HDL cholesterol efflux capacity is related to disease activity in psoriatic arthritis patients

• Published in: Clinical rheumatology 2020-06, Vol.39 (6), p.1871-1880
• Main Authors: Ferraz-Amaro, Iván, Hernández-Hernández, María Vanesa, Armas-González, Estefanía, Sánchez-Pérez, Hiurma, Machado, José David, Díaz-González, Federico
• Format: Article
• Language: English
• Subjects: Adult; Aged; Arteriosclerosis; Arthritis; Arthritis, Psoriatic - metabolism; Cardiovascular diseases; Case-Control Studies; Cholesterol; Cholesterol - metabolism; Cholesterol, HDL - metabolism; Down-Regulation; Female; Health risk assessment; High density lipoprotein; Humans; Inflammation; Linear Models; Lipids - blood; Low density lipoprotein; Macrophages; Macrophages - metabolism; Male; Medicine; Medicine & Public Health; Metabolic disorders; Middle Aged; Multivariate Analysis; Original Article; Plaque, Atherosclerotic - metabolism; Psoriatic arthritis; Rheumatology; Risk factors; Serum levels
• ISSN: 0770-3198; 1434-9949
• DOI: 10.1007/s10067-020-04961-4

Objective Cholesterol efflux capacity (CEC) is the ability of high-density lipoprotein (HDL) cholesterol to accept cholesterol from macrophages. CEC is linked to cardiovascular events in the general population, and it has been shown to be disrupted in inflammatory states. The aim of this study was to establish whether CEC is impaired in PsA patients and if this could be explained by disease-related features like disease activity. Methods Case-control study that encompassed 105 individuals: 52 PsA patients and 53 controls. CEC, using an in vitro assay, and lipoprotein serum concentrations were assessed in patients and controls. Disease activity in patients with PsA was measured using the Disease Activity Index for Psoriatic Arthritis (DAPSA). Multivariate analysis was performed to study the differences between CEC in patients and controls, and the relation of CEC with PsA activity-related data and lipid profile. Results Total cholesterol, apolipoprotein A1, and LDL cholesterol serum levels were downregulated in PsA patients. CEC did not differ between controls and patients (17 ± 10 vs. 18 ± 2%, p  = 0.15) after adjusting for traditional cardiovascular risk factors or other variations in the lipid profile related to the disease. Traditional cardiovascular risk factors, both in patients and controls, were not related to CEC. After multivariate regression analysis, the DAPSA score was inversely and independently associated with CEC (beta coefficient − 0.75 [95%CI − 1.39–− 0.11] %, p  = 0.023). Conclusion CEC is inversely associated with disease activity in PSA patients, reinforcing the role of disease activity as a key factor in the development of accelerated atherosclerosis in these patients. Key Points • Cholesterol efflux capacity is linked to cardiovascular events in the general population. • In patients with psoriatic arthritis, cholesterol efflux capacity is inversely associated with disease activity (beta coefficient − 0.75[95% CI −  1.39– −  0.11] %, p = 0.023). • This finding reinforces the role of disease activity as a key factor in increasing cardiovascular risk in psoriatic arthritis patients.