Department of Medicine, Kuopio University Hospital, Kuopio, Finland.
Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland.
Ann Med. 2020 Feb-Mar;52(1-2):32-42. doi: 10.1080/07853890.2020.1724321. Epub 2020 Feb 10.
We investigated lipid concentrations, particle sizes and antibodies binding to periodontal bacteria and and to malondialdehyde-acetaldehyde (MAA) modified low-density lipoprotein in immunoglobulin (Ig) class A, G and M among patients with newly diagnosed rheumatoid arthritis (RA) in a population-based cohort. Concentrations and sizes of lipoprotein particles analysed by proton nuclear magnetic resonance spectroscopy and antibody levels to MAA modified low-density lipoprotein were studied at baseline and after one-year of follow-up. Serum Ig A and G class antibodies to periodontal bacteria were determined at baseline. Sixty-three patients were divided into tertiles according to disease activity by disease activity score with 28 joint count and erythrocyte sedimentation rate (ESR) (<3.9, 3.9-4.7, >4.7). Small low-density lipoprotein concentration was lowest in the tertile with the highest disease activity. In high-density lipoprotein, the concentrations of total, medium and small particles decreased with disease activity. The particle size in low-density lipoprotein associated with disease activity and the presence of antibodies to . Ig G and M antibodies to MAA modified low-density lipoprotein correlated with disease activity. Inflammation associated changes faded by one year. Drug naive RA patients had proatherogenic changes in lipid profiles, but they were reversible, when inflammation diminished.Key messagesPatients with drug naive rheumatoid arthritis showed proatherogenic lipid profiles.Reversible changes in lipid profiles can be achieved as response to inflammation suppression.Active therapy aimed at remission is essential in all patients with rheumatoid arthritis.
我们在一个基于人群的队列中研究了新诊断为类风湿关节炎(RA)患者的血脂浓度、颗粒大小以及与牙周细菌和丙二醛-乙醛(MAA)修饰的低密度脂蛋白结合的抗体,以及免疫球蛋白(Ig)A、G 和 M 类。通过质子核磁共振光谱分析了脂蛋白颗粒的浓度和大小,并在基线和随访一年后研究了对 MAA 修饰的低密度脂蛋白的抗体水平。在基线时测定了血清 Ig A 和 G 类抗体对牙周细菌的抗体。根据红细胞沉降率(ESR)和 28 关节计数的疾病活动评分将 63 例患者分为三组(<3.9、3.9-4.7、>4.7)。在疾病活动最高的三分位中,小而密的 LDL 浓度最低。在高密度脂蛋白中,总浓度、中浓度和小浓度随疾病活动而降低。与疾病活动相关的 LDL 颗粒大小以及对. 的抗体。IgG 和 M 类抗体与 MAA 修饰的低密度脂蛋白的抗体与疾病活动相关。与炎症相关的变化在一年内消失。无药物治疗的 RA 患者的血脂谱具有动脉粥样硬化前变化,但随着炎症的消退,这些变化是可逆的。
关键信息
新诊断的类风湿关节炎患者表现出动脉粥样硬化前的血脂谱。
随着炎症的抑制,血脂谱的变化是可逆的。
所有类风湿关节炎患者均应采用积极的缓解治疗。