Low levels of total cholesterol, high-density lipoprotein, and apolipoprotein A1 in association with anticardiolipin antibodies in patients with systemic lupus erythematosus.

OBJECTIVE

To determine if there is an association between low levels of high-density lipoprotein cholesterol (HDL), apolipoprotein A1 (Apo A1), total cholesterol, and anticardiolipin antibody (aCL) in patients with systemic lupus erythematosus (SLE) who are not taking corticosteroids.

METHODS

We studied 75 outpatients with documented SLE who were attending our hospital clinics: 57 were aCL positive and 18 were aCL negative. Both IgG and IgM aCL levels were determined by enzyme-linked immunosorbent assay. Lipid fractions (total cholesterol, HDL, low-density lipoprotein, very-low-density lipoprotein, and triglycerides) were determined by standard enzymatic techniques. Apo A1 and Apo B levels were determined by nephelometry.

RESULTS

Patients with SLE who were IgG aCL+ had low levels of serum cholesterol (mean +/- SD 173.6 +/- 34.6 mg/dl) and HDL (43.9 +/- 16.3 mg/dl) compared with aCL- SLE patients, normal donors, and patients with other diseases. Apo A1 levels were also low in the aCL+ group (95.5 +/- 50.9 mg/dl) compared with the aCL- group (152.7 +/- 32.6 mg/dl). There was no association of total cholesterol level or aCL titer with clinical activity.

CONCLUSION

These data indicate that in SLE patients, there is an association between antibody against the phospholipid cardiolipin and low levels of cholesterol, HDL, and Apo A1.