Background: The main cause of death in patients with the inflammatory arthropathies is involvement of the cardiovascular system, and primarily atherosclerotic lesion with its complications. Initiation and progression of these arthropathies are underlied with similar immune and inflammatory mechanisms and associated with highly atherogenic changes of blood lipoproteins.

Objectives: Identification of particular qualities of the lipid profile in rheumatoid (RA) and psoriatic (PsA) arthritis, ankylosing spondylitis (AS) and their relationship with essential predisposing factors.

Methods: We enrolled 20 patients with RA, 15 with PsA, and 15 with AS, receiving basic anti-inflammatory therapy with methotrexate 10 to 20 mg per week for 6 months, in combination with various non-steroidal anti-inflammatory drugs. These diagnoses were verified according to the ACR/EULAR 2010, CASPAR 2006, ASAS 2009 criteria, respectively. The single exclusion criterion was the presence of a concomitant disease that could affect lipid metabolism. Total cholesterol (TC), HDL cholesterol, and triglycerides (TG) were measured in the plasma samples of all the patients, LDL cholesterol was calculated using Friedewald’s formula: TC – (HDL + (TG/2.2)). The atherogenic index was taken as (TC – HDL)/HDL. Results were expressed as arithmetic means ± standard deviations. Differences were considered significant when p<0.05.

Results: The age of all patients ranged from 30 to 67 years, disease duration range was 1.5 to 12 years. All the patients with chronic arthritis had moderate or high disease activity grades. In the subgroup of RA patients average TC value was 5.63±1.6 mmol/l, HDL – 1.09±0.2 mmol/l, LDL – 3.74±1.16 mmol/l. Increased TC levels were detected in 80% of cases, TG - in 40%, LDL - in 80%, and decreased HDL - in 60% patients. There were strong relationships of TC with age, menopause, or overweight. The duration of RA also positively correlated with TC (r=0.189, p<0.05) and LDL (r=0.159, p<0.05). RA (C-reactive protein level) activity was negatively associated with HDL (r=-0.169, p<0.05). 80% of PsA patients had increased TC levels, but TG or HDL levels were within reference intervals. Mean TC in this subgroup was 6.04±1.55 mmol/l. TC values of PsA patients also positively correlated with age, BMI, and duration of PsA. There was an increase in TC, LDL, and the atherogenic coefficient in AS patients. Mean values ​​of TC, TG, LDL, and HDL in this subgroup were 5.65±0.28, 1.28±0.12, 3.86±0.23 and 1.09±0.06 mmol/l, respectively.

Conclusion: Lipid disorders in patients with chronic inflammatory joint diseases may be a source of increased risk of early atherosclerosis and the cardiovascular events. Increased TC and LDL were most pronounced changes in lipid profiles of RA, PsA and AS patients. All these markers were revealed to be associated with both common cardiovascular (age, increased BMI) and the disease-associated factors (arthritis duration, activity of the underlying disease).

Disclosure of Interests: None declared