Are lipid ratios less susceptible to change with systemic inflammation than individual lipid components in patients with rheumatoid arthritis?

Angiology. 2011 Feb;62(2):167-75. doi: 10.1177/0003319710373749. Epub 2010 Aug 3.


Rheumatoid arthritis (RA) associates with excess cardiovascular risk and there is a need to assess that risk. However, individual lipid levels may be influenced by disease activity and drug use, whereas lipid ratios may be more robust. A cross-sectional cohort of 400 consecutive patients was used to establish factors that influenced individual lipid levels and lipid ratios in RA, using multiple regression models. A further longitudinal cohort of 550 patients with RA was used to confirm these findings, using generalized estimating equations. Cross-sectionally, higher C-reactive protein (CRP) levels correlated with lower levels of total cholesterol (TC), low-density lipoprotein-cholesterol (LDL-C), and high-density lipoprotein-cholesterol ([HDL-C] P ≤ .015), whereas lipid ratios did not correlate with CRP. The findings were broadly replicated in the longitudinal data. In summary, the effects of inflammation on individual lipid levels may underestimate lipid-associated cardiovascular disease (CVD) risk in RA, thus lipid ratios may be more appropriate for CVD risk stratification in RA.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Anti-Inflammatory Agents / therapeutic use
  • Antirheumatic Agents / therapeutic use
  • Arthritis, Rheumatoid / blood*
  • Arthritis, Rheumatoid / complications
  • Arthritis, Rheumatoid / drug therapy
  • C-Reactive Protein / metabolism
  • Cohort Studies
  • Cross-Sectional Studies
  • Dyslipidemias / blood*
  • Dyslipidemias / complications
  • Dyslipidemias / drug therapy
  • Female
  • Humans
  • Lipids / blood*
  • Male
  • Middle Aged
  • Retrospective Studies
  • Risk Factors


  • Anti-Inflammatory Agents
  • Antirheumatic Agents
  • Lipids
  • C-Reactive Protein