Division of Rheumatology, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Curr Opin Rheumatol. 2017 May;29(3):277-284. doi: 10.1097/BOR.0000000000000378.
To highlight recently published studies addressing lipid changes with disease-modifying antirheumatic drug use and outline implications on cardiovascular outcomes in rheumatoid arthritis (RA).
Growing evidence suggests lower lipid levels are present in patients with active RA vs. general population, and significant modifications of lipid profile with inflammation suppression. Increase in lipid levels in patients with RA on synthetic and biological disease-modifying antirheumatic drugs may be accompanied by antiatherogenic changes in lipid composition and function. The impact of lipid changes on cardiovascular outcomes in RA is a subject of active research. The role of lipids in cardiovascular risk in RA may be overpowered by the benefits of inflammation suppression with antirheumatic medication use. Recommendations on lipid management in RA are evolving but uncertainty exists regarding frequency of lipid testing and goals of treatment.
Knowledge about quantitative and qualitative lipid changes in RA is expanding. The relative role of lipids in cardiovascular risk in the context of systemic inflammation and antirheumatic therapy remains uncertain, delaying development of effective strategies for cardiovascular risk management in RA. Studies are underway to address these knowledge gaps and may be expected to inform cardiovascular risk management in RA and the general population.
强调最近发表的关于疾病修饰抗风湿药物使用与类风湿关节炎（RA）心血管结局相关的脂质变化的研究，并概述其对心血管结局的影响。
越来越多的证据表明，与一般人群相比，活动期 RA 患者的血脂水平较低，炎症抑制可显著改变血脂谱。在使用合成和生物疾病修饰抗风湿药物的 RA 患者中，血脂水平升高可能伴随着脂质成分和功能的抗动脉粥样硬化变化。血脂变化对 RA 心血管结局的影响是一个活跃的研究课题。在 RA 中，血脂在心血管风险中的作用可能会被抗风湿药物使用抑制炎症带来的益处所超越。RA 中的血脂管理建议正在不断发展，但血脂检测的频率和治疗目标仍存在不确定性。
关于 RA 中血脂的定量和定性变化的知识正在不断增加。在系统性炎症和抗风湿治疗的背景下，血脂在心血管风险中的相对作用仍不确定，这延迟了制定 RA 心血管风险管理有效策略的发展。正在进行研究以解决这些知识空白，并有望为 RA 和一般人群的心血管风险管理提供信息。
