Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement
Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.
There Are No Differences in Lipids between RA Patients and Their Siblings, Despite Higher Incidence of CHD in RA.
Kumar, Namita, J. Marshall, Nicola, J. Walker, David, N. Platt, Philip
The interest in coronary heart disease (CHD) and cardiovascular risk remains high in our patients with inflammatory arthritis and especially Rheumatoid Arthritis (RA). The exact cause of the increased risk is still unclear with contradictory data regards the role of lipids and their response to treatment.
We looked at a cohort of RA patients and their siblings to assess this further.
A population of RA patients and their same sex siblings were studied in Newcastle-upon-Tyne, UK. This population were matched for age and sex. Diagnosis of CHD and a number of risk factors were assessed and compared. Diabetics were excluded.
Data from 79 pairs were available, Female:male ratio was 67: 12. There was a twofold increase in the amount of diagnosed CHD in the index cases compared to the siblings (Mann-Whitney test, (p less than 0.0001). There was a significant increase in CRP and ESR (p less than 0.0004) in the index cases and increased BMI in the siblings. Current and previous smoking status between the 2 groups was similar. There was no difference in the use of statins and other lipid lowering drugs between the 2 groups.
Linear regression showed no association between CRP, cholesterol: HDL, LDL apolipoprotein A or B and the incidence of CHD in our patients with RA. There was also no correlation with CRP and any of the lipids shown in Table 1.
|N = 79 pairs||RA||Sibling||P-value|
|Age||61.9 (9.2)||59.4 (10.8))||ns|
|Diagnosed CHD||16 (20%)||9 (11%)||<0.0001|
|CRP mg/l median (range)||11 (3.232)||3 (0.21)||<0.001|
|BMI (kg/m2) (mean SD)||25.7 (5.6)||27.3 (5.1)||x0.016|
|Cholesterol mmol/l (mean, SD)||5.5 (1.1)||5.9 (1.2)||ns|
|Triglycerides mmol/l||1.5 (0.6, 3.8)||1.3 (0.4, 4.1)||ns|
|HDL-cholesterol mmol/l||1.5 (0.4)||1.6 (0.4)||ns|
|Cholesterol: HDL mmol/l||3.8 (1.0)||3.9 (1.0)||ns|
|LDL mmol/l (mean, SD)||3.3 (1.0)||3.6 (1.1)||ns|
|Apolipoprotein A1 (mean, SD)||1.45 (0.3)||1.5 (0.3)||ns|
|Apolipoprotein B (mean, SD)||0.99 (0.25)||1.01 (0.3)||ns|
In those pairs who had no CHD there was still no difference in cholesterol, triglycerides, cholesterol: HDL and apolipoprotein A and B levels, all of which were in the normal range.
RA patients have higher CHD than same sex siblings when matched for age, sex, diabetes and smoking status. They have lower BMIs and higher inflammatory markers. This data suggest that lipids within this RA population were not a major component of risk.
To cite this abstract, please use the following information:
Kumar, Namita, J. Marshall, Nicola, J. Walker, David, N. Platt, Philip; There Are No Differences in Lipids between RA Patients and Their Siblings, Despite Higher Incidence of CHD in RA. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :1064