High serum cholesterol predicts rheumatoid arthritis in women, but not in men: a prospective study

Abstract

IntroductionEnvironmental exposures, including smoking, hormone-related factors, and metabolic factors, have been implicated in the etiology of rheumatoid arthritis (RA). A previous study has indicated that blood lipid levels may influence the development of RA. The objective of this study was to investigate the impact of serum total cholesterol and triglycerides on the risk of RA in a prospective study.MethodsAmong participants in a large population-based health survey (n = 33,346), individuals who subsequently developed RA were identified by linkage to four different registers and a structured review of the medical records. In a nested case-control study, with controls, matched for age, sex, and year of inclusion, from the health survey database, the relation between serum lipids (levels of total cholesterol and triglycerides) and future RA development was examined.ResultsIn total, 290 individuals (151 men and 139 women) whose RA was diagnosed a median of 12 years (range of 1–28) after inclusion in the health survey were compared with 1160 controls. Women with a diagnosis of RA during the follow-up had higher total cholesterol levels at baseline compared with controls: odds ratio (OR) 1.54 per standard deviation; 95 % confidence interval (CI) 1.22–1.94. This association remained statistically significant in multivariate models adjusted for smoking and a history of early menopause and in analyses stratified by rheumatoid factor status and time to RA diagnosis. Total cholesterol had no significant impact on the risk of RA in men (OR 1.03; 95 % CI 0.83–1.26). Triglycerides did not predict RA in men or women.ConclusionsA high total cholesterol was a risk factor for RA in women but not in men. This suggests that sex-specific exposures modify the impact of lipids on the risk of RA. Hormone-related metabolic pathways may contribute to RA development.Electronic supplementary materialThe online version of this article (doi:10.1186/s13075-015-0804-1) contains supplementary material, which is available to authorized users.

Western and Healthy Dietary Patterns and Risk of Rheumatoid Arthritis: A Case-Control Study

“…Whole grains in the healthy dietary pattern decrease inflammations (40,41), while sweets and refined grains in the Western dietary pattern causes high glycemic loads, leading to persistent hyperglycemia, production of advanced glycation products, insulin resistance and initiation of inflammatory cascade (42)(43)(44). The positive association between the egg consumption and RA risk that is found in the current study has not been reported by the previous studies; however, current evidence indicate associations between the serum cholesterol and RA risk (45,46). This association might be a resultant of the inflammatory processes caused by high serum cholesterols (47).…”

Nutrition Interventions in Rheumatoid Arthritis: The Potential Use of Plant-Based Diets. A Review

“…Women diagnosed with RA at follow-up had higher total cholesterol levels at baseline compared with healthy controls (OR 1.42; 95% CI 1.08–1.87). However, this relationship was not observed in men (39). The positive association between total cholesterol levels and RA development in women suggests a possible mechanism related to female sex hormones.…”

“…The positive association between total cholesterol levels and RA development in women suggests a possible mechanism related to female sex hormones. A low-fat, vegan diet, which reduces plasma cholesterol and has a hormone-stabilizing effect (40–42), may therefore help protect against the development of RA in women (39).…”

Circulating Pro- and Anti-Inflammatory Metabolites and Its Potential Role in Rheumatoid Arthritis Pathogenesis

“…Cholesterol comes from the diet and its levels are increased in RA patients [2,6]; this was found to be predictive of RA in women, but not men [182]. Lipid metabolism is altered in RA, but cholesterol metabolism in RA has not been specifically studied.…”