Relations between autoantibodies against oxidized low-density lipoprotein, inflammation, subclinical atherosclerosis, and cardiovascular disease in rheumatoid arthritis.
OBJECTIVE
Rheumatoid arthritis (RA) is associated with an unexplained increased cardiovascular risk. Autoantibodies recognizing oxidized low-density lipoprotein (oxLDL-ab) are associated with atherosclerosis in the general population and have been reported in several autoimmune diseases. We investigated relations between oxLDL-ab, inflammation, subclinical atherosclerosis, and cardiovascular disease (CVD) in patients with RA.


METHODS
In a nested case-control study, serum concentrations of oxLDL-ab were measured in 140 RA patients. Ultrasound examination of the carotid artery [i.e., carotid intima-media thickness (CIMT)] was performed in a third of these patients. Correlations were calculated for oxLDL-ab, C-reactive protein (CRP), and high-density lipoprotein (HDL) cholesterol. Regression analyses were used to examine associations between oxLDL-ab and prevalent CVD, and oxLDL-ab and CIMT.


RESULTS
OxLDL-ab were positively correlated with CRP (r = 0.33, p < 0.001) and negatively correlated with HDL cholesterol (r = -0.28, p = 0.001). An indication for interaction was found (p = 0.09), suggesting that inflammation modifies the relation between HDL cholesterol and oxLDL-ab. OxLDL-ab were independently associated with intimal thickening, but not associated with prevalent CVD.


CONCLUSIONS
OxLDL-ab were strongly related with the degree of inflammation and may predispose to a higher risk for CVD, as they were independently associated with subclinical atherosclerosis in patients with RA.
Peters
Mike J L
MJ
Department of Rheumatology, VU University Medical Center, Amsterdam, The Netherlands.
van Halm
Vokko P
VP
Nurmohamed
Michael T
MT
Damoiseaux
Jan
J
Tervaert
Jan Willem Cohen
JW
Twisk
Jos W R
JW
Dijkmans
Ben A C
BA
Voskuyl
Alexandre E
AE
D000368:Aged; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000276:immunology*; D001323:Autoantibodies / Q000276:immunology*; D002340:Carotid Artery Diseases / Q000150:complications / Q000276:immunology* / Q000473:pathology; D016022:Case-Control Studies; D003324:Coronary Artery Disease / Q000150:complications / Q000276:immunology*; D005260:Female; D006801:Humans; D008077:Lipoproteins, LDL / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D010084:Oxidation-Reduction; D012307:Risk Factors
D001323:Autoantibodies; D008077:Lipoproteins, LDL; C099252:oxidized low density lipoprotein