Nutritional Effect on Lipoproteins Associated With Psoriatic Arthritis

A study published in Advances in Rheumatology found that recognition of pro-atherogenic low-density lipoprotein (LDL) subfractions in patients with psoriatic arthritis (PsA) may help identify those at higher cardiovascular risk

This study aimed to evaluate the effects of a 12-week nutritional intervention on high-density lipoprotein (HDL) and LDL cholesterol levels and their subfractions in patients with PsA, a group known to have altered lipid metabolism and increased risk of cardiovascular diseases. The trial involved 91 patients with PsA who were randomly assigned to 1 of 3 groups: a placebo group (soybean oil, no diet intervention), a diet plus supplementation group (individualized diet with omega-3 fatty acids), and a diet plus placebo group (individualized diet with soybean oil).

Lipoprotein subfractions were classified as atherogenic, highly atherogenic, or non-atherogenic for LDL, and as small, medium, or large for HDL. The study found that 62% of patients had atherogenic or highly atherogenic LDL profiles, with male gender, longer skin disease duration, and higher body mass index being key risk factors. Notably, 35% of patients had a high-risk lipoprotein profile despite having LDL levels below 100 mg/dL.

The 12-week intervention did not affect LDL subfractions, but it did significantly improve HDL subfractions, particularly increasing the large HDL particles, which are considered protective against cardiovascular disease. Additionally, the intervention improved the large LDL subfraction in individuals with hypercholesterolemia.

In conclusion, recognizing pro-atherogenic LDL subfractions in patients with PsA may help identify those at higher cardiovascular risk, independent of total LDL levels. A short-term, supervised nutritional intervention with omega-3 supplementation positively influenced HDL subfractions, suggesting its potential benefit for reducing cardiovascular risk in patients with PsA.

Reference
Scherer D, Leite BF, Morimoto MA, et al. Nutritional effect on lipoproteins and their subfractions in patients with psoriatic arthritis: a 12-week randomized trial-the DIETA trial. Adv Rheumatol. Published online June 13, 2024. doi:10.1186/s42358-024-00389-5