Abstract P216: The Association Between Reduction in Inflammation and Changes in Lipoprotein Levels and HDL Cholesterol Efflux Capacity in Rheumatoid Arthritis
Background: Potent anti-inflammatory RA treatments are associated with reduced cardiovascular (CV) risk as well as increases in low density lipoprotein (LDL). This apparent paradox may be explained by favorable changes in other lipid measurements. The objective of this study was to determine the longitudinal association between changes in inflammation with advanced lipoprotein measurements and HDL cholesterol efflux capacity.
Methods and Results: We conducted this study in a longitudinal RA cohort from a large academic center. We included subjects with hsCRP reduction ≥10mg/L at two time points one year apart. Subjects on statins during the study period or 6 months prior were excluded. We measured total cholesterol (TC), LDL, high density lipoprotein (HDL), apolipoprotein B (apoB), apoA1, and HDL cholesterol efflux capacity at baseline and one year follow-up. We determined the correlations between reduction in hsCRP and change in lipid parameters using the Pearson test.
We studied 90 RA subjects, mean age 57 years, 89% female, all subjects were on disease modifying anti-rheumatic drugs; median baseline hsCRP was 28.6mg/L and follow-up 4.3 mg/L (reduction of 85%, p<0.0001). We observed significant correlations between a reduction in hsCRP with increases in LDL (r=0.25,p=0.02, Figure 1a), HDL (r=0.23, p=0.03), apoA1 (r=0.27, p=0.01 and HDL cholesterol efflux capacity (r=0.24, p=0.02), an overall improvement of efflux capacity of 5.7% (p=5x10-4, Figure 1b).
Conclusion: Reduction in inflammation was associated increased LDL levels, and concomitant increases in HDL, ApoA1, and improvements in HDL cholesterol efflux capacity. These findings provide further insight into lipid modulation and the beneficial effect of reduction in inflammation on lipids in vivo.
Author Disclosures: K. Liao: None. M. Playford: None. M. Frits: None. J. Coblyn: G. Consultant/Advisory Board; Modest; CVS-Caremark. C. Iannaccone: None. M. Weinblatt: B. Research Grant; Significant; Bristol Myers Squibb, UCB, Crescendo Bioscience. G. Consultant/Advisory Board; Modest; Medimmune, AstraZeneca, Amgen, Abbvie, Bristol Myers Squibb, Crescendo Bioscience, Lilly, Pfizer, UCB, Roche. N. Shadick: B. Research Grant; Significant; Crescendo Bioscience, Amgen, UCB, Abbvie, Bristol Myers Squibb, Genentech. N. Mehta: None.
- © 2015 by American Heart Association, Inc.