Comparison of carotis intima media thickness and lipoprotein associated phospholipase A2 levels for evaluating atherosclerosis in rheumatoid arthritis patients

Background and aim: Rheumatoid arthritis (RA) is a chronic, systemic and inflammatory disease with an unclear etiology which initially influences the joints and also has effects on neurological, cardiovascular, hematological, respiratory systems and may cause renal and ophthalmic injury. The cardiovascular effects are the reasons of increased mortality in RA.Recent studies showed that some indicators of inflammatory process contribute development of atherosclerosis in RA. One of these is lipoprotein associated phospholipase A2 (Lp- PLA2). Lp-PLA2 is an enzyme of phospholipase A2 family; catalyzing the oxidation reaction of lisophosphotidilkolin and LDL, that comprises proinflammatory and proatherogenic products such as oxide free fatty acids. With this study we aimed to evaluate the LpPLA2 activity levels in RA patients and consider the relationship between Lp-PLA2 activity levels and CIMT (carotid intima media thickness) appraised with non-invasive tests such as Doppler ultrasound.Patients and Methods: 25 patients with established RA and 40 controls 20 of which had type 2 diabetes mellitus (DM) were accepted to the study. Biochemical tests, hemogram, CRP, sedimentation, HDL-cholesterol, LDL-cholesterol, total cholesterol measurements were performed. Disease activity was calculated with DAS-28 and HAQ score was evaluated in RA group. For measuring Lp-PLA2 activity levels, fasting blood samples were assessed in 2 tubes with EDTA. Both left and right CIMT rates were also quantified in all participants.Findings: Lp-PLA2 activity levels were significantly higher in DM group (P: 0,006). LDL-cholesterol levels were significantly lower in RA and healthy control groups compared with diabetics (respectively p: 0,001 and p: 0,029). Right CIMT rates were significantly different in DM patients (p: 0,047); but none of groups exposed significantly different results in measurement of left CIMT (P> 0,05).Result: Lp-PLA2 activity is not altered in RA group compared with healthy controls but meaningfully higher than both in diabetics. CIMT was not eventuated distinct than healthy controls in RA group. Normality of Lp-PLA2 activity levels in RA patients can be explained with the treatment they 've been taking and low disease activity scores as its result.