Total cholesterol and LDL levels decrease before rheumatoid arthritis

• Published in: Annals of the rheumatic diseases Vol. 69; no. 7; pp. 1310 - 1314
• Main Authors: Myasoedova, Elena, Crowson, Cynthia S, Kremers, Hilal Maradit, Fitz-Gibbon, Patrick D, Therneau, Terry M, Gabriel, Sherine E
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and European League Against Rheumatism 01.07.2010; BMJ Publishing Group; Elsevier Limited
• Subjects: Adult; Age; Aged; Arthritis, Rheumatoid - blood; Arthritis, Rheumatoid - epidemiology; Biological and medical sciences; Body mass index; Calendars; Cholesterol; Cholesterol - blood; Cholesterol, LDL - blood; Diseases of the osteoarticular system; Drugs; Epidemiologic Methods; Epidemiology; Family medical history; Female; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use; Inflammation; Inflammatory joint diseases; Lipids; Male; Medical records; Medical sciences; Middle Aged; Minnesota - epidemiology; Mortality; Population; Rheumatoid arthritis; Studies; Trends; Triglycerides - blood; Minnesota; Immunopathology; Chronic; Rheumatoid arthritis; Diseases of the osteoarticular system; Rheumatology; Autoimmune disease; Inflammatory joint disease; Cholesterol
• ISSN: 0003-4967; 1468-2060; 1468-2060
• DOI: 10.1136/ard.2009.122374

Objectives To compare lipid profiles in patients with rheumatoid arthritis (RA) and in non-RA subjects during the 5 years before and 5 years after the RA incidence/index date. Methods Lipid measures were abstracted in a population-based incident cohort of patients with RA (1987 American College of Rheumatology criteria) first diagnosed between 1 January 1988 and 1 January 2008 and in non-RA subjects. Random-effects models adjusting for age, sex and calendar year were used to examine trends in lipid profiles, accounting for multiple measurements for each subject. Results The study population included a cohort of 577 patients with RA (a total of 3088 lipid measurements) and 540 non-RA subjects (a total of 3048 lipid measurements). There were significant decreases in total (TC) and low-density lipoprotein cholesterol (LDL) levels in the RA cohort during the 5 years before RA, compared with the non-RA cohort (p<0.001). Decreases of 0.58 mmol/l for TC and 0.61 mmol/l for LDL were noted in RA compared with decreases of 0.09 mmol/l for TC and 0.22 mmol/l for LDL in the non-RA cohort. Trends in other lipid measures (triglycerides (TGs) and high-density lipoprotein cholesterol (HDL)) were similar in RA and non-RA cohorts during the 5 years before and 5 years after the RA incidence/index date. During the 5 years before the RA incidence/index date, the proportion of patients with RA with elevated TC or LDL measures, but not with abnormal HDL and TG measures, significantly decreased compared with non-RA subjects. Lipid-lowering drugs (statins in particular) were less often prescribed to patients with RA than to non-RA subjects (34% vs 41%; p=0.02). Conclusion TC and LDL levels and the prevalence of abnormal TC or LDL measures decreased significantly during the 5 years before the RA incidence/index date in patients with RA as compared with the non-RA cohort. These trends in lipid profile in RA are unlikely to be solely due to lipid-lowering treatment.