The Differential Influence of Immunological Process of Autoimmune Disease on Lipid Metabolism: A Study on RA and SLE

Abstract

Metabolic parameters like uric acid, lipids and homocysteine are influenced by immunopathological mechanisms underlying the autoimmune disease processes. The current study examined the differences in these parameters and the correlation between inflammatory and metabolic variables in rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) patients. The cross-sectional prospective study included 24 treatment-naïve patients with moderate to severe diseases-15 subjects had RA and 9 had SLE. Atherogenic index of plasma (AIP) was used to assess the cardiovascular risk of the patients. Spearman's correlation was performed to verify the relationship between inflammatory and metabolic parameters. A two-tailed P \ 0.05 was considered statistically significant for all the analysis. SLE patients had higher uric acid levels, very low density lipoprotein-cholesterol, total cholesterol/high density lipoprotein-cholesterol ratio (TC/ HDL-C) and logarithmic ratio of triglycerides to HDL-cholesterol (log[TG/HDL-C]) than RA. Whereas, reduced total lymphocyte count, lipoprotein(a), and low density lipoprotein cholesterol were noted in the former than latter group. Majority of the SLE patients had increased risk of cardiovascular diseases ([ 0.24 AIP score) and RA patients in comparison had lower risk. Correlation among serum uric acid, lipid profile constituents and AIP was noted. The immunological process of SLE has greater impact on the metabolic parameters. Higher uric acid levels are suggestive of dysfunctional lipid profile. Understanding the implications of risk factors and its inflammatory role in autoimmune processes may assist in disease management.

Fasting triglycerides and glucose index: a useful screening test for assessing insulin resistance in patients diagnosed with rheumatoid arthritis and systemic lupus erythematosus

“…It may be elicited by the induction of renal arteriolopathy through vascular smooth cell proliferation or the increased expression of epithelial sodium channel units, causing a decrease in urinary sodium excretion [42, 43]. An increased frequency of hyperuricaemia has been described in RA and SLE [44]. On the other hand, insulin has physiologic effects, induces vasorelaxation by stimulating nitric oxide production in the endothelium, and regulates sodium homeostasis by enhancing sodium reabsorption in the kidneys, which contributes to blood pressure regulation [45, 46].…”

“…However, this test is not easily available in clinical settings. The major limitations of this test include the cost of the test and the equipment and technical training requirements [44]. Consequently, Clamp has limited efficiency as a screening test for epidemiological studies.…”

Identifying serum metabolite biomarkers for autoimmune diseases: a two-sample mendelian randomization and meta-analysis

“…Lipid uptake or efflux influences cellular lipid burden and function, which is particularly notable in autoimmunity, where dyslipidemia and cardiovascular complications are common. The metabolism of lipids is crucial in a range of ADs (52)(53)(54). Elevations in both cell membrane glycosphingolipids and cholesterol are associated with heightened T cell and B cell receptor signaling, leading to activation and inflammation.…”

Cardiovascular Risk Factors and Metabolic Syndrome in Rheumatoid Arthritis and Spondyloarthritis: Correlation With Uric Acid Levels

“…There is developing evidence that uric acid levels can have a role in CVD risk. In several studies, hyperuricemia was associated with insulin resistance, hypertension, coronary artery disease risk, and obesity (6,8,9,28,29). Authors advocated that uric acid might promote endothelial dysfunction and increase platelet adhesiveness.…”