Resumo

MENDOZA COUSSETTE, Ulises; RODRIGUEZ GONZALEZ, Antonio  e  ALONSO BIOSCA, María Eugenia. Markers of inflammatory response and coronary risk in patients with rheumatoid arthritis. Rev Cubana Invest Bioméd [online]. 2013, vol.32, n.3, pp.338-343. ISSN 0864-0300.

Objective: evaluate the association between serum levels of C-reactive protein and the indices apoprotein B/apoprotein A1, apoprotein B/LDL cholesterol, LDL/HDL cholesterol, atherogenic index, lipoprotein (a) and serum complement components C3 and C4, as well as the prediction capacity of C-reactive protein, C3 and C4 complement with respect to the above mentioned lipidogram parameters. A cross-sectional study was conducted of patients with rheumatoid arthritis and healthy controls from the province of Matanzas. Methods: individual parameters were determined by immunoturbidimetry and enzymatic colorimetry. Results were processed with the statistical software SPSS version 18.0. Results: spearman rank correlation spotted an association of C-reactive protein with indices ApoB/LDL cholesterol and LDL/HDL cholesterol exclusively in patients, Spearman's Rho = 0.439 (p=0.002); -0.300 (p=0.043); -0.300 (p=0.043), respectively; and an association of C-reactive protein with C4 complement in both groups, Spearman's Rho = 0.355 (p=0.015); 0.376 (p=0.000), patients and controls, respectively. C-reactive protein predicted the ApoB/LDL cholesterol index by linear regression analysis in patients: R²=0.192 F=10.488 (p=0.002), whereas C3 and C4 complement proteins significantly estimated the level of lipoprotein (a): R²=0.170 F=4.396 (p=0.018). Results support the hypothesis about the link between inflammatory response and the predominance of more proatherogenic low density lipoproteins, as well as the potential estimation of coronary risk markers related to lipoprotein metabolism based on serum levels of C-reactive protein, C3 and C4 complement in patients with rheumatoid arthritis. Conclusions: demonstration of a direct link between the magnitude of the inflammatory response and the predominance of more proatherogenic LDL's, as well as the usefulness of markers of such a response PCR, C3 and C4 for the estimation of markers of coronary risk ApoB/LDLc and Lp(a) in patients with rheumatoid arthritis, suggest an evaluation of the association between the lipidogram parameters studied and more specific markers of vascular activity and dysfunction in this disease.

Palavras-chave : rheumatoid arthritis; C-reactive protein; lipidogram; ApoB/LDL cholesterol index; serum complement; lipoprotein (a); ApoB/LDL cholesterol.

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