relation between inflammatory markers, lipid parameters and antioxidant vitamins in rheumatoid arthritis patients

ABSTRACT

The association between rheumatoid arthritis and increased risk of atherosclerosis and coronary heart disease is well recognized. The role of chronic inflammation, dyslipoproteinemia, lipid peroxidation and low levels of antioxidant vitamins [vitamin A and E] in the development of atherosclerosis and coronary heart disease is being established. To study the relationship between lipid profile abnormalities, antioxidant vitamins and inflammatory markers in rheumatoid arthritis patients. Thirty rheumatoid arthritis patients and twenty apparently healthy volunteers as a control group were studied .The following parameters were measured for all included subjects: markers of inflammation; CRP, RF, ESR, and VCAM [Vascular Cell Adhesion Molecule], lipid parameters; total cholesterol, triglycerides, direct HDL and LDL cholesterol and Lp [a] and antioxidant vitamins A and E. The inflammatory markers [CRP, ESR and VCAM] were significantly higher in patients compared to controls [p<0.01]. Total cholesterol and LDL cholesterol in rheumatoid arthritis patients were significantly higher compared to the controls [p<0.05]. Also Lipoprotein [a] was significantly higher in rheumatoid arthritis patients compared to the controls [p<0.01]. Vitamins A and E were significantly lower in rheumatoid arthritis patients compared to the control group [p<0.01]. A significant positive correlation was found between total cholesterol, LDL-C, lipoprotein [a] and VCAM [p<0.001, and p<0.01 and p<0.01] respectively. A significant negative correlation between the antioxidant vitamins E and A and VCAM [p<0.05 and p<0.05] in rheumatoid arthritis patients was also observed. A significant negative correlation was also found between lipoprotein [a] and both vitamins [E and A] [p<0.01 and p<0.001] respectively. The association of VCAM with high lipid parameters and low levels of antioxidant vitamins, might explain the association of chronic inflammatory processes with atherosclerosis and the high risk of cardiovascular disease in rheumatoid arthritis patients