title: Inflammation, lipid metabolism and cardiovascular risk in rheumatoid arthritis: A qualitative relationship?
abstract: Life expectancy in patients with rheumatoid arthritis (RA) is reduced compared to the general population owing to an increase in cardiovascular diseases (CVD) not fully explained by traditional cardiovascular risk factors. In recent years, interest has been focused on the alterations in lipid metabolism in relation to chronic inflammation as one of the possible mechanisms involved in the pathogenesis of atherosclerosis of RA patients. Research regarding this issue has revealed quantitative alterations in lipoproteins during the acute-phase reaction, and has also demonstrated structural alterations in these lipoproteins which affect their functional abilities. Although many alterations in lipid metabolism have been described in this regard, these structural changes associated with inflammation are particularly important in high-density lipoproteins as they affect their cardioprotective functions. In this respect, excessive oxidation in low-density lipoprotein (LDL) and increased lipoprotein(a) with a predominance of smaller apolipoprotein(a) isoforms has also been reported. This article will discuss proinflammatory high-density lipoproteins (piHDL), oxidized LDL and lipoprotein(a). Elevated concentrations of these lipoproteins with marked pro-atherogenic properties have been observed in RA patients, which could help to explain the increased cardiovascular risk of these patients.
authors.affiliation: Carmen García-Gómez, Maria Bianchi, Department of Rheumatology, Consorci Sanitari de Terrassa (CST), Unitat Investigació Biomèdica CST-UAB (Universitat Autònoma de Barcelona), 08227-Terrassa, Barcelona, Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: García-Gómez
authors.affiliation: Carmen García-Gómez, Maria Bianchi, Department of Rheumatology, Consorci Sanitari de Terrassa (CST), Unitat Investigació Biomèdica CST-UAB (Universitat Autònoma de Barcelona), 08227-Terrassa, Barcelona, Spain.
authors.forename: Maria
authors.initials: M
authors.lastname: Bianchi
authors.affiliation: Carmen García-Gómez, Maria Bianchi, Department of Rheumatology, Consorci Sanitari de Terrassa (CST), Unitat Investigació Biomèdica CST-UAB (Universitat Autònoma de Barcelona), 08227-Terrassa, Barcelona, Spain.
authors.forename: Diana
authors.initials: D
authors.lastname: de la Fuente
authors.affiliation: Carmen García-Gómez, Maria Bianchi, Department of Rheumatology, Consorci Sanitari de Terrassa (CST), Unitat Investigació Biomèdica CST-UAB (Universitat Autònoma de Barcelona), 08227-Terrassa, Barcelona, Spain.
authors.forename: Lina
authors.initials: L
authors.lastname: Badimon
authors.affiliation: Carmen García-Gómez, Maria Bianchi, Department of Rheumatology, Consorci Sanitari de Terrassa (CST), Unitat Investigació Biomèdica CST-UAB (Universitat Autònoma de Barcelona), 08227-Terrassa, Barcelona, Spain.
authors.forename: Teresa
authors.initials: T
authors.lastname: Padró
authors.affiliation: Carmen García-Gómez, Maria Bianchi, Department of Rheumatology, Consorci Sanitari de Terrassa (CST), Unitat Investigació Biomèdica CST-UAB (Universitat Autònoma de Barcelona), 08227-Terrassa, Barcelona, Spain.
authors.forename: Emili
authors.initials: E
authors.lastname: Corbella
authors.affiliation: Carmen García-Gómez, Maria Bianchi, Department of Rheumatology, Consorci Sanitari de Terrassa (CST), Unitat Investigació Biomèdica CST-UAB (Universitat Autònoma de Barcelona), 08227-Terrassa, Barcelona, Spain.
authors.forename: Xavier
authors.initials: X
authors.lastname: Pintó
keywords: Cardiovascular disease; Inflammation; Lipid metabolism; Lipoprotein(a); Lipoproteins; Oxidized low-density lipoproteins; Proinflammatory high-density lipoproteins; Rheumatoid arthritis