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28.01.2020 | Original Article | Ausgabe 6/2020

Clinical Rheumatology 6/2020

HDL cholesterol efflux capacity is related to disease activity in psoriatic arthritis patients

Zeitschrift:
Clinical Rheumatology > Ausgabe 6/2020
Autoren:
Iván Ferraz-Amaro, María Vanesa Hernández-Hernández, Estefanía Armas-González, Hiurma Sánchez-Pérez, José David Machado, Federico Díaz-González
Wichtige Hinweise
Iván Ferraz-Amaro and María Vanesa Hernández-Hernández contributed equally to this work.

Publisher’s note

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Abstract

Objective

Cholesterol efflux capacity (CEC) is the ability of high-density lipoprotein (HDL) cholesterol to accept cholesterol from macrophages. CEC is linked to cardiovascular events in the general population, and it has been shown to be disrupted in inflammatory states. The aim of this study was to establish whether CEC is impaired in PsA patients and if this could be explained by disease-related features like disease activity.

Methods

Case-control study that encompassed 105 individuals: 52 PsA patients and 53 controls. CEC, using an in vitro assay, and lipoprotein serum concentrations were assessed in patients and controls. Disease activity in patients with PsA was measured using the Disease Activity Index for Psoriatic Arthritis (DAPSA). Multivariate analysis was performed to study the differences between CEC in patients and controls, and the relation of CEC with PsA activity-related data and lipid profile.

Results

Total cholesterol, apolipoprotein A1, and LDL cholesterol serum levels were downregulated in PsA patients. CEC did not differ between controls and patients (17 ± 10 vs. 18 ± 2%, p = 0.15) after adjusting for traditional cardiovascular risk factors or other variations in the lipid profile related to the disease. Traditional cardiovascular risk factors, both in patients and controls, were not related to CEC. After multivariate regression analysis, the DAPSA score was inversely and independently associated with CEC (beta coefficient − 0.75 [95%CI − 1.39–− 0.11] %, p = 0.023).

Conclusion

CEC is inversely associated with disease activity in PSA patients, reinforcing the role of disease activity as a key factor in the development of accelerated atherosclerosis in these patients.
Key Points
• Cholesterol efflux capacity is linked to cardiovascular events in the general population.
• In patients with psoriatic arthritis, cholesterol efflux capacity is inversely associated with disease activity (beta coefficient − 0.75[95% CI − 1.39–− 0.11] %, p = 0.023).
• This finding reinforces the role of disease activity as a key factor in increasing cardiovascular risk in psoriatic arthritis patients.

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