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Evidence for increased chylomicron remnants in rheumatoid arthritis
Author(s) -
Burggraaf Benjamin,
van Breukelenvan der Stoep Deborah F.,
Zeben Jendé,
Meulen Noelle,
Geijn GertJan M.,
Liem Anho,
Valdivielso Pedro,
Rioja Villodres José,
RamírezBollero José,
Zwan Ellen,
Castro Cabezas Manuel
Publication year - 2018
Publication title -
european journal of clinical investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.164
H-Index - 107
eISSN - 1365-2362
pISSN - 0014-2972
DOI - 10.1111/eci.12873
Subject(s) - medicine , rheumatoid arthritis , diabetes mellitus , subclinical infection , gastroenterology , endocrinology , chylomicron , risk factor , apolipoprotein b , cholesterol , lipoprotein , very low density lipoprotein
Abstract Background Levels of apolipoprotein (apo) B48 may be increased in conditions associated with systemic inflammation and increased cardiovascular disease ( CVD ) risk such as rheumatoid arthritis ( RA ). We aimed to evaluate apo B48 levels in patients with RA in relation to subclinical atherosclerosis. Methods Patients with RA (without CVD ) and controls without RA but with high CVD risk (based on the presence of diabetes mellitus or a history of CVD ) and healthy controls were included in this cross‐sectional study. Carotid intima‐media thickness ( cIMT ) was measured as a surrogate for vascular damage. Results In total, 312 patients with RA , 65 controls with high CVD risk and 36 healthy controls were included. Patients with RA had the highest mean apo B48 (10.00 ± 6.65 mg/L) compared to controls with high CVD risk and healthy controls (8.37 ± 5.16 and 5.22 ± 2.46, P < .001). Triglycerides levels were comparable with controls. In RA , apo B48 correlated positively with triglycerides ( r = .645; P < .001) but not with cIMT . However, in RA subjects not using lipid or blood pressure lowering medication, a weak correlation was found with cIMT ( r = .157; P = .014). RA patients in the highest apo B48 tertile were more often rheumatoid factor positive and anti‐ CCP positive compared to the lowest tertile. Conclusion Rheumatoid arthritis patients have higher levels of apo B48 compared to controls with high CVD risk and healthy controls, with normal levels of triglycerides. This accumulation of atherogenic chylomicron remnants may contribute to the elevated CVD risk in RA patients.