Active rheumatoid arthritis is linked to higher CETP activity and impaired paraoxonase function, with apoA-I predicting arterial stiffness (Atherosclerosis 2016)

Original title: Associations between disease activity, markers of HDL functionality and arterial stiffness in patients with rheumatoid arthritis

Atherosclerosis · 11 June 2016 · 6

Botta E, Meroño T, Saucedo C, Martín M, Tetzlaff W, Sorroche P, Boero L, Malah V, Menafra M, Gómez Rosso L, Chapman JM, Kontush A et al.

Comparing 27 patients with active rheumatoid arthritis (RA, DAS-28 above 3.2), 17 with inactive RA (DAS-28 below 3.2), and 33 healthy controls, active RA patients had elevated high-sensitivity C-reactive protein (P < 0.001) but similar lipid profiles and insulin resistance markers across groups. Active RA patients had higher cholesteryl ester transfer protein (CETP) activity than the other two groups (P = 0.026), along with altered phenylacetate and paraoxonase activities (P = 0.034 and P = 0.041). Carotid-femoral pulse wave velocity was significantly higher in active RA than controls after age adjustment (P = 0.030). Age (standardized beta = 0.468, P = 0.013) and apoA-I (standardized beta = -0.405, P = 0.029) independently predicted pulse wave velocity in an adjusted model (r2 = 0.42).

Original abstract

Background And Aims: Rheumatoid arthritis (RA) is a chronic, inflammatory disease associated with increased risk of cardiovascular disease (CVD). Measures of HDL metabolism/function were shown to be altered in RA patients with high disease activity. We aimed at evaluating the effect of HDL characteristics on arterial stiffness in RA patients classified according to the inflammatory disease activity.

Methods: RA patients were classified according to disease activity (DAS-28) into active RA (n = 27; DAS-28 > 3.2) and inactive RA patients (n = 17; DAS-28 < 3.2). A control group of healthy individuals was also studied (n = 33). Clinical and biochemical characteristics, cholesteryl ester transfer protein (CETP) and paraoxonase 1 (phenylacetate and paraoxonase) activities and carotid-femoral pulse wave velocity (cf-PWV) were determined.

Results: Anthropometric characteristics were similar in all groups. In accordance with the inflammatory status, active RA patients presented elevated hsCRP levels (p < 0.001). There were no differences in the lipid profile between groups. Similarly, features of insulin resistance were absent in RA patients (p = non-significant). Active RA patients presented higher CETP activity than the other two groups (p = 0.026). Phenylacetate and paraoxonase activities were altered in active RA patients in comparison with the other groups (p = 0.034 and p = 0.041, respectively). Cf-PWV was significantly higher in active RA patients in comparison with controls, following adjustment by age (p = 0.030). Age (βst = 0.468, p = 0.013) and apo A-I levels (βst = -0.405, p = 0.029) were independent predictors of cf-PWV in a model including hsCRP, HOMA-IR, and phenylacetate activity (r(2) = 0.42).

Conclusions: High DAS-28 identifies patients with alterations in HDL characteristics. Plasma levels of apo A-I can be used as a marker of arterial stiffness in RA.

Summary written by cetpinhibition.org from the published abstract; figures as published. Page updated 19 August 2026. Methods.