vitro assay, and lipoprotein serum concentrations were assessed in patients and controls. A multivariable analysis was performed to study the differences in CEC between patients and controls, and if SSc-related data could explain such differences. Results. The multivariate analysis adjusted for demographic characteristics, cardiovascular risk factors and lipid-related molecules showed that total cholesterol (beta coefficient: -22 [95%CI -37- -7], p=0.004), triglycerides (beta coefficient: 24 [95%CI 2-47], p=0.033), lipoprotein A (beta coefficient: 22 [95%CI 2-43], p=0.033) and CEC (beta coefficient: -6 [95%CI -10- -2]%,p=0.002) were significantly differences between patients and controls. Skin thickness, as assessed by modified Rodnan skin score, was independently associated with a lower CEC (beta coefficient: -0.21 [95%CI -0.37- -0.05]%, p=0.011) after multivariable adjustment.Conclusion: SSc patients show an abnormal lipid profile respect to controls including CEC, a finding that could be involved in the increased cardiovascular burden suffered by these patients. Skin thickness is independent and inversely associated with CEC in SSc patients.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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HDL-Cholesterol Efflux Capacity and Lipid Profile in Patients With Systemic Sclerosis

Ferraz‐Amaro

Delgado-Frías

Hernández-Hernández

et al. 2020

Preprint

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“…However, the epidemiological data that have been used to explore the association between CEC and RA are inconsistent. Some of the previous studies have shown that the CEC is signi cantly lower in RA patients than in healthy controls, but others have failed to reach conclusions [24][25][26][27][28][29][30][31][32][33].…”

Section: Introductionmentioning

confidence: 93%

HDL cholesterol efflux capacity and concentration in patients with rheumatoid arthritis: a systematic review and meta-analysis

Xie¹,

Liu

et al. 2020

Preprint

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Background: Poor cholesterol efflux capacity (CEC) has been proposed to be an independent risk factor for cardiovascular diseases. However, the current evidences in the literature are inconsistent. This meta-analysis aimed to identify whether CEC is impaired or altered by drug therapy in individuals with rheumatoid arthritis (RA).Methods: The PubMed, Embase, and Cochrane library databases were searched to identify studies on CEC in RA patients. The searches were focused on studies in human subjects that were published before 10 June 2020, without language restrictions. The primary outcomes were CEC and the high-density lipoprotein cholesterol (HDL-C) and C-reactive protein levels (CRP) levels.Results: A total of 11 eligible articles, including 6 observational and 5 intervention studies, were retrieved. The pooled results showed that CEC is not significantly lower in RA patients than in healthy controls (SMD: -0.22, 95% CI: -0.65 to 0.20), whereas the plasma HDL-C level is not significantly (WMD: -3.98, 95% CI: -8.32 to 0.37, I² = 54%, P for heterogeneity = 0.050) but is significantly decreased in the RA patients with moderate body mass index (BMI) (WMD: -5.46, 95% CI: -9.40 to -1.52, I² = 37%, P for heterogeneity = 0.175). Furthermore, in the before-after studies, the CEC of RA patients (SMD: 0.20, 95% CI: 0.03 to 0.38) increased, but the plasma HDL-C level (WMD: 3.26, 95% CI: -0.17 to 6.69) remained at a similar level after anti-rheumatic treatment compared to the baseline. In addition, stratified analysis suggested that the Disease Activity Score for 28 joints could be a potential source of heterogeneity for CEC. The funnel plot was relatively symmetric and did not suggest the presence of publication bias.Conclusion：The current meta-analysis demonstrated that HDL-mediated CEC can be improved by the early control of inflammation and anti-rheumatic treatment in RA patients, which is independent of HDL-C levels. Future research is needed to determine whether therapeutic strategies to enhance CEC in RA patients have beneficial effects for preventing CVD.

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“…However, the epidemiological data that have been performed to explore the association between CEC and RA was less convincing. Some of them have shown that the CEC was signi cantly reduced in RA patients compared to healthy controls, but others failed to reach the conclusions [19][20][21][22][23][24][25][26][27][28]. In 2012, Charles-schoeman et al rst reported that there was no signi cant difference in CEC among RA patients comparing to control groups, but which was inversely associated with high disease activity in RA patients [21].…”

Section: Introductionmentioning

confidence: 99%

HDL Cholesterol Efflux Capacity and Concentration in Patients With Rheumatoid Arthritis: a Systematic Review and Meta-Analysis

Xie¹,

Liu

et al. 2020

Preprint

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Background: HDL cholesterol efflux capacity has been proposed as an independent risk factor of cardiovascular diseases. However, the presented data has been less than convincing in RA. This meta-analysis aimed to identify whether CEC was impaired in RA or altered by drug therapy.Methods: PubMed, Embase, and Cochrane library databases were searched to identify studies for CEC in RA patients. The primary outcomes were CEC, high-density lipoprotein cholesterol and C-reactive protein.Results: A total of 11 eligible articles including 6 observational and 5 intervention studies. Pooled results showed there was no significantly decrease in the CEC of RA patients comparing with the healthy controls (SMD: -0.22, 95% CI: -0.65 to 0.20), whereas the plasma HDL-C levels was decreased in RA patients (WMD: -5.21, 95% CI: -7.69 to -2.72). Furthermore, in the before-after studies, CEC of RA patients (SMD: 0.20, 95% CI: 0.03 to 0.38) was increased but the plasma HDL-C levels (WMD: 3.26, 95% CI: -0.17 to 6.69) was similar after anti-rheumatic treatment comparing to the baseline. In addition, stratified analysis suggested that DAS28 could be potential sources of heterogeneity for CEC. The funnel plot was relatively symmetric and was not suggestive of presence of publication bias.Conclusion The current meta-analysis demonstrated a slight, nonsignificant, decrease in the CEC among RA patients as compared with healthy individuals, but it can be improved substantially following anti-rheumatic treatment. More large population studies evaluating the predictive role of CEC on cardiovascular risk in RA are needed.

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HDL cholesterol efflux capacity in rheumatoid arthritis patients: contributing factors and relationship with subclinical atherosclerosis

Cited by 46 publications

References 32 publications

HDL-Cholesterol Efflux Capacity and Lipid Profile in Patients With Systemic Sclerosis

HDL-Cholesterol Efflux Capacity and Lipid Profile in Patients With Systemic Sclerosis

HDL cholesterol efflux capacity and concentration in patients with rheumatoid arthritis: a systematic review and meta-analysis

HDL Cholesterol Efflux Capacity and Concentration in Patients With Rheumatoid Arthritis: a Systematic Review and Meta-Analysis

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