Division of Cardiology, Brigham and Women's Hospital, Boston, MA, USA.
Division of Rheumatology, Immunology, and Allergy, Brigham and Women's Hospital, 60 Fenwood Road, Boston, MA, 02115, USA.
Curr Rheumatol Rep. 2018 Feb 21;20(2):8. doi: 10.1007/s11926-018-0715-7.
In rheumatoid arthritis (RA), lipid levels are dynamic and can fluctuate along with changes in inflammation. A reduction in inflammation, most commonly as a result of disease-modifying anti-rheumatic drug (DMARD) therapy, is associated with increases in total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C). In this review, we discuss new evidence shedding light on the potential mechanism underlying changes in lipid levels observed with changes in inflammation.
Measured lipid levels in the blood are a result of a balance between synthesis and catabolism or absorption. Recent human studies in active RA show that the catabolic rates of lipids are higher than expected compared to expected rates in the general population. DMARD therapy appears to allow a return to baseline lower catabolic rates, resulting in an apparent increase in lipids. Increases in lipids observed with control of inflammation and RA treatment suggest a return to homeostasis. Studies are underway to understand the overall impact on cardiovascular risk in RA when lipid levels increase as a result of controlling inflammation.
在类风湿关节炎（RA）中，血脂水平是动态的，并可能随着炎症的变化而波动。炎症的减轻，通常是由于疾病修饰抗风湿药物（DMARD）治疗，与总胆固醇（TC）和低密度脂蛋白胆固醇（LDL-C）的增加有关。在这篇综述中，我们讨论了新的证据，这些证据阐明了与炎症变化相关的血脂水平变化的潜在机制。
血液中测量的血脂水平是合成和分解代谢或吸收之间平衡的结果。在活动性 RA 中的最近的人体研究表明，与普通人群的预期速率相比，脂质的分解代谢率更高。DMARD 治疗似乎允许恢复到基线更低的分解代谢率，从而导致脂质的表观增加。随着炎症的控制和 RA 治疗，观察到的脂质增加表明恢复到体内平衡。目前正在进行研究，以了解当由于控制炎症而导致脂质水平升高时，RA 对心血管风险的总体影响。
