Disease activity [12], we studied whether lipid levels correlated with RA activity in our cohort. When patients were divided into three tertile groups according to time-integrated lipid levels, patients with LDL cholesterol levels in the third tertile had persistently higher erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and DAS28 levels than the first tertile group (Figure 1). The patients with triglyceride levels in the third tertile also had higher baseline CRP and DAS28 levels than the first tertile group; however, there was no significant MedChemExpress Microcystin-LR difference across the HDL tertiles. Interestingly, although the three tertile groups of LDL cholesterol and triglyceride showed a decreasing tendency of disease activity with anti-rheumatic treatments, this decreasing 24195657 trend was significantly attenuated in the highest tertile group (Figure 1). These results suggest that patients with higher LDL cholesterol and triglyceride levels are in a more active state of disease, showing a poor response to medical treatment.Dyslipidemia and Radiographic ProgressionWe studied further whether lipid tertile could reflect radiographic progression. The result showed that the radiographic score increased with increasing LDL cholesterol and triglyceride tertile. Moreover, rapid progression was observed in the highest LDL cholesterol group (Table S2). In univariate analyses for the determination of factors affecting radiographic progression and time-integrated LDL cholesterol, disease duration, the presence of ACPA and RF, time-integrated CRP, time-integrated ESR, and the use of methotrexate were found to be statistically significant (Table 1 and Table S3, respectively). These variables were therefore included in the multivariate logistic models (Table 2). As shown in Table 2, time-integrated LDL cholesterol levels were independently associated with radiographic progression (highest tertile versus lowest tertile OR = 2.831, 95 CI: [1.561?.246], P = 0.031); however, neither time-integrated triglyceride nor HDL levels were found to significantly increase the risk of radiographic progression of RA. Since TNF-a blocking agents and statin therapy can affect radiographic progression and LDL cholesterol, respectively [5,6,27], we further analyzed the potential effects of these agents. The association between radiographic progression and LDL cholesterol levels remained significant after adjustment for the use of TNF-a inhibitors (OR = 2.194 [1.532?.141], P = 0.039) and the use of statin (OR = 3.124, P = 0.001). Inaddition, radiographic progression rate may be also influenced by the baseline radiographic severity. Thus, we further performed linear regression analysis of the absolute radiographic scores as a dependent variable after BIBS39 biological activity adjusting the baseline radiographic score. When the multivariate regression analysis was performed after adjusting for confounders, time-integrated LDL cholesterol remained an independent risk factor for radiographic severity at 24 weeks (Table S4). To analyze the effect of other lipid levels on disease acceleration linked to LDL cholesterolemia, we divided the patients into nine groups based on three tertiles of LDL cholesterol, triglyceride, and HDL cholesterol (Figure 2A and 2B). Patients with both LDL cholesterol and triglyceride levels in the lowest tertile (dark gray column in the first row) were considered the reference subgroup. As a result, the adjusted odds ratios of radiographic progression additively rose as triglycerid.Disease activity [12], we studied whether lipid levels correlated with RA activity in our cohort. When patients were divided into three tertile groups according to time-integrated lipid levels, patients with LDL cholesterol levels in the third tertile had persistently higher erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and DAS28 levels than the first tertile group (Figure 1). The patients with triglyceride levels in the third tertile also had higher baseline CRP and DAS28 levels than the first tertile group; however, there was no significant difference across the HDL tertiles. Interestingly, although the three tertile groups of LDL cholesterol and triglyceride showed a decreasing tendency of disease activity with anti-rheumatic treatments, this decreasing 24195657 trend was significantly attenuated in the highest tertile group (Figure 1). These results suggest that patients with higher LDL cholesterol and triglyceride levels are in a more active state of disease, showing a poor response to medical treatment.Dyslipidemia and Radiographic ProgressionWe studied further whether lipid tertile could reflect radiographic progression. The result showed that the radiographic score increased with increasing LDL cholesterol and triglyceride tertile. Moreover, rapid progression was observed in the highest LDL cholesterol group (Table S2). In univariate analyses for the determination of factors affecting radiographic progression and time-integrated LDL cholesterol, disease duration, the presence of ACPA and RF, time-integrated CRP, time-integrated ESR, and the use of methotrexate were found to be statistically significant (Table 1 and Table S3, respectively). These variables were therefore included in the multivariate logistic models (Table 2). As shown in Table 2, time-integrated LDL cholesterol levels were independently associated with radiographic progression (highest tertile versus lowest tertile OR = 2.831, 95 CI: [1.561?.246], P = 0.031); however, neither time-integrated triglyceride nor HDL levels were found to significantly increase the risk of radiographic progression of RA. Since TNF-a blocking agents and statin therapy can affect radiographic progression and LDL cholesterol, respectively [5,6,27], we further analyzed the potential effects of these agents. The association between radiographic progression and LDL cholesterol levels remained significant after adjustment for the use of TNF-a inhibitors (OR = 2.194 [1.532?.141], P = 0.039) and the use of statin (OR = 3.124, P = 0.001). Inaddition, radiographic progression rate may be also influenced by the baseline radiographic severity. Thus, we further performed linear regression analysis of the absolute radiographic scores as a dependent variable after adjusting the baseline radiographic score. When the multivariate regression analysis was performed after adjusting for confounders, time-integrated LDL cholesterol remained an independent risk factor for radiographic severity at 24 weeks (Table S4). To analyze the effect of other lipid levels on disease acceleration linked to LDL cholesterolemia, we divided the patients into nine groups based on three tertiles of LDL cholesterol, triglyceride, and HDL cholesterol (Figure 2A and 2B). Patients with both LDL cholesterol and triglyceride levels in the lowest tertile (dark gray column in the first row) were considered the reference subgroup. As a result, the adjusted odds ratios of radiographic progression additively rose as triglycerid.
