Dr. Raouf R. Mirza FRCP, DMR, M.Phil U.K. and *Dr. Soran Mohammed Gharib MBChB, HDRMR


Background: Rheumatoid Arthritis is a systemic inflammatory disease characterized by chronic and erosive polyarthritis. it is the most common inflammatory arthritis, affecting from 0.5-1% of the general population. Dyslipidemia is a lipid-metabolism disorder, which is characterized by increased or decreased serum lipid fraction (lipoprotein). The main defects of lipid fraction are: increased total cholesterol, low density lipoprotein (LDL) cholesterol level and triglycerides serum level while decreased high density lipoprotein (HDL) cholesterol level. Dyslipidemia is a quite important problem in Rheumatoid Arthritis (RA) patient, which causes morbidity and mortality. As known, dyslipidemia is one of atherosclerosis risk-factor and main mortality cause of longstanding RA patient. Objectives: are to measure Prevelance of Dyslipidemia in patients with Rheumatoid Arthritis compared with healthy control peoples and to find out Association between Dyslipidemia and disease activity in patients with Rheumatoid Arthritis. Patients and Methods: A total of one hundred patients with RA (80 female and 20 male) were included in the study, they were attending consultation clinics and Unit of Rheumatology in the General Teaching Hospital in Sulaimani city from (October 2015 to September 2016) who fulfilling the 2010 American College of Rheumatology/European League Against Rheumatism classification criteria for RA and one hundred healthy age and sex-matched controls. Fasting lipid profiles of cases and control were estimated after an overnight fast of 12 hours. Correlation between lipid profile and disease activity using disease activity score DAS 28, inflammatory markers (CRP and ESR) was also determined. Results: RA patients showed a higher prevalence of associated dyslipidemia (48%) in comparison to control (4%) p- value less than 0.001. Our result showed a significant reduction in serum high density lipoproteins (HDL) p-value less than 0.001, with significant elevation of serum total cholesterol, triglyceride, low density lipoprotein and very low density lipoprotein p-value 0.001,0.007,0.01 and 0.5 respectively in comparison to controls. there is a significant association between dyslipidemia and high DAS 28 score (p=0.02). there is a significant association between high ESR of RA patients and dyslipidemia (p=0.001). A significant association was observed between high CRP level and RA patients with no dyslipidemia (p<0.001). Conclusion: Dyslipidemias are frequent among the patients with rheumatoid arthritis and highly associated with active RA. Serum HDL was significantly reduced while other parameters of lipid profiles significantly increased in comparisons to control.

Keywords: Rheumatoid arthritis, Dyslipidemia, Disease activity.

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