Dyslipidaemia in rheumatoid arthritis: the role of inflammation, drugs, lifestyle and genetic factors.

Rheumatoid arthritis (RA) associates with excess cardiovascular morbidity and mortality, resulting in significantly shortened lifespan. Traditional risk factors (e.g. dyslipidaemia and hypertension) and novel risk factors (e.g. systemic inflammation) contribute to the development of cardiovascular disease (CVD) in RA. In the general population, dyslipidaemia has been found to be central to the development of CVD, playing an important role in all stages of atherosclerotic plaque formation. In RA, lipid metabolism may be altered by systemic inflammation, environmental lifestyle factors, drug therapy and several genetic factors. This may result in changes in overall lipid levels, as well as modifications of lipid/lipoprotein structure and function. In this review, we discuss lipid abnormalities specifically in the context of RA and highlight the potential impact of inflammation, genetic factors, lifestyle, and anti-rheumatic drugs on lipid metabolism.