Lipid Patterns and HDL-Cholesterol Efflux Capability in Systemic Lupus Erythematosus and Rheumatoid Arthritis

Blood sample positive with systemic lupus erythematosus (SLE) test
This study investigated the differences in cholesterol efflux capacity between patients with systemic lupus erythematosus and those with rheumatoid arthritis.

The lipid pattern among patients with rheumatoid arthritis (RA) is more pro-atherogenic than that of patients with systemic lupus erythematosus (SLE), but cholesterol efflux capacity (CEC) is downregulated in the latter, according to study results published in Arthritis Care & Research.

Previous studies reported that secondary to disease activity and inflammation, patients with SLE and RA have altered CEC and lipid patterns. The goal of the current study was to investigate the differences in CEC between patients with SLE and those with RA.

The study included 460 adults aged 18 years and older, including 195 (mean age 51, 185 women) patients with SLE and 265 (mean age 54, 212 women) patients with RA. All participants had no known condition or drug treatment history that might influence lipid profile.

After adjustment for age, sex, classic cardiovascular risk factors and disease-related data, patients with SLE had higher HDL-cholesterol and lower apolipoprotein B serum levels, compared to lipid patterns evident in patients with RA. However, independently of traditional cardiovascular risk factors, statin use, disease-related data and other variations in the lipid profile related to these diseases, CEC was lower in patients with SLE, compared to those with RA (P ≤.001).

While lack of age- and sex-matching was a potential limitation of the study, the researchers noted that the size effect of these differences was small.

“Our results suggest that SLE and RA dyslipidemia occurs by different and specific mechanisms attributable to each disease. Additional studies comparing dyslipidemia among different inflammatory disorders are needed to better understand the mechanisms by which inflammation modifies lipids,” wrote the researchers.

Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.


Quevedo-Abeledo JC, Sánchez-Pérez H, Tejera-Segura B, et al. Differences in HDL-cholesterol efflux capacity between patients with systemic lupus erythematosus and rheumatoid arthritis. Arthritis Care Res (Hoboken). Published online Aug 8, 2020. doi:10.1002/acr.24407