A study on interleukin -1β and lipid profile as markers of cardiovascular risk in rheumatoid arthritis

Introduction: The dyslipidaemia in Rheumatoid Arthritis (RA) is associated with accelerated atherosclerosis. A prospective clinical evaluation study was undertaken to find out the proportion of the rheumatoid arthritis patients who were suffering from dyslipidaemia, the change in the lipid levels and the disease activity after an intervention with antirheumatic therapy.

Aims and objectives: To study the disease activity in Rheumatoid arthritis patients by measuring the serum levels of interleukin-1β (IL-1 β), to find out the proportion of rheumatoid arthritis patients who were suffering from dyslipidaemia, to correlate the disease activity with the lipid profile and to look for the change in the lipid levels and the disease activity after an intervention with antirheumatic therapy.

Material and methods: This study was done on 30 RA patients (fulfilling the American College of Rheumatology criteria). The lipid profile estimation was done by an enzymatic, colourimetric method and IL-1β was estimated by a chemiluminescence method. Dyslipidaemia was defined by taking the cut-off values of the NCEP-ATPIII guidelines. The patients with other comorbid illnesses and those who were on statins were excluded. The patients were followed up after 12 weeks of starting with the anti-rheumatic therapy.

Results: 36.7% of the patients had high total cholesterols, 53.3% of the patients had high triacylglycerol levels, 73.3% of the patients had decreased HDL-cholesterol and 33.3% of the patients had high LDL-cholesterols. 86.7% of the patients had IL-1β levels which were above the reference range. After the treatment, the number of patients with dyslipidaemia came down, with 23.3% patients having high total cholesterol levels, 43.3% of the patients having elevated triacylglycerol levels, 46.7% patients having low HDL-cholesterol levels and 20% patients having elevated LDL-cholesterol levels. 66.7% of the patients had IL-1β which was above the reference range.

Conclusion: The proportion of dyslipidaemic patients had decreased in the follow up visit, along with a decrease in the disease activity, as were indicated by the decreased levels of IL-1β. The management of dyslipidaemia in RA should be a part of the general cardiovascular risk management. Therefore, a good control of the disease activity should be given priority, so that both the quality of life and the long-term outcomes can be improved.