The Clinical Study Of Dyslipoproteinemia In Patients With Early Rheumatoid Arthritis

Objective:To assess the incidence and the possible factors of dyslipoproteinemia in patients with early active rheumatoid arthritis(RA),and the changes of dyslipoproteinemia in remission after standardized treatment,and examine the changes of dyslipoproteinemia treating with low-dose glucocorticoids(GC).To provide evidence on prevention and treatment of RA patients with cardio-cerebral vascular system disease.Methods:Fifty early active rheumatoid arthritis patients in the First Affiliated Hospital of Jinan University from January 2007 to October 2009 and fifty healthy controls were included in the study,the patients had not treated with glucocorticoids or disease modifying anti-rheumatic drugs (DMARDs). Total cholesterol (TC), triglyceride (TG) high density lipoprotein-cholesterol (HDL-C),low density lipoprotein-cholesterol(LDL-C),apolipoprotein AI (apoAI),apolipoprotein B(apoB) and lipoprotein(a)[LP(a)] were detected for all patients and controls, comparing the dyslipoproteinemia between patients and controls. Erythroeyte sedimentation rate(ESR),C-reactive protein(CRP),immunoglobulin A(IgA),immunoglobulin G (IgG), immu-noglobulin M(IgM), serum creatinine(Ser),urea nitrogen(BUN),fasting plasma glucose (FPG), serum albuurnin(Alb),serum globulin(Glb) were measured in patients,assess the factors which would possibly influence dyslipoproteinemia in early active RA patients. Fifty RA patients were randomised to receive either disease modifying anti-rheumatic drugs(DMARDs) or low-dose glucocorticoids(GC) based DMARDs,and measuring the lipoproteinemia after treatment 6 months as they were inactivity,assess the influence for lipoproteinemia of the low-dose GC, comparing the changing of lipoproteinemia before and after treatment.Results:(1)Compared with controls, TG,LDL-C,apoB,LP (a) levels were found increased in the early active patients,and HDL-C,apoAI levels were decreased. (2) After standardized treatment for 6 months as inactivity, HDL-C,apoAI levels were increased, LDL-C,LP(a)levels were decreased. (3)With the DMARDs added low-dose GC treatment, HDL-C,apoAI increased,TC,LP(a) decreased. (4)90% patients complicated dyslipoproteinemia in early active RA, the rate of dyslipoproteinemia:LP(a)(68%,34 cases),apoAI(40%,20 cases),HDL-C(30%,15 cases),TG(22%,11 cases), apoB(22%,11 cases),LDL-C(16%,8 cases),TG(16%,8 cases). (5)In early active RA patients,TC showed positive correlation with age and BMI,,TG positive correlation with BMI,HDL-C negatively related with CRP and the scores of DAS28,LDL-C had positive correlation with age and BMI, apoAI negative correlation with the scores of DAS28,apoB positive correlation with age and BMI. (6)The levels of TC,TG,apoAI,apoB were higer in the pausimenia RA patients.Conclusions:(1)The early active RA patients had significantly dyslipoproteinemia,characterized by an increase in TG,LDL-C,apoB,LP(a) and decrease in HDL-C and apoAI. (2) After standardized treatment,the dyslipoproteinemia were changing better. (3)Based on the DMARDs, low-dose GC had good function on dyslipoproteinemia of RA patients. (4)HDL-C,apoAI were correlated with the disease activity.