J Clin Med Res

Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc

Journal website https://jocmr.elmerjournals.com

Original Article

Volume 18, Number 5, May 2026, pages 283-291

Oxidized High-Density Lipoprotein and Cardiovascular Risk in Rheumatoid Arthritis

↓ Figure 1. Statistically significant findings from the cardiovascular risk analysis included a positive correlation between oxHDL and BMI (a), as well as negative correlations between oxHDL and total cholesterol (b) and the average daily prednisolone dose (c). Individuals with hypertension (d) and overweight status (e) exhibited higher oxHDL levels. BMI: body mass index; oxHDL: oxidized high-density lipoprotein.

↓ Figure 2. Statistically significant findings from the RA disease activity analysis. Individual with positive RF (a) and positive anti-CCP (b) displayed lower oxHDL, respectively. CCP: cyclic citrullinated peptide; oxHDL: oxidized high-density lipoprotein; RA: rheumatoid arthritis; RF: rheumatoid factor.

↓ **Table 1.** Baseline Characteristics of All Included Patients
Variable	Result
BMI: body mass index; CAD: coronary artery disease; CCP: cyclic citrullinated peptide; CRP: C-reactive protein; CV: cardiovascular; DAS28: Disease Activity Score 28; HDL: high-density lipoprotein; HF: heart failure; HFQ: Hannover Functional Questionnaire; IL-6: interleukin-6; LDL: low-density lipoprotein; NSAID: non-steroidal anti-inflammatory drug; RF: rheumatoid factor; SD: standard deviation; TNF: tumor necrosis factor; VAS: Visual Analogue Scale.
Gender (females, males), n (%)	134 (67%), 66 (33%)
Age (± SD), years	62.5 ± 12.4
BMI, kg/m²	28.7 ± 5.6
VAS (mean ± SD)	4.0 ± 2.5
HFQ (mean ± SD), %	75.2 ± 22.2
DAS28 (mean ± SD)	3.7 ± 1.4
Swollen small joints (mean ± SD), n	3.1 ± 7.8
Swollen large joints (mean ± SD), n	0.7 ± 1.3
Painful small joints (mean ± SD), n	5.8 ± 9.8
Painful large joints (mean ± SD), n	2.1 ± 2.4
RF, %	64.1
Anti-CCP, %	55.6
Medication
NSAID therapy, %	28.7
Daily prednisolone (mean ± SD), mg	3.4 ± 2.9
Sulfasalazine, %	12.5
Leflunomide, %	7.5
Anti-TNF-alpha, %	11.0
Anti-IL-6, %	3.0
Anti-CD80/86, %	0
Anti-CD20, %	1.5
CV risk factors/morbidities
Smoking, %	32.3
Physical exercise, %	42.3
Distress, %	38.9
arterial hypertension, %	65
CAD, %	7
HF, %	4.1
Family history of CAD, %	23
Diabetes mellitus, %	14
Obesity, %	35.5
Laboratory findings
CRP (mean ± SD), mg/L	6.3 ± 9.8
Hb (mean ± SD), g/L	134.8 ± 22.2
Platelets (mean ± SD), × 100,000/µL	273.6 ± 73.1
Serum creatinine (mean ± SD), µmol/L	71.2 ± 15.9
HbA1c (mean ± SD), %	5.6 ± 0.7
Triglycerides (mean ± SD), mmol/L	1.5 ± 0.9
Total cholesterol (mean ± SD), mmol/L	5.4 ± 1
LDL (mean ± SD), mmol/L	3.2 ± 0.9
HDL (mean ± SD), mmol/L	1.7 ± 0.5

↓ Table 1. Baseline Characteristics of All Included Patients

Variable

Result

BMI: body mass index; CAD: coronary artery disease; CCP: cyclic citrullinated peptide; CRP: C-reactive protein; CV: cardiovascular; DAS28: Disease Activity Score 28; HDL: high-density lipoprotein; HF: heart failure; HFQ: Hannover Functional Questionnaire; IL-6: interleukin-6; LDL: low-density lipoprotein; NSAID: non-steroidal anti-inflammatory drug; RF: rheumatoid factor; SD: standard deviation; TNF: tumor necrosis factor; VAS: Visual Analogue Scale.

