Department of General Internal Medicine and Ambulatory Treatment, Baylor College of Medicine and The University of Texas M.D. Anderson Cancer Center, 1400 Pressler Street, Unit 1465, Houston, TX 77030, USA.
Curr Rheumatol Rep. 2012 Oct;14(5):428-37. doi: 10.1007/s11926-012-0269-z.
Rheumatoid arthritis (RA) is associated with increased cardiovascular (CV) morbidity and mortality, related not only to traditional CV risk factors, but also to a chronic inflammatory state. However, lipid profiles in RA are different from those observed in the general population at risk of CV disease, where there is evidence of a positive relationship between disease and high cholesterol levels. In untreated patients with active RA this relationship is different, with a paradoxical effect resulting in lower levels of cholesterol associated with an increased risk of CV disease. In this review, we summarize the latest evidence on lipid abnormalities in the setting of RA and the interaction between inflammation and lipoproteins, as well as the effect of DMARDs and biologic therapies on lipid profiles and the possible implications for CV outcomes in this population.
类风湿关节炎（RA）与心血管（CV）发病率和死亡率的增加有关，这不仅与传统的 CV 危险因素有关，还与慢性炎症状态有关。然而，RA 患者的血脂谱与 CV 疾病高危人群中的血脂谱不同，后者有证据表明疾病与高胆固醇水平之间存在正相关。在未经治疗的活动期 RA 患者中，这种关系是不同的，其结果是一种矛盾的效应，导致胆固醇水平降低，同时 CV 疾病的风险增加。在这篇综述中，我们总结了 RA 患者血脂异常的最新证据，以及炎症与脂蛋白之间的相互作用，以及 DMARDs 和生物疗法对血脂谱的影响，以及对该人群 CV 结局的可能影响。
