43. Cholesterol and Modifications of Cholesterol in Rheumatic Disorders

  1. Gary S. Hoffman MD, MS2,
  2. Cornelia M. Weyand MD, PhD3,
  3. Carol A. Langford MD, MHS2 and
  4. Jörg J. Goronzy MD, PhD3
  1. Jan Willem Cohen Tervaert MD, PhD

Published Online: 3 MAY 2012

DOI: 10.1002/9781118355244.ch43

Inflammatory Diseases of Blood Vessels, Second Edition

Inflammatory Diseases of Blood Vessels, Second Edition

How to Cite

Cohen Tervaert, J. W. (2012) Cholesterol and Modifications of Cholesterol in Rheumatic Disorders, in Inflammatory Diseases of Blood Vessels, Second Edition (eds G. S. Hoffman, C. M. Weyand, C. A. Langford and J. J. Goronzy), Wiley-Blackwell, Oxford, UK. doi: 10.1002/9781118355244.ch43

Editor Information

  1. 2

    Department of Rheumatic and Immunologic Diseases, Center for Vasculitis Care and Research, Cleveland Clinic, Lerner College of Medicine, Cleveland, OH, USA

  2. 3

    Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA

Author Information

  1. Division of Clinical and Experimental Immunology, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands

Publication History

  1. Published Online: 3 MAY 2012
  2. Published Print: 8 JUN 2012

ISBN Information

Print ISBN: 9781444338225

Online ISBN: 9781118355244



  • Cardiovascular mortality;
  • premature atherosclerosis;
  • pro-inflammatory HDL particles;
  • oxidized LDL;
  • anti-ox LDL antibodies;
  • statins;
  • statin-induced myopathy;
  • statin induced autoimmunity


In many systemic autoimmune diseases, accelerated atherosclerosis has become a leading cause of death. Diabetes, hypertension, dyslipidemia, abdominal obesity (metabolic syndrome), impaired renal function, persistent proteinuria and increased production of C-reactive protein are more common in these patients than in healthy controls. Low density lipoproteins may become pro-inflammatory/pro-atherogenic after modification/oxidation in blood vessels. Modifications in high density lipoproteins (HDL) may produce pro-inflammatory species. While glucocorticoid therapy increases lipids and lipid proteins, including pro-inflammatory HDL, anti-tumor necrosis factor therapy, methotrexate and hydroxychloroquine lower cholesterol levels. Patients with systemic autoimmune diseases should be treated with statins. In some patients niacin, fibrates and/or omega-3 fatty acids are additionally needed.