Remnant cholesterol can serve as a key predictor of rheumatoid arthritis

A recent study featured in Lipids in Health and Diseases has reported that elevated levels of remnant cholesterol (RC) are significantly associated with increased susceptibility to rheumatoid arthritis (RA). This groundbreaking finding underscores the potential of RC as a promising prognostic indicator for assessing the predisposition to RA. 

The population-based study conducted by Dr. Yan and colleagues involved a thorough examination using data extracted from the National Health and Nutrition Examination Survey (NHANES) 1999–2008 database. The study included 7,777 patients, among whom 581 individuals (7.47%) were diagnosed with RA. The multivariate logistic regression analysis revealed a notable correlation between elevated RC levels and an increased likelihood of RA (odds ratio [OR] = 1.54; 95% confidence interval [CI]: 1.11–2.13; P = 0.0092). Notably, the interaction test did not yield statistically significant effects on this association. 

RA is linked to an unusual lipoprotein pattern, particularly low HDL-C. Moreover, it involves elevated levels of lipid derivatives like leukotriene B4, derived from arachidonic acid, contributing to the observed pro-inflammatory environment. Furthermore, RA exhibits imbalances in lipid derivatives, showing increased levels of pro-inflammatory leukotriene B4 and decreased levels of pro-resolving lipid mediators such as resolvins D3, D4, and E3. 

RC has emerged as a significant indicator, reflecting cholesterol levels within triglyceride-rich lipoproteins and its implications extend across various health conditions, including cardiovascular and metabolic disorders. Recent findings have demonstrated that RC holds comparable precision to LDL-C (low-density lipoprotein cholesterol) or very low-density lipoprotein in predicting the risk of atherosclerotic cardiovascular disease (CVD). Moreover, the variability in RC levels has consistently shown a correlation with an increased likelihood of experiencing ischemic stroke, independent of LDL-C levels. Additionally, preliminary studies have suggested a potential link between RC and hypertension, as well as type 2 diabetes mellitus, indicating its broader relevance in metabolic health. 

The study revealed a distinct and statistically significant positive correlation between RC levels and RA. These results constitute a significant addition to the growing body of evidence supporting the clinical utility of RC as a predictive marker for RA. By elucidating this association, the research offers vital insights that could guide the formulation of early intervention strategies aimed at populations susceptible to RA However, to validate these findings and ensure their relevance on a global scale, further comprehensive studies across diverse populations worldwide are warranted. 


Yan Y, La R, Jiang M, Xu W, Jiang D, Wang S, et al. The association between remnant cholesterol and rheumatoid arthritis: insights from a large population study. Lipids Health Dis. 2024 Feb 7;23:38. 




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