Gender (females, males), n (%)

134 (67%), 66 (33%)

Age (± SD), years

62.5 ± 12.4

BMI, kg/m²

28.7 ± 5.6

VAS (mean ± SD)

4.0 ± 2.5

HFQ (mean ± SD), %

75.2 ± 22.2

DAS28 (mean ± SD)

3.7 ± 1.4

Swollen small joints (mean ± SD), n

3.1 ± 7.8

Swollen large joints (mean ± SD), n

0.7 ± 1.3

Painful small joints (mean ± SD), n

5.8 ± 9.8

Painful large joints (mean ± SD), n

2.1 ± 2.4

RF, %

64.1

Anti-CCP, %

55.6

Medication

NSAID therapy, %

28.7

Daily prednisolone (mean ± SD), mg

3.4 ± 2.9

Sulfasalazine, %

12.5

Leflunomide, %

7.5

Anti-TNF-alpha, %

11.0

Anti-IL-6, %

3.0

Anti-CD80/86, %

Anti-CD20, %

1.5

CV risk factors/morbidities

Smoking, %

32.3

Physical exercise, %

42.3

Distress, %

38.9

arterial hypertension, %

CAD, %

HF, %

4.1

Family history of CAD, %

Diabetes mellitus, %

Obesity, %

35.5

Laboratory findings

CRP (mean ± SD), mg/L

6.3 ± 9.8

Hb (mean ± SD), g/L

134.8 ± 22.2

Platelets (mean ± SD), × 100,000/µL

273.6 ± 73.1

Serum creatinine (mean ± SD), µmol/L

71.2 ± 15.9

HbA1c (mean ± SD), %

5.6 ± 0.7

Triglycerides (mean ± SD), mmol/L

1.5 ± 0.9

Total cholesterol (mean ± SD), mmol/L

5.4 ± 1

LDL (mean ± SD), mmol/L

3.2 ± 0.9

HDL (mean ± SD), mmol/L

1.7 ± 0.5

↓ **Table 2.** Cardiovascular Risk Factor Analysis
Variable	Result	P-value
Summary of all correlation and association analyses between oxHDL and the defined nominal and metric variables. oxHDL concentrations are reflected by arbitrary units, respectively. BMI: body mass index; LDL: low-density lipoprotein; oxHDL: oxidized high-density lipoprotein.
Age (years)	r = −0.06	0.42
Gender (females vs. males)	1.47 ± 0.6 vs. 1.6 ± 0.7	0.3
BMI (kg/m²)	r = 0.15	0.038
Average daily prednisone dosage (mg)	r = −0.25	0.001
Serum creatinine (µmol/L)	r = 0.11	0.13
HbA1c (%)	r = −0.08	0.29
Total cholesterol (mmol/L)	r = −0.17	0.01
LDL (mmol/L)	r = 0.04	0.55
Smoking (yes vs. no)	1.4 ± 0.6 vs. 1.5 ± 0.6	0.38
Physical exercise (yes vs. no)	1.5 ± 0.6 vs. 1.5 ± 0.6	0.73
Distress (yes vs. no)	1.6 ± 0.6 vs. 1.4 ± 0.6	0.21
Arterial hypertension (yes vs. no)	1.5 ± 0.6 vs. 1.4 ± 0.6	0.042
Coronary artery disease (yes vs. no)	1.4 ± 0.5 vs. 1.5 ± 0.6	0.74
Heart failure (yes vs. no)	1.5 ± 0.3 vs. 1.4 ± 0.6	0.36
Family history of atherosclerosis (yes vs. no)	1.4 ± 0.5 vs. 1.5 ± 0.6	0.6
Diabetes mellitus (yes vs. no)	1.6 ± 0.7 vs. 1.5 ± 0.6	0.18
Obesity (yes vs. no)	1.6 ± 0.7 vs. 1.4 ± 0.6	0.01

