Background: Clinical evidence suggests that oxidatively modified form of low-density lipoprotein cholesterol (LDL) is more important than native LDL in atherogenesis and vascular damage. The accelerated development of atherosclerosis has been recognized in patients with autoimmune diseases. An autoimmune component of atherogenesis is actually discussed.
Objectives: The aim of our study was to detect the relationship of OxLDL, anti-OxLDL, inflammatory markers and cardiovascular risk factors in the development of atherosclerosis in female patients with RA.
Methods: The study included 37 female patients with RA (ACR, 1987), mean age 45,0 (33,0; 51,0) years old, disease duration 9,0 (3,0; 14,0) years, and high disease activity (DAS28= 5,37 (4,69; 5,86) points). Thirty healthy subjects of the same age formed the control group.
The levels of OxLDL, high sensitive C-reactive protein (hs-CRP), interleukin-6 (IL-6), tumor necrosis factor - α (TNF-α), antibodies to OxLDL were determined with ELISA according to the instruction of manufacturer.
The presence of atherosclerotic alterations of the common carotid artery (CCA) was revealed ultrasonographically according to standard procedures.
Results: The asymptomatic atherosclerotic alterations of the vessel wall were found in 18 (48,65%) patients with RA and in 10 (33,33%) without it.
The comparative analysis of inflammatory markers revealed an increase of hs-CRP, fibrinogen, IL-6, anti-OxLDL levels in patients with RA and atherosclerosis than in control subjects (p=0,001, p=0,008, p=0,0006, p=0,045, respectively).
Selection by traditional risk factors (age, smoking, arterial hypertension, obesity, hypercholesterolemia) in subjects with atherosclerotic alterations revealed positive correlation between OxLDL and hs-CRP in patients with RA in middle age (r=0,732, p=0,039), in nonsmokers (r=0,565, p=0,044) and in obesity (r=0,775, p=0,041). Positive correlation between anti-OxLDL and DAS28 (r=0,665, p=0,013) was observed in nonsmokers RA patients. The significant correlations between investigated parameters were not revealed in the control group.
Conclusions: Thus, the relationship between OxLDL and inflammatory markers, anti-OxLDL and disease activity in selection by traditional risk factors was identified in patients with RA and vascular atherosclerotic alterations that can confirm the development of endothelial dysfunction in patients with autoimmune pathology.