Total cholesterol and LDL levels decrease before rheumatoid arthritis

Abstract

Objectives

Relationships between Serum Resistin and Fat Intake, Serum Lipid Concentrations and Adiposity in the General Population

“…In contrast, the Mediterranean diet, which is low in saturated fat and rich in monounsaturated fat, inflammation, the serum lipid levels are often decreased, possibly in relation to the accumulation of lipids in macrophages as a result of the actions of resistin 29) . This view is compatible with the observation of elevated resistin levels in patients with inflammatory diseases, such as rheumatoid arthritis, as the onset of arthritis is known to be preceded by a decrease in the levels of serum lipids 38) and an increase in the levels of proinflammatory cytokines 39) . This same line of reasoning can be invoked to explain why the serum lipid levels are increased in patients with rheumatoid arthritis who receive anti-inflammatory treatment 40) .…”

Targeting Interleukin-6 in Rheumatoid Arthritis

“…A possible explanation is that active RA is associated with lowering of the serum cholesterol and LDL levels thus treatment with tocilizumab returns these levels to what would be 'normal' for that patients [71][72][73]. On a positive note, the STREAM study found no evidence of an increased risk of cardiovascular disease at 5-year follow-up [48].…”

Artrite reumatóide e doença cardiovascular na atualidade: o que sabemos sobre essa associação e o que podemos fazer pelo paciente?

“…Paradoxalmente, outros autores caracterizaram um perfil lipídico com colesterol total, LDL-colesterol, HDL-colesterol diminuídos e aumento de triglicérides, correlacionados diretamente com a atividade inflamatória sistêmica 2,11 . Reforçando essa última corrente, há evidência de que o perfil lipídico tenha um efeito paradoxal no risco cardiovascular em pacientes com AR, já que se mostrou que os níveis de colesterol total e LDL-colesterol diminuem bruscamente no período de 3 a 5 anos que precede a incidência da AR 6,17 . Portanto, valores menores de colesterol total e LDL-colesterol corresponderiam a um maior risco cardiovascular nesses pacientes devido à suposta maior atividade inflamatória associada.…”