Prevalence of lipid phenotypes, serum lipid behaviour over follow-up and predictors of serum lipid levels in a cohort of Mexican Mestizo early rheumatoid arthritis patients treated with conventional disease-modifying anti-rheumatic drugs.

OBJECTIVES: Our aim was to describe the prevalence of dyslipidaemia, serum lipid behaviour and predictors of serum lipid levels in a cohort of early rheumatoid arthritis (RA) patients. METHODS: Charts from 146 patients who were lipid-lowering therapy (LLT) free at inclusion and had baseline complete serum fasting lipid profile and ≥1 lipid profile/patient/year of follow-up were reviewed. Patient's prevalence of dyslipidemia was compared to matched controls. Linear regression analysis was applied in 101 patients who achieved remission to define predictors of lipid levels according to disease activity status. RESULTS: At baseline, the 146 patients were most frequently female (89.7%), middle aged (37.6±12.5 years) and had high disease activity; 37 of them (25.3%) had normal lipid profile. When compared to controls, patients had lower prevalence of hypercholesterolaemia (19.8% vs. 33.5%) and raised LDL cholesterol (22.6% vs. 33.5%), and higher prevalence of hypoaphalipoproteinemia (54.8% vs. 18.4%) and of hypertriglycediremia (28.1% vs. 4.8%), p≤0.05. During follow-up (45.6±26.3 months), 108 patients did not receive LLT; lipid levels increased up to last follow-up meanwhile DAS28, C-reactive protein and COL/HDL ratio decreased, especially during the first 2 years when RA treatment was intensive. Age, gender and body mass index predicted individual lipid levels in 101 patients who achieved remission. LLT was a strong predictor of triglycerides levels and of COL/HDL ratio only during remission. CONCLUSIONS: The prevalence of dyslipidaemia in early RA patients differed from the matched controls. During follow-up and parallel to disease activity, the COL/HDL ratio decreased. Demographic and anthropometric variables and LLT predicted individual serum lipid levels.