Hypocholesterolaemia and abnormal high-density lipoprotein in rheumatoid arthritis

Plasma lipid and lipoprotein patterns were determined in 54 female patients with rheumatoid arthritis (RA). The patients were divided into four groups, on the basis of the treatment that was being administered (gold, penicillamine, hydroxychloroquine and nonsteroidal anti-inflammatory drugs). Plasma cholesterol levels were significantly reduced in all groups. The reduced plasma cholesterol level was a result of 26% and 36% reductions in low- and high-density lipoproteins (LDL and HDL), respectively. Very-low-density lipoprotein cholesterol was reduced only in the group receiving hydroxychloroquine, and this was associated with decreased plasma triglycerides in this group. Plasma apolipoprotein (apo) B, the LDL protein moiety, demonstrated a pattern similar to that shown for LDL cholesterol. Plasma apo A-I, the major HDL protein, was, however, in the normal range, suggesting an abnormal HDL fraction. Even though reduced HDL cholesterol was found in RA patients, the HDL/LDL ratio was normal and the apo A-I/apo B ratio was increased, suggesting that these patients are not at increased risk for atherosclerosis.