Correlation Between Lipid Profile and Bacterial Infection in Iraqi Rheumatoid Arthritis Cases

Abstract

Background: Rheumatoid arthritis (RA) is a chronic inflammatory disorder associated with dyslipidemia and increased cardiovascular risk. Bacterial infections may further exacerbate metabolic disturbances. This study evaluated corelated between lipid profile and bacterial infection in Iraqi R.A.
Methods: A case-control study was conducted with (No.=90) participants divided into three groups: Rheumatoid arthritis with bacterial infection (No.=30), R.A without bacterial infections (No.=30), and control (No.=30). Lipid profiles, inflammatory markers (ESR; Procalcitonin & CRP), and synovial fluid parameters were assessed. used culture and biochemical tests for identification bacteria.
Results: R.A patients demonstrated significant lipid alterations compared to control. The most changes occurred in patients with bacterial R.A, characterized by decreased total cholesterol (149.26 ± 23.52 mg/dL) and both (LDL, HDL) as (83.77 ± 16.95 mg/dL), (31.19 ± 6.72 mg/dL) respectively as well as elevated triglycerides (165.86±33.04 mg/dL) (p<0.001). negative correlated between lipid parameters and inflammatory markers (p<0.01). so the predominant pathogens were both Staphylococcus aureus and Escherichia coli as (35.7 & 27.7) %) respectively, Synovial fluid analysis showed significantly elevated WBC counts and LDH levels in infected joints (p<0.001), whilst no significant differences in lipid profiles among different bacterial isolates.
Conclusions: Bacterial infection exacerbates lipid disturbances in R.A patients, likely driven by systemic inflammation. The inverse relationship between lipid levels and inflammatory markers supports the "lipid paradox" in RA. These findings highlight the importance of cardiovascular risk assessment in Rheumatoid arthritis patients with concurrent infections.