Evidence for increased chylomicron remnants in rheumatoid arthritis

Burggraaf, Benjamin; Stoep, D. F. Van Breukelen-van der; Zeben, J. van; Meulen, N. van der; Geijn, Gert‐Jan M. van de; Liem, Anho; Valdivielso, Pedro; Villodres, José Rioja; Ramírez-Bollero, José; Zwan, Ellen van der; Cabezas, Manuel Castro

doi:10.1111/eci.12873

Cited by 9 publications

(12 citation statements)

References 47 publications

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“…Cardiovascular morbidity and mortality are high in patients with RA owing to accelerated atherosclerosis [33,34]. Hyperlipidemia is an increasingly interesting cardiovascular risk factor given that postprandial triglycerides are similar to and even better than fasting triglycerides as a predictor of cardiovascular disease, with the practical advantage that the patient is not required to fast [15,35,36].…”

Section: Discussionmentioning

confidence: 99%

“…Consistent with this approach, we observed that fasting triglyceride and ApoB48 levels were similar in patients with RA and controls, although postprandial ApoB48 levels were higher. Burggraaf et al [33] showed that patients with RA had higher levels of baseline ApoB48 than controls and that the accumulation of atherogenic chylomicron remnants could contribute to the high risk of cardiovascular disease in these patients. Similarly, the authors did not find differences in triglyceride levels between patients and controls, suggesting that lipolysis of chylomicrons could be normal in patients with RA and that perhaps the abnormality lies in the catabolism of chylomicron remnants in the liver.…”

Section: Discussionmentioning

confidence: 99%

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Postprandial Apolipoprotein B48 is Associated with Subclinical Atherosclerosis in Patients with Rheumatoid Arthritis

Mena-Vázquez

Rojas-Giménez

Núñez

et al. 2020

JCM

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Objective: To describe postprandial lipemia in patients with rheumatoid arthritis (RA) and to analyze its association with subclinical atherosclerosis measured as carotid intima-media thickness (cIMT). Methods: We performed an observational study of 40 patients with RA and 40 sex and age-matched controls. Patients with dyslipidemia were excluded. Pathologically increased cIMT was defined as a carotid thickness greater than the 90th percentile (>p90) for age and sex. Fasting and postprandial plasma lipids, cholesterol, triglycerides, apolipoprotein B48 (ApoB48), and total ApoB were evaluated. The other variables included were clinical and laboratory values, Framingham score, and the 28-joint Disease Activity Score (DAS28). Two multivariate models were constructed to identify factors associated with pathologic cIMT in patients with RA. Results: Fasting lipid values were similar in patients with RA and controls, although those of postprandial ApoB48 were higher (median (IQR), 14.4 (10.8–12.1) vs. 12.1 (2.3–9,8); p = 0.042). Pathologic cIMT was recorded in 10 patients with RA (25%) and nine controls (22.5%). In patients with RA, pathologic cIMT was associated with postprandial ApoB48 (OR (95% CI), 1.15 (1.0–1.3)) and total ApoB (OR [95% CI], 1.12 [1.1–1.2]). The second model revealed a mean increase of 0.256 mm for cIMT in patients with elevated anticitrullinated protein antibodies (ACPAs). Conclusion: Postprandial ApoB48 levels in patients with RA are higher than in controls. Postprandial ApoB48 and total ApoB levels and markers of severity, such as ACPAs, are associated with pathologic cIMT in patients with RA. Our findings could indicate that these atherogenic particles have a negative effect on the endothelium.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Postprandial Apolipoprotein B48 is Associated with Subclinical Atherosclerosis in Patients with Rheumatoid Arthritis

Mena-Vázquez

Rojas-Giménez

Núñez

et al. 2020

JCM

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“…Furthermore, postprandial triglyceride levels >220 mg/dL are also considered abnormally high [ 14 ]. Postprandial lipidemia has been shown to be higher in RA patients than healthy controls, and an association between postprandial ApoB48 levels and pathologic carotid intima media thickness (cIMT) has been reported [ 15 , 16 ].…”

Section: Introductionmentioning

confidence: 99%

“…In RA, higher ApoB48 values are associated with positive titers of anticyclic citrullinated peptide antibody (ACPA) and rheumatoid factor (RF). In contrast, no association was found between inflammatory activity and the use of disease-modifying drugs, possibly because other inflammatory parameters were not assessed and baseline ApoB48 was measured instead of postprandial ApoB48 [ 16 ]. No factors associated with postprandial hyperlipidemia have been identified in patients with RA.…”

Section: Introductionmentioning

confidence: 99%

Postprandial Hyperlipidemia: Association with Inflammation and Subclinical Atherosclerosis in Patients with Rheumatoid Arthritis

et al. 2022

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Objective: To describe postprandial lipidemia in patients with rheumatoid arthritis (RA) and to analyze its association with subclinical atherosclerosis and inflammatory activity. Methods: Observational study of 80 cases of RA and 80 sex- and age-matched controls. We excluded individuals with dyslipidemia. Postprandial hyperlipidemia (PPHL) was defined as postprandial triglycerides >220 mg/dL and/or postprandial ApoB48 levels >75th percentile (>p75). Plasma lipids, cholesterol, triglycerides, ApoB48, and total ApoB were evaluated at baseline and after a meal. Other variables analyzed included subclinical atherosclerosis (defined as presence of carotid atheromatous plaque), inflammatory activity (disease activity score (DAS28-ESR)), cytokines, apolipoproteins, and physical activity. A multivariate analysis was performed to identify factors associated with PPHL in patients with RA. Results: A total of 75 patients with RA and 67 healthy controls fulfilled the inclusion criteria. PPHL was more frequent in patients with RA than controls (No. (%), 29 (38.70) vs. 15 (22.40); p = 0.036), as was subclinical atherosclerosis (No. (%), 22 (30.10) vs. 10 (14.90); p = 0.032). PPHL in patients with RA was associated with subclinical atherosclerosis (OR (95% CI) 4.69 (1.09–12.11); p = 0.037), TNF-α (OR (95% CI) 2.00 (1.00–3.98); p = 0.048), high-sensitivity C-reactive protein (OR (95% CI) 1.10 (1.01–1.19); p = 0.027), and baseline triglycerides (OR (95% CI) 1.02 (1.00–1.04); p = 0.049). Conclusion: PPHL was more frequent in patients with RA than in controls. PPHL in patients with RA was associated with inflammation and subclinical atherosclerosis.

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“…It has been demonstrated that ongoing inflammation causes an increased clearance of LDL-cholesterol from the circulation, but not necessarily a decreased risk of CVD [6]. Also, an increase in remnants of the triglyceride transporting protein Apolipoprotein B-48 in patients with RA compared to others with high risk of CVD has been seen [7], suggesting an altered blood lipid metabolism. An increased disease activity and inflammation in RA is associated with an altered blood lipid profile and anti-inflammatory pharmacological therapy reduces these alterations [6].…”

Section: Introductionmentioning

confidence: 99%

Diet intervention improves cardiovascular profile in patients with rheumatoid arthritis: results from the randomized controlled cross-over trial ADIRA

Hulander

Bärebring

Wadell

et al. 2021

Nutr J

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Background The chronic inflammation in patients with rheumatoid arthritis (RA) increases the risk for cardiovascular diseases (CVD). The contribution of diet as a risk factor for CVD among these patients is however not fully understood. The aim of this study is to investigate if a proposed anti-inflammatory diet improves cardiovascular profile in weight stable patients with RA. Methods Patients (n = 50) with RA were included in a cross-over trial. They were randomized to either a diet rich in whole grain, fatty fish, nuts, vegetables and fruit and supplemented with probiotics, or a control diet resembling average nutritional intake in Sweden, for ten weeks. After a 4-month washout they switched diet. Participants received food bags and dietary guidelines. Primary outcome was triglyceride (TG) concentration. Secondary outcomes were total-, high density lipoprotein- (HDL) and low density lipoprotein- (LDL) cholesterol, Apolipoprotein-B100 and -A1, lipoprotein composition, plasma phospholipid fatty acids and blood pressure. Results Forty-seven patients completed at least one period and they remained weight stable. There was a significant between-dietary treatment effect in TG and HDL-cholesterol concentration in favor of intervention (p = 0.007 and p = 0.049, respectively). Likewise, Apolipoprotein-B100/A1 ratio shifted toward a less atherogenic profile in favor of the intervention (p = 0.007). Plasma fatty acids increased in polyunsaturated- and decreased in monounsaturated- and saturated fatty acids between diet periods in favor of the intervention period. Conclusion Blood lipid profile improved indicating cardioprotective effects from an anti-inflammatory dietary intervention in patients with RA. Trial registration This trial is registered at ClinicalTrials.gov as NCT02941055.

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Evidence for increased chylomicron remnants in rheumatoid arthritis

Abstract: Rheumatoid arthritis patients have higher levels of apo B48 compared to controls with high CVD risk and healthy controls, with normal levels of triglycerides. This accumulation of atherogenic chylomicron remnants may contribute to the elevated CVD risk in RA patients.

Cited by 9 publications

References 47 publications

Postprandial Apolipoprotein B48 is Associated with Subclinical Atherosclerosis in Patients with Rheumatoid Arthritis

Postprandial Apolipoprotein B48 is Associated with Subclinical Atherosclerosis in Patients with Rheumatoid Arthritis

Postprandial Hyperlipidemia: Association with Inflammation and Subclinical Atherosclerosis in Patients with Rheumatoid Arthritis

Diet intervention improves cardiovascular profile in patients with rheumatoid arthritis: results from the randomized controlled cross-over trial ADIRA

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