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Needed:  1 brain, no fog

My poor ole brain can't seem to handle reading scientific articles anymore.  I am trying to read this study abstract from 2003 to determine what it says about RA and high triglyceride levels.
 
Explaining How "High-Grade" Systemic Inflammation Accelerates Vascular Risk in Rheumatoid Arthritis
http://circ.ahajournals.org/cgi/content/full/circulationaha;108/24/2957
 
Below is the section I am trying to decipher. I think I get the idea that they're saying higher triglycerides are found in RA patients despite lower levels of HDL and LDL.  But I'm not sure about that, not sure if they explain why, or what more they might be saying.
 
Dyslipidemia in RA

Despite lower total cholesterol concentration, an observation that helps explain a failure of cholesterol adjustment to account for any excess CHD risk in RA,2 when taken as a whole, the dyslipidemic pattern observed is highly atherogenic. Low HDL cholesterol is a strong predictor of cardiovascular events, whereas small, dense LDL, triglyceride-rich particles, and elevations in FFAs are proatherogenic (reviewed in Sattar et al20).

Mechanisms underlying the lipid pattern in RA include effects of cytokines at adipose tissue to increase FFA release, at the liver to increase FFA and triglyceride synthesis, and at the vascular endothelium to reduce lipoprotein lipase activity,15 the principal catabolic enzyme for triglyceride-rich lipids. High triglyceride levels reduce HDL cholesterol by virtue of neutral lipid exchange, and this same process promotes synthesis of small, dense LDL.15 Finally, high lipoprotein(a) is a consistent finding in RA16; again, such elevation may be secondary to inflammatory activity in RA.16 A meta-analysis of prospective studies supports a role of lipoprotein(a) in atherogenesis.21

gees   Means that what they found makes for more plaque buildup in the arteries of RA patients. Watching your cholesterol is therefore more important if you have RA. mabs you are the...Brain   [QUOTE=mab52]Means that what they found makes for more plaque buildup in the arteries of RA patients. Watching your cholesterol is therefore more important if you have RA. [/QUOTE]
 
That's it? All that gobbledy-gook for that?  I knew that already but was looking for more on why the triglycerides are higher, not just the cholesterol in general.
 
Thanks anyway. It's in the high triglyceride levels - it works to reduce the HDL cholesterol by virtue of neutral lipid exchange.  It's the HOW, not the why.  Doesn't this remind you of the diabetes study where the people dropped dead by reducing the AC1 too much.  Not the why, but the HOW. 
 
In the concluding remarks they say:
 
This review has collated evidence to suggest that the systemic inflammatory response in RA is central to the accelerated atherogenesis in this condition by its accentuation of established and novel risk factor pathways. From this model, we predict that long-term suppression of the systemic inflammatory response in RA should lessen CHD risk, and available evidence favors this likelihood. Likewise, a paradoxical improvement in insulin sensitivity with steroid treatment in RA strongly supports our suggestion. We also suggest that classic and novel risk factors that can be significantly influenced by the systemic inflammation in RA (for example, HDL cholesterol, von Willebrand factor, and markers of insulin resistance), rather than cholesterol or blood pressure alone, will better predict CHD risk in RA. Future prospective studies are required to confirm this proposal. Finally, because some existing cardioprotective therapies exhibit antiinflammatory properties, which appear beneficial, at least in the context of the low-grade chronic inflammatory response of CHD, we predict that the relative magnitude of benefit accrued from such therapies may be greater in RA than in noninflamed controls. Clinical trials are urgently required to test this proposal. "
 
See the connection to insulin.  I'm telling you - this is key - reduce inflammation and all the associated risks with RA are nullified.
 
And I have no idea why this is typing so small.
 
Pip
 
 Edited for using the wrong word.
Pip!2008-05-20 09:43:00pip you are to the Brain.. I feel so stupid these days. I tried to read that article and my brain went into overload and shut down completely.
Why does everything have to be written so complicated. Just spit it out!

The more you read of this stuff the more it all sounds the same.  LOL  Nobody is stupid; we're sick and it's darn hard to concentrate when we feel bad!  My favorite part is the usual "more studies are needed to verify what I just said".  LOL

Hugs,
 
Pip
P.S.  There's that insulin resistance thing again.  I cannot tell you how many studies I've read that say we have that - even if we're not diabetic - YET.
Well the reason for my research is that my triglycerides have just hit an all-time scary high while my HDL is fine and my LDL...well they couldn't measure this time because of the triglycerides.    And my glucose is still fine.  I am have always been on the lookout for diabetes because I have family risk and obesity risk, but so far so good.
 
I am on Zetia for the cholesterol and I take a daily supplement with plant stanols/sterols.  However I refuse to take statins due to the muscle pain risk.  I do what I can with my diet considering all else I'm dealing with.  And I do the only exercises I am able to do.
 
So I'm wondering if the RA or inflammation itself (or even the meds) is building up the tri's somehow, since it seemed to say that the HDL/LDL wasn't the issue.  I know the causality is a lot more difficult to prove than the correlation.  Mainly I want to know why my tri's are now through the roof.  I'm not saying they were normal before, but they weren't like this.  I'd also like to know if getting the inflammation/RA under control will help the tri level.  Or getting the tri level under control will help the inflammation/RA.
 
Unfortunately I can read/understand/remember just enough to be dangerous!
Pip...maybe it's the probiotics that are raising my tri's

And it shouldn't be the probiotics - they work to lower inflammation.  I wonder if they have the same effect as antibiotics - IE get a worse before you get better?

So...you flared recently, right?  So if flaring = inflammation then wouldn't the trig's rise to compensate?

Pip
My trigycerides are always very high.  Last reading was 240 My cholesteral  was 240 also but I'm never put on meds because the bad is low and the good is way high.
My mom's trigycerides are always high. Even on meds which brought down her HDL & LDL numbers.
this is confusing   

I forget which is good and which is bad but the bad was 155 and the good was 85

HDL is good, LDL is bad, and Boney it sounds like your lab was using a different scale.
 
I'm not sure flare is the right word because my symptoms are never under control, but the Fred Flintstone feet were pretty bad and have since gone back to my usual.
 
However, I was doing some more thinking and reading and now I'm wondering if the Imuran is affecting my triglycerides.
Oh I hate Flintstone feet- glad yours went down.
I keep trying to think up a way to remember the bad from the good using the first letter of each but I never come up with anything.
 
H makes me think horrible then I get screwed up.
 
 
must be uk differences

Boney

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