Article
Small, dense LDL cholesterol is a cardiovascular risk factor in several chronic inflammatory diseases
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Published: | August 29, 2016 |
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Outline
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Background: Subjects with Chronic inflammatory diseases (CID) exhibit a profound increase of cardiovascular risk (CVR) resulting in reduced life expectancy. At the same time LDL-cholesterol serum levels seem to be low in these patients suggesting a special type of “rheumatic dyslipidemia”.
Methods: In our mono-centre, longitudinal, observational study small dense LDL-cholesterol (sdLDL) was measured in n=141 subjects with CID (Rheumatoid Arthritis n= 59, Inflammatory Bowel Disease n= 35, Ankylosing Spondylitis n= 25, Psoriasis n= 22) at baseline, 6 and 26 weeks after initiation of different anti-cytokine therapies (anti-TNFα, anti-IL-6). Age-, BMI- and sex-matched subjects (n=143) served as healthy controls.
Results: CID patients exhibit a significant increase in the sdLDL/LDL ratio at baseline independent of the kind of CID compared to controls. Interestingly, while anti-cytokine treatment induced a profound improvement of the CID (as measured by disease activity scores and CRP-levels), none of the biological agents affected the sdLDL/LDL ratio in a time period of 6 and 26 weeks.
Conclusion: While anti-cytokine therapies exhibit a dramatic improvement of the CID, the “rheumatic dyslipidemia” is not affected by such agents. This suggest that Endocrinologists and Diabetologists should be involved in the standard patient care in CID in order to improve CVR-factors by additional diagnostics and therapies to extent patients life-expectancy to normal.