Low dose glucocorticoid therapy for rheumatoid arthritis (RA) is associated with a subsequent increase in high-density lipoprotein (HDL) cholesterol, report researchers in the European Journal of Clinical Investigation.
"Patients with RA have a higher mortality rate than the general population, with cardiovascular disease resulting from accelerated atherosclerosis being the most common cause of death," say Carmen García-Gómez and colleagues from the Hospital Universitari de Bellvitge in Barcelona, Spain.
They note that some studies have shown that active RA untreated with anti-rheumatic drugs such as glucocorticoids is associated with an adverse lipid profile, including low HDL cholesterol, which improves following treatment.
"On the other hand, it has generally been perceived that glucocorticoids adversely affect lipid metabolism," they add.
García-Gómez investigated the association of low dose glucocorticoid therapy with lipid metabolism in 78 consecutive women with RA who attended a rheumatology clinic in Barcelona.
The participants were aged 60 years on average and had a mean RA disease duration of 13 years. Sixty-five (83%) women were taking low dose glucocorticoids and 13 (17%) were untreated and were used as controls.
The researchers found that the patients taking glucocorticoids had 14.7% higher HDL cholesterol than untreated patients. They explain that this was mainly due to an increase in the HDL2 subfraction, which increased by 24.4%, as opposed to the HDL3 subfraction, which only increased by 7.4%.
The other factors tested, namely, glucose, total cholesterol, triglycerides, low-density lipoprotein cholesterol, very-low-density lipoprotein cholesterol, and apolipoproteins A-I and B, were not significantly different between the control and glucocorticoid-treated groups.
García-Gómez et al conclude: "These lipid changes may be considered as an overall favorable lipid profile."
They add: "In accordance with our findings, recently published studies on this topic found that long term and low dose glucocorticoid therapy is not associated with endothelial dysfunction (an early step in the atherogenesis process) or an increased risk of cardiovascular diseases."