Associations of Atherogenic Lipid Ratios and Visceral Adiposity Indices with Cardiovascular Risk Scores in Rheumatoid Arthritis

Background/Aims: Rheumatoid arthritis (RA) is associated with increased cardiovascular risk beyond traditional risk factors. Recently, atherogenic lipid ratios and visceral adiposity indices have emerged as potential markers of cardiometabolic risk in chronic inflammatory diseases. This study aimed to examine their associations with estimated cardiovascular risk scores in patients with RA.

Materials and Methods: This cross-sectional study included 198 patients with RA. Individuals with established cardiovascular disease or majör comorbid conditions were excluded. Atherogenic lipid ratios, including the Atherogenic Index of Plasma (AIP), Atherogenic Coefficient (AC), Castelli Risk Index (CRI)-1, CRI-2, and triglycerides (TG)/high-density lipoprotein cholesterol (HDL-C) ratio, were calculated. Visceral adiposity indices included the Visceral Adiposity Index (VAI), Lipid Accumulation Product (LAP), and Waist-Triglyceride Index. Ten-year cardiovascular risk was estimated using the modified Framingham Risk Score (FRS) and the modified Systematic Coronary Risk Evaluation (SCORE) system.

Results: Atherogenic lipid ratios, particularly AC, CRI-1, and CRI-2, demonstrated weak but statistically significant positive correlations with both modified SCORE and modified FRS. In contrast, adiposity-related indices (LAP and VAI) and atherogenic lipid ratios (AIP and the TG/HDL-C ratio) were significantly associated with the modified FRS but not with the modified SCORE. No significant associations were observed between RA disease activity measures and cardiovascular risk scores.

Conclusion: In RA, cardiovascular risk is linked closely to adiposity and lipid disturbances than current disease activity. Modified FRS may better capture adiposity-related cardiovascular risk than modified SCORE, and incorporation of atherogenic lipid and visceral adiposity indices may improve risk stratification.

Cite this article as: Demir UG, Demir AN, Uysal A. Associations of atherogenic lipid ratios and visceral adiposity indices with cardiovascular risk scores in rheumatoid arthritis. ArchRheumatol. 2026;41(3):242-248.