title: Cholesteryl ester transfer protein in patients with rheumatoid arthritis.
abstract: OBJECTIVE
  To investigate how cholesteryl ester transfer protein (CETP), one of the enzymes involved in the reverse cholesterol transfer, is expressed in patients with rheumatoid arthritis (RA) and its potential relationship with both dyslipidemia and the risk of cardiovascular mortality observed in these patients.
  
  
  METHODS
  Plasma CETP concentrations and CETP activity were measured in 101 patients with RA and 115 sex- and age-matched controls. A multivariable analysis adjusted for standard cardiovascular risk factors, including high-density lipoprotein cholesterol, was performed to evaluate the influence of CETP on dyslipidemia and cardiovascular mortality risk, as assessed by the Systematic Coronary Risk Evaluation (SCORE) risk function.
  
  
  RESULTS
  Patients with RA showed lower CETP activity [beta coefficient = -10.82 (95% CI -19.56 to 2.07) pmol/3 h; p = 0.02] and an inferior CETP mass [β = -0.85 (95% CI -1.64 to 0.05) μg/ml; p = 0.03] versus controls. Divided into those taking and those not taking glucocorticoids, patients taking glucocorticoids revealed lower CETP activity and mass [β = -8.98 (95% CI -14.55 to 3.41) pmol/3 h; p = 0.00, for CETP activity; and β = -0.77 (95% CI -1.46 to 0.08) μg/ml; p = 0.03, for CETP mass]. Patients with RA not taking glucocorticoids showed no differences versus controls in either CETP activity or mass. Both current prednisone intake [β = -16.14 (95% CI -24.87 to 7.41) pmol/3 h; p = 0.00] and average daily prednisone intake during the last 3 months [β = -0.36 (95% CI -0.54 to 0.18) μg/ml; p = 0.01] were strongly and inversely correlated with CETP activity and mass, respectively. CETP activity showed an inverse trend compared to SCORE risk, demonstrating that lower levels were effective predictors of total mortality when a higher SCORE risk was found [β = -4.7 (95% CI -9.3 to 0.02) pmol/3 h; p = 0.04] in patients with RA.
  
  
  CONCLUSIONS
  CETP is downregulated in patients with RA who are taking glucocorticoids. Low CETP activity is associated with an increased level of cardiovascular risk in patients with RA.
authors.affiliation: Rheumatology Division, Hospital Universitario de Canarias, Tenerife, Spain. iferrazamaro@hotmail.com
authors.forename: Iván
authors.initials: I
authors.lastname: Ferraz-Amaro
authors.forename: Miguel A
authors.initials: MA
authors.lastname: González-Gay
authors.forename: José A
authors.initials: JA
authors.lastname: García-Dopico
authors.forename: Federico
authors.initials: F
authors.lastname: Díaz-González
mesh_terms: D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000097:blood / Q000150:complications / Q000201:enzymology*; D002318:Cardiovascular Diseases / Q000097:blood / Q000150:complications / Q000201:enzymology*; D053480:Cholesterol Ester Transfer Proteins / Q000097:blood*; D003430:Cross-Sectional Studies; D050171:Dyslipidemias / Q000097:blood / Q000150:complications / Q000201:enzymology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis
chemical_list: D053480:Cholesterol Ester Transfer Proteins
keywords: CARDIOVASCULAR MORTALITY; CHOLESTERYL ESTER TRANSFER PROTEIN; DYSLIPIDEMIA; RHEUMATOID ARTHRITIS; RISK