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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.