Recent publications on Residual Risk

Emerging data suggest a link between triglyceride-rich lipoproteins, inflammation and atherogenesis. This study adds to this, suggesting that increased number of triglyceride-rich lipoproteins and dysfunctional high-density lipoproteins (HDL) may represent the missing link between inflammation and lipids in rheumatoid arthritis.
 
This prospective study measured inflammatory mediators, paraoxonase-1 (PON1) activity, and serum total antioxidant capacity in 113 patients with rheumatoid arthritis, 113 healthy controls, and 27 dyslipidaemic subjects. Overall, 26% (29/113) rheumatoid arthritis patients had atherogenic dyslipidaemia, characterised by high fasting triglycerides and low HDL-C. These patients also had significantly increased serum levels of inflammatory mediators (including tumour necrosis factor alpha and monocyte chemotactic protein, both p=0.004), and leptin, p <0.001) but decreased PON1 and antioxidant activity. Moreover, the high triglycerides/low HDL-C profile was also associated with poor clinical response to tumour necrosis factor-? blockade.
 
These data suggest the importance of atherogenic dyslipidaemia beyond the setting of residual cardiovascular risk, to also include management of inflammatory disease such as rheumatoid arthritis.