Department of Internal Medicine, Medical School, University of Ioannina, Ioannina, Greece.
Scand J Rheumatol. 2013;42(3):169-75. doi: 10.3109/03009742.2012.745013. Epub 2013 Jan 14.
Patients with rheumatoid arthritis (RA) have increased cardiovascular risk. The aim of the present study was the assessment of low density lipoprotein (LDL) and high density lipoprotein (HDL) subclass distribution in patients with early RA (ERA, n = 30) compared with age- and sex-matched healthy subjects (n = 30), as well the effect of treatment for 12 months with the disease-modifying anti-rheumatic drugs (DMARDs) methotrexate and prednisone in this distribution.
LDL and HDL subclass distribution was determined using a polyacrylamide gel-tube electrophoresis method.
ERA patients exhibited increased levels of inflammatory markers and high disease activity score. ERA patients had higher serum levels of total cholesterol (TC), LDL cholesterol (LDL-C), and triglycerides (TG) whereas their serum HDL cholesterol (HDL-C) levels were significantly lower compared with controls. ERA patients exhibited significantly higher plasma levels of small dense LDL-C (sdLDL-C), leading to a significantly decreased mean LDL diameter. ERA patients had significantly decreased small HDL particles (HDL-3) concentration whereas serum levels of large HDL particles (HDL-2) did not differ compared with controls. Treatment with DMARDs resulted in a significant decrease in inflammatory markers and disease activity, along with a significant increase in HDL-C serum levels. The concentration of sdLDL-C did not change significantly during treatment. We observed a significant increase in the levels of large HDL-2 whereas the concentration of small HDL-3 did not significantly change.
Patients with ERA have increased sdLDL-C levels and decreased HDL-C levels because of decreased concentration of the small HDL-3 subclass. The administration of DMARDs induced a significant increase in HDL-C levels, which was attributed to the increase in large HDL-2 serum concentration.
类风湿关节炎（RA）患者存在心血管风险增加。本研究的目的是评估早期 RA（ERA，n=30）患者与年龄和性别匹配的健康对照者（n=30）之间的低密度脂蛋白（LDL）和高密度脂蛋白（HDL）亚类分布，并评估疾病修饰抗风湿药物（DMARDs）甲氨蝶呤和泼尼松治疗 12 个月对这种分布的影响。
使用聚丙烯酰胺凝胶管电泳法测定 LDL 和 HDL 亚类分布。
ERA 患者表现出炎症标志物水平升高和高疾病活动评分。与对照组相比，ERA 患者的总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）和甘油三酯（TG）血清水平更高，而 HDL 胆固醇（HDL-C）血清水平显著降低。ERA 患者的小而密 LDL-C（sdLDL-C）血浆水平显著升高，导致 LDL 平均直径显著降低。ERA 患者的小 HDL 颗粒（HDL-3）浓度显著降低，而大 HDL 颗粒（HDL-2）血清水平与对照组无差异。DMARDs 治疗可显著降低炎症标志物和疾病活动度，同时显著增加 HDL-C 血清水平。治疗期间 sdLDL-C 浓度无明显变化。我们观察到大 HDL-2 水平显著升高，而小 HDL-3 浓度无明显变化。
ERA 患者由于小 HDL-3 亚类浓度降低，导致 sdLDL-C 水平升高，HDL-C 水平降低。DMARDs 的给药导致 HDL-C 水平显著升高，这归因于大 HDL-2 血清浓度的增加。
