Dyslipidemia in Women with Autoimmune Diseases: Systemic Lupus Erythematosus, Rheumatoid Arthritis, and Beyond

Women with autoimmune diseases such as systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), and others face a disproportionate burden of cardiovascular disease (CVD), in part due to inflammation-driven dyslipidemia. Unlike classical metabolic dyslipidemia, these lipid abnormalities are characterized by low high-density lipoprotein (HDL) cholesterol, elevated triglycerides, dysfunctional HDL, and increased oxidized low-density lipoprotein. The interplay of chronic inflammation, immune dysregulation, hormonal factors, and treatment-related effects contributes to a unique lipid phenotype that amplifies CVD risk in women. This narrative review explores the epidemiology, pathophysiology, and clinical manifestations of dyslipidemia in SLE and RA, with an extension to other autoimmune diseases such as psoriatic arthritis, Sjögren’s syndrome, systemic sclerosis, and autoimmune thyroid disorders. Management strategies, including early screening, inflammation control, statin therapy, and gender-specific considerations, are highlighted. The article underscores the urgent need for tailored risk assessment tools and therapeutic approaches to mitigate premature cardiovascular morbidity and mortality in this vulnerable population.