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Inflammation, lipid metabolism and cardiovascular risk in rheumatoid arthritis: A qualitative relationship?

世界骨科杂志：英文版 2014年第3期5卷 304-311页

作者： Carmen García-Gómez Maria Bianchi Diana de la Fuente Lina Badimon teresa padró Emili Corbella Xavier Pintó Department of Rheumatology Consorci Sanitari de Terrassa (CST)Unitat Investigació Biomèdica CST-UAB (Universitat Autònoma de Barcelona)08227-TerrassaBarcelonaSpain Department of Rheumatology Hospital de Viladecans08840-ViladecansBarcelonaSpain Cardiovascular Research Center CSIC-ICCCBiomedical Research Institute Sant-Pau08025-BarcelonaSpain Lipid and Vascular Risk Unit Department of Internal MedicineHospital Universitari de Bellvitge-IDIBELLL’Hospitalet de LlobregatBarcelona University08907 FipecCIBERobn ISCIIISpain

Life expectancy in patients with rheumatoid arthritis(RA)is reduced compared to the general population owing to an increase in cardiovascular diseases(CVD)not fully explained by traditional cardiovascular risk factors.In recent years,interest has been focused on the alterations in lipid metabolism in relation to chronic inflammation as one of the possible mechanisms involvedin the pathogenesis of atherosclerosis of RA patients.Research regarding this issue has revealed quantitative alterations in lipoproteins during the acute-phase reaction,and has also demonstrated structural alterations in these lipoproteins which affect their functional abilities.Although many alterations in lipid metabolism have been described in this regard,these structural changes associated with inflammation are particularly important in high-density lipoproteins as they affect their cardioprotective functions.In this respect,excessive oxidation in low-density lipoprotein(LDL)and increased lipoprotein(a)with a predominance of smaller apolipoprotein(a)isoforms has also been reported.This article will discuss proinflammatory high-density lipoproteins(pi HDL),oxidized LDL and lipoprotein(a).Elevated concentrations of these lipoproteins with marked pro-atherogenic properties have been observed in RA patients,which could help to explain the increased cardiovascular risk of these patients.

关键词： Rheumatoid arthritis Cardiovascular disease Lipoproteins Proinflammatory high-density lipoproteins Lipoprotein(a) Oxidized low-density lipoproteins Lipid metabolism Inflammation

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