↓ Table 2. Cardiovascular Risk Factor Analysis

Variable

Result

P-value

Age (years)

r = −0.06

0.42

Gender (females vs. males)

1.47 ± 0.6 vs. 1.6 ± 0.7

0.3

BMI (kg/m²)

r = 0.15

0.038

Average daily prednisone dosage (mg)

r = −0.25

0.001

Serum creatinine (µmol/L)

r = 0.11

0.13

HbA1c (%)

r = −0.08

0.29

Total cholesterol (mmol/L)

r = −0.17

0.01

LDL (mmol/L)

r = 0.04

0.55

Smoking (yes vs. no)

1.4 ± 0.6 vs. 1.5 ± 0.6

0.38

Physical exercise (yes vs. no)

1.5 ± 0.6 vs. 1.5 ± 0.6

0.73

Distress (yes vs. no)

1.6 ± 0.6 vs. 1.4 ± 0.6

0.21

Arterial hypertension (yes vs. no)

1.5 ± 0.6 vs. 1.4 ± 0.6

0.042

Coronary artery disease (yes vs. no)

1.4 ± 0.5 vs. 1.5 ± 0.6

0.74

Heart failure (yes vs. no)

1.5 ± 0.3 vs. 1.4 ± 0.6

0.36

Family history of atherosclerosis (yes vs. no)

1.4 ± 0.5 vs. 1.5 ± 0.6

0.6

Diabetes mellitus (yes vs. no)

1.6 ± 0.7 vs. 1.5 ± 0.6

0.18

Obesity (yes vs. no)

1.6 ± 0.7 vs. 1.4 ± 0.6

0.01

↓ **Table 3.** RA Disease Activity Analysis
Variable	Result	P-value	Adapted P-value
Summary of all correlation and association analyses between oxHDL and the defined nominal and metric variables. oxHDL concentrations are reflected by arbitrary units, respectively. The last column shows the adapted P-values after multiple linear regression. For this purpose, age, gender, and BMI were chosen as further covariables, oxHDL was the dependent variable. CCP: cyclic citrullinated peptide; oxHDL: oxidized high-density lipoprotein; RA: rheumatoid arthritis.
Visual Analog Scale	r = 0.03	0.6
Hannover Functional Questionnaire (%)	r = 0.05	0.47
Disease Activity Score 28	r = 0.1	0.19
C-reactive protein (mg/L)	r = −0.12	0.1
Platelet count (× 100,000/µL)	r = −0.17	0.021	0.43
Rheumatoid factor positive (yes vs. no)	1.4 ± 0.6 vs. 1.6 ± 0.7	0.018	0.046
Anti-CCP positive (yes vs. no)	1.4 ± 0.6 vs. 1.6 ± 0.7	0.012	0.019

↓ Table 3. RA Disease Activity Analysis

Variable

Result

P-value

Adapted P-value

Summary of all correlation and association analyses between oxHDL and the defined nominal and metric variables. oxHDL concentrations are reflected by arbitrary units, respectively. The last column shows the adapted P-values after multiple linear regression. For this purpose, age, gender, and BMI were chosen as further covariables, oxHDL was the dependent variable. CCP: cyclic citrullinated peptide; oxHDL: oxidized high-density lipoprotein; RA: rheumatoid arthritis.

Visual Analog Scale

r = 0.03

0.6

Hannover Functional Questionnaire (%)

r = 0.05

0.47

Disease Activity Score 28

r = 0.1

0.19

C-reactive protein (mg/L)

r = −0.12

0.1

Platelet count (× 100,000/µL)

r = −0.17

0.021

0.43

Rheumatoid factor positive (yes vs. no)

1.4 ± 0.6 vs. 1.6 ± 0.7

0.018

0.046

Anti-CCP positive (yes vs. no)

1.4 ± 0.6 vs. 1.6 ± 0.7

0.012

0.019