Epicardial Fat Thickness as Cardiovascular Risk Factor and Therapeutic Target in Patients with Rheumatoid Arthritis Treated with Biological and Nonbiological Therapies

Rheumatoid arthritis (RA) is a chronic inflammatory disease associated with high cardiovascular morbidity and mortality. Epicardial adipose tissue (EAT) thickness may act as a therapeutic target during treatments with drugs modulating the adipose tissue. We evaluate EAT thickness in RA patients treated with biological and nonbiological disease-modifying antirheumatic drugs (DMARDs). A cross-sectional study was conducted with a cohort of 34 female RA patients and 16 controls matched for age and body mass index (BMI). Plasma glucose, basal insulin, plasma lipids, and high-sensitivity C-reactive protein (hs-CRP) were assessed. EAT thickness and left ventricular mass (LVM) were measured by echocardiography. No significant differences in waist circumference (WC), blood pressure, fasting blood glucose, basal insulin, and lipid parameters were found between the groups. The control group showed lower concentrations (P=0.033) of hs-CRP and LVM (P=0.0001) than those of the two RA groups. Patients treated with TNF-α inhibitors showed significantly lower EAT thickness than those treated with nonbiological DMARDs (8.56 ± 1.90 mm versus 9.71 ± 1.45 mm; P=0.04). Women with no RA revealed reduced EAT thickness (5.39 ± 1.52 mm) as compared to all RA patients (P=0.001). Results suggest that RA patients have greater EAT thickness than controls regardless of BMI and WC.

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Effect of Pravastatin on Development of Diabetes Mellitus - A Statement of Review

International Journal of Pharmaceutics & Pharmacology ◽

10.31531/2581-3080.1000148 ◽

2020 ◽

Vol 4 (2) ◽

pp. 1-4

Author(s):

Ramu G ◽

Keyword(s):

Diabetes Mellitus ◽

Adipose Tissue ◽

Plasma Lipids ◽

Fasting Blood Glucose ◽

Tissue Perfusion ◽

Lipid Lowering ◽

Control Group ◽

Glucose Levels ◽

Insulin Tolerance ◽

Anti Inflammatory

According to the ADA, diabetes mellitus is defined as having fasting blood glucose levels >= 7.0mmol/l. Statins are the lipid-lowering agents used to treat dyslipidemia and act by inhibiting the HMG Co-A reductase enzyme. Very few studies have reported the results of drugs concerning the profile of blood lipids or which have anti-inflammatory activity behaviour on diabetes. Pravastatin is such a drug that shows inherent beneficial pleiotropic effects on plasma lipids and inflammatory actions. Pravastatin remarkably reduced the increased levels of plasma glucose when compared with the control group, subjecting to no change in body weight or food intake in mice. By performing certain insulin tolerance tests using tracers like 2- [3 H]-deoxy glucose (2DG), they concluded that insulin-induced glucose uptake is increased in adipose tissue. Pravastatin is shown to reduce the circulating concentration of the interleukin-6, cytokines, and TNF-alpha. Pravastatin's anti-inflammatory properties interrupt the natural progression from central obesity to insulin resistance mediated by cytokines from the adipose tissue. Pravastatin can significantly impact selective tissue perfusion through restoring the endothelial function and thus benefit the transportation of glucose and insulin.

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Selective TNF-α targeting with infliximab attