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Deutscher Rheumatologiekongress 2023

51. Kongress der Deutschen Gesellschaft für Rheumatologie (DGRh)
37. Jahrestagung der Deutschen Gesellschaft für Orthopädische Rheumatologie (DGORh)
33. Jahrestagung der Gesellschaft für Kinder- und Jugendrheumatologie (GKJR)

30.08. - 02.09.2023, Leipzig

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Dysfunctional high-density Lipoprotein in chronic inflammatory rheumatic diseases

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  • Sabina Waldecker-Gall - Rheumazentrum Ruhrgebiet, Ruhr-University Bochum, Herne; Rheumazentrum Ruhrgebiet, Herne
  • Felix Sebastian Seibert - University Hospital Marien Hospital Herne, Ruhr-University Bochum, Medical Department 1, Herne
  • Sebastian Bertram - University Hospital Marien Hospital Herne, Ruhr-University Bochum, Medical Department 1, Herne
  • Adrian Doevelaar - University Hospital Marien Hospital Herne, Ruhr-University Bochum, Medical Department 1, Herne
  • Nina Babel - Center for Translational Medicine, University Hospital Marien Hospital Herne, Bochum
  • Christoph Waldecker - St. Marien-Hospital Mülheim an der Ruhr, Department of Nephrology, Mülheim an der Ruhr
  • Jürgen Braun - Rheumazentrum Ruhrgebiet, Ruhr-University Bochum, Herne
  • Xenofon Baraliakos - Rheumazentrum Ruhrgebiet, Ruhr-University Bochum, Herne
  • Linda Scharow - University Hospital Ruppin-Brandenburg, Brandenburg Medical School, Neuruppin, Department of Cardiology, Brandenburg
  • Nikolaos Pagonas - University Hospital Ruppin-Brandenburg, Brandenburg Medical School, Neuruppin, Department of Cardiology, Brandenburg
  • Timm Henning Westhoff - University Hospital Marien Hospital Herne, Ruhr-University Bochum, Medical Department 1, Herne

Deutsche Gesellschaft für Rheumatologie. Deutsche Gesellschaft für Orthopädische Rheumatologie. Gesellschaft für Kinder- und Jugendrheumatologie. Deutscher Rheumatologiekongress 2023, 51. Kongress der Deutschen Gesellschaft für Rheumatologie (DGRh), 37. Jahrestagung der Deutschen Gesellschaft für Orthopädische Rheumatologie (DGORh), 33. Jahrestagung der Gesellschaft für Kinder- und Jugendrheumatologie (GKJR). Leipzig, 30.08.-02.09.2023. Düsseldorf: German Medical Science GMS Publishing House; 2023. DocET.02

doi: 10.3205/23dgrh022, urn:nbn:de:0183-23dgrh0221

Published: August 30, 2023

© 2023 Waldecker-Gall et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Background/Objective: The mechanisms explaining low cholesterol levels in chronic inflammatory rheumatic disease (CIRD) is incompletely understood. We hypothesized that chronic inflammation impairs the functionality of high-density lipoprotein (HDL) by oxidative processes. The role of oxidized HDL (HDLox) a marker of dysfunctional HDL, has not been studied to date. Therefore, we measured HDLox serum levels in patients first diagnosed with CIRD before and after the initiation of immunosuppressive therapy and to compare it with non-CIRD controls.

Methods: A total of 180 patients, 44 with newly diagnosed CIRD and 136 without CIRD as controls, were prospectively included in the study after informed consent. In CIRD patients, peripheral blood samples were drawn before (baseline) and 12 weeks after the initiation of immunosuppressive therapy. Lipid profiles including HDLox and C-reactive protein (CRP) serum levels were measured in both groups at baseline. Validated outcome tools for disease activity and function were assessed at baseline and after 12 weeks.

Results: A total of 33 patients with rheumatoid arthritis (RA, 75%), 7 with axial spondyloarthritis (16%), and 4 with systemic lupus erythematosus (9%) were included. Groups were comparable for gender, age, and BMI. CIRD patients had higher HDLox concentrations (1.57 vs. 0.78, p=0.02), and tended to have lower low-density lipoprotein cholesterol (LDL-C), HDL-cholesterol (HDL-C), and cholesterol levels compared to controls. HDLox (1.57 vs.1.4, p=0.26) and C-reactive protein levels (2.1 mg/dl vs. 0.7 mg/dl, p<0.01) decreased in CIRD patients from baseline to follow up.

Conclusion: CIRD is associated with an impairment of the anti-inflammatory properties of HDL-C as reflected by an increase in HDLox concentrations. This may contribute to the increased cardiovascular risk of these patients.