Association of atherogenic indices with C-reactive protein and risk factors to assess cardiovascular risk in rheumatoid arthritis patient at Tikur Anbessa Specialized Hospital, Addis Ababa

Abstract

Background Rheumatoid arthritis (RA) is an autoimmune systemic chronic inflammatory disorder, which is characterized by joint stiffness, damage, and destruction of bone. In RA patients, the risk of cardiovascular disease is increased by 2–3 folds as compared to the general population. The major burden of RA is the development of cardiovascular diseases, including congestive heart failure, stroke, and myocardial infarction. Objectives Assessment of the association of atherogenic indices with C-reactive protein to evaluate CVD risk was one of the purposes of this study. In addition, the association of atherogenic indices with elevated levels of cardiovascular risk factors (LDL-C and TG) was another aim of this study. Methods The preferred study design for this study was a hospital based comparative cross-sectional study method. Data were cleaned, coded, and entered into Epi Data version 4.6 software, and exported to SPSS version 20 for further analysis of atherogenic indices, C-reactive protein, and risk factors. The comparison of atherogenic indices and other variables among the case and control groups was estimated by the independent t-test statistical analysis method. All variables with a p-value less than 0.2 during binary linear regression analysis were selected for multinomial logistic regression analysis. The association of atherogenic indices with C-reactive protein and risk factors was computed using multiple logistic regressions. The data were presented using tables and figures for clarification of the study. Results The levels of atherogenic indices were computed for both RA patients and the control group. The values of atherogenic indices were significantly associated with cardiovascular risk factor (CRP ≥ 2mg/L). Atherogenic index of plasma (AIP) and TC/HDL-C ratio had a statistically significant association with an elevated levels of triglycerides (P<0.01). The TC/HDL-Cratio value of the patient had 2.38 folds more likely to have an elevated low density lipoprotein level. In addition, AIP of RA patients had 57.51 and 23.65 folds more to have elevated low density lipoprotein and triglycerides respectively. Conclusions The result of this study showed that TC/HDL-C, LDL/HDL-C ratio values, and atherogenic index of plasma had a statistically significant association with elevated level of low density lipoprotein and triglycerides. In addition to this, they have a statistically significant association with the level of C-reactive protein. There was a highly significant statistical association between atherogenic indices, elevated low density lipoprotein, and triglycerides values. Therefore, the result of this finding confirmed that atherogenic indices have a potential role in the prediction and management of CVD risk in RA patients.

Evaluation of Biochemical and Oxidative Stress Markers in the Early Stages of Rheumatoid Arthritis in a Comparative Study of Two Different Therapeutic Approaches

“…Recent studies have investigated the relationship between changes in serum lipid levels in RA patients before and after treatment [19,24,48]. During the active phase of the disease, some studies have observed elevated levels of LDL and TG, while HDL levels were decreased [49][50][51]. These findings are consistent with our results.…”

Evaluation of pro‐atherogenic lipid profile and high atherohenic indexes in patients with Behçet's disease: A case–control study

“…In the literature, the importance of atherogenic indexes has been investigated in many diseases that are considered auto‐immune and auto‐inflammatory, such as Behçet's disease. A study evaluating the hsCRP and atherogenic indexes of patients with rheumatoid arthritis, which is deemed specific to cardiovascular diseases, showed that AIP, CRI‐I, and CRI‐II values were significantly associated with hsCRP elevation and increased the risk of cardiovascular disease 28 . A study on patients with ankylosing spondylitis stated that patients with ankylosing spondylitis had a significantly higher AIP value compared to the healthy control group.…”

“…A study evaluating the hsCRP and atherogenic indexes of patients with rheumatoid arthritis, which is deemed specific to cardiovascular diseases, showed that AIP, CRI-I, and CRI-II values were significantly associated with hsCRP elevation and increased the risk of cardiovascular disease. 28 A study on patients with ankylosing spondylitis stated that patients with ankylosing spondylitis had a significantly higher AIP value compared to the healthy control group. In addition, it was noted that there was no significant difference between the case and control group in the CRI-I index, which indicates the TC/HDL-C ratio.…”

Anemia in elderly rheumatoid arthritis patients: a cohort study

“…As a possible abnormal index of anemia in elderly patients with RA, PLR and hs-CRP have no significant correlation with the increase of immunoglobulin, while hs-CRP, as an important indicator of inflammatory response in the early stage of RA, and LDL-C and TC as important monitoring indexes of abnormal lipid metabolism, can better reflect the possibility of atherosclerosis [29,30]. Therefore, anemia in elderly patients with RA is closely related to lipid metabolism and inflammatory reaction [31][32][33].…”