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ORIGINAL RESEARCH article

Front. Cardiovasc. Med.
Sec. Lipids in Cardiovascular Disease
Volume 11 - 2024 | doi: 10.3389/fcvm.2024.1449219
This article is part of the Research Topic Evidence of Atherogenic Lipoproteins: what we gain from in vitro and in vivo research View all 5 articles

Elevated Remnant Cholesterol as a Potential Predictor for Cardiovascular Events in Rheumatoid Arthritis Patients

Provisionally accepted
Ching-Kun Chang Ching-Kun Chang 1,2,3Yi-Chen Li Yi-Chen Li 4,5Po-Ku Chen Po-Ku Chen 2,6Shih-Hsin Chang Shih-Hsin Chang 2,6,7Der-Yuan Chen Der-Yuan Chen 2,6,8*
  • 1 1Rheumatology and Immunology Center, China Medical University Hospital, Taichung, Taiwan
  • 2 College of Medicine, China Medical University, Taichung, Taiwan
  • 3 Organ-on-a chip Fabrication and Verification Division, National Applied Research Laboratories, Hsinchu, Taiwan
  • 4 Clinical Medicine Research Center, National Cheng Kung University Hospital, Tainan, Taiwan
  • 5 Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Tainan County, Taiwan
  • 6 Rheumatology and Immunology Center, China Medical University Hospital, Taichung, Taiwan
  • 7 Ph.D. Program in Translational Medicine and Rong Hsing Research Center for Translational Medicine, National Chung Hsing University, National Chung Hsing University, Taichung, Taiwan
  • 8 Institute of Medicine, Chung Shan Medical University, Taichung, Taichung County, Taiwan

The final, formatted version of the article will be published soon.

    Objective: The risk of cardiovascular disease (CVD) in patients with rheumatoid arthritis (RA) remains inadequately defined. Consequently, this study aims to evaluate the predictive value of remnant cholesterol (RC) for assessing CVD risk in RA patients.Methods: Plasma RC levels were measured in 114 RA patients and 41 healthy controls, calculated as total cholesterol minus HDL-C and LDL-C. These levels were further analyzed using 1 H-NMR lipid/metabolomics. Meanwhile, the 28-joint Disease Activity Score (DAS28) assessed RA activity.Results: RC levels were significantly elevated in RA patients (19.0 mg/dL, p < 0.001) compared to healthy controls (14.5 mg/dL). Furthermore, RC levels were significantly elevated at 37.4 mg/dL in patients who experienced cardiovascular event (CVE) compared to 17.4 mg/dL in those without CVE (p < 0.001). To enhance the precision and reliability of RC measurements, RC concentrations were further validated using 1 H-NMR spectroscopy. Additionally, a positive correlation was observed between RC levels and DAS28. Multivariate analysis identified RC as a significant predictor of CVE (odds ratio = 1.82, p = 0.013). ROC curve analysis revealed superior predictive capability of RC for CVE (AUC = 0.919, p < 0.001) compared to LDL-C (AUC = 0.669, p = 0.018), with a high sensitivity of 94.7% and a specificity of 82.1%.Elevated RC levels demonstrate greater accuracy in predicting CVE occurrence in RA patients compared to traditional measures such as LDL-C. These findings suggest that elevated RC levels may serve as a novel predictor for occurrence of CVE in RA patients, facilitating early intervention strategies based on the risk stratification.

    Keywords: Remnant cholesterol (RC), Low-density lipoprotein (LDL), prediction, Cardiovascular events (CVE), rheumatoid arthritis (RA)

    Received: 14 Jun 2024; Accepted: 27 Aug 2024.

    Copyright: © 2024 Chang, Li, Chen, Chang and Chen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Der-Yuan Chen, Rheumatology and Immunology Center, China Medical University Hospital, Taichung, 404, Taiwan

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