Lipid profiles in early untreated rheumatoid arthritis: relation to disease activity

Rheumatoid arthritis [RA] is a chronic, systemic inflammatory disorder of unknown etiology that primarily targets the synovium. Cardiovascular morbidity and mortality appear to be increased in rheumatoid arthritis which might be due to increased prevalence of risk factors for disease such as an accelerated progression of atherosclerosis. Patients with active rheumatoid arthritis show an atherogenic lipid profile, which has been linked with the inflammatory reaction. The effect of treatment of RA on the adverse lipid profile is the subject of intensive research. We investigated lipid profile in newly diagnosed untreated RA patients, compared it with matched control and determined the relation of these lipid profiles to disease activity. Fifty three patients with early RA who met the American College of Rheumatology criteria were included in this study. They had disease duration of less than one year and had not had prior treatment for it. Thirty healthy volunteers [controls] were also included. Serum lipid profile including total cholesterol [TC], low density lipoprotein cholesterol [LDL-C], high density lipoprotein cholesterol [HDL-C], triglyceride [TG], apolipoprotein A-l [apo-A], apolipoprotein B [apo-B] and lipoprotein [a] were measured in the controls and in patients with RA at baseline and 6 months after treatment. Patients with RA exhibited higher serum levels of TC, LDL-C, and TG compared to controls whereas their serum HDL-C and apo-A levels were significantly lower compared to controls. As a consequence, the atherogenic ratio of TC/HDL-C as well as that of LDL-C/HDL-C was significantly higher in RA patients compared to controls. From the included 53 patients with RA, 39 patients [73.6%] met the improvement criteria in RA after 6 months of treatment with DMARDs. Those responders showed a significant reduction of atherogenic ratio of TC/HDL-C as well as that of LDL-C/HDL-C [p value 0.008 and 0.02 respectively], a finding that was primarily due to the increase of serum HDL-C levels [p. value 0.0004]. Patients with early untreated RA are characterized by an atherogenic lipid profile, which improves after therapy. Thus, early immunointervention to control disease activity may reduce the risk of atherosclerotic process and cardiovascular events in RA patients

Plasma antioxidative enzymes in down syndrome

Numerous biochemical abnormalities are present in Down syndrome [DS] patients, and these abnormalities have not yet been completely-clarified, the antioxidant defense system enzymes have shown to be altered due to increased gene on chromosome 21. In this study we investigated the activities of plasma superoxide dismutase [SOD-1] and glutathione peroxidase [GSH-Px] enzymes and the levels of their cofactors zinc[zn] and selenium [Se] in plasma of 20 Down Syndrome patients 14 males and 6 females with age ranging from 3-14 years, comparing the results with age and sex- matched controls [n=15]. Plasma GSH-Px, SOD-1 were significantly decreased in DS patient group [p<0.001]. Also their cofactors Zn and se were significantly; decreased with [p<0.05] and these changes in the plasma enzyme levels and their cofactors were not correlated to age or sex of the patients. We conclude that evaluation of these antioxidative enzymes and their cofactors are of great importance in DS patients