Beijing Da Xue Xue Bao Yi Xue Ban. 2026 Oct 18;58(5):1031-1037.
ABSTRACT
OBJECTIVE: To analyze the characteristics of lipid profile and the risk factors of carotid atherosclerosis (CAS) in patients with rheumatoid arthritis (RA).
METHODS: Subjects with 216 RA and 214 healthy controls, both without known cardiovascular disease (CVD), were included. CAS plaques were determined by color Doppler ultrasound. Lipid levels were compared between RA patients and healthy controls, and independent risk factors for CAS plaques in the RA patients were analyzed.
RESULTS: (1) The total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) levels were lower (P < 0.001, P=0.001, P < 0.001), TC/HDL-C and LDL-C/HDL-C were higher (P=0.003, P=0.009) in the RA group than in the healthy controls. (2) In RA group, TC and HDL-C were negatively correlated with high-sensitivity C-reactive protein (hs-CRP) (r=-0.237, P=0.002; r=-0.351, P < 0.001), neutrophil-to-lymphocyte ratio (NLR) (r=-0.210, P=0.006; r=-0.182, P=0.018); LDL-C was negatively correlated with NLR (r=-0.200, P=0.009), triglyceride (TG) was negatively correlated with erythrocyte sedimentation rate (r=-0.184, P=0.016), TC/HDL-C was positively correlated with hs-CRP and NLR (r=0.286, P < 0.001; r=0.159, P=0.039), LDL-C/HDL-C was positively correlated with hs-CRP (r=0.161, P=0.040). In patients with RA, HDL-C levels were higher, and TG and TC/HDL-C levels were lower in the group treated regularly with conventional synthetic disease modifying anti-rheumatic drugs (csDMARDs) than without csDMARDs (P=0.035, P=0.003, P=0.006). (3) The prevalence of CAS plaques in RA patients was 37.5%. Age, disease duration, prevalence of hypertension, prevalence of diabetes, LDL-C/HDL-C, homocysteine (Hcy) and hs-CRP levels were higher in the RA with plaque group than in the RA without plaque group (all P < 0.05). (4) Logistic regression showed that age (OR=1.085, 95%CI: 1.045-1.128), disease duration (OR=1.008, 95%CI: 1.003-1.014), diabetes (OR=4.326, 95%CI: 1.606-11.655), and hs-CRP (OR=1.022, 95%CI : 1.006-1.038) were independent risk factors for the presence of CAS plaques in the RA patients.
CONCLUSION: Patients with RA are more likely to exhibit lipid metabolic abnormalities which are mainly manifested as low cholesterol levels (TC, LDL-C, HDL-C) and high lipid ratios (TC/HDL-C, LDL-C/HDL-C). Such disordered lipid profileis are associated with gender, inflammatory and drug therapy. Age, disease duration, inflammatory status, and diabetes are independent risk factors for CAS plaques in RA patients. Effective control of inflammatory status are important goals of RA management and may also be essential to delay the progression of atherosclerosis.
PMID:42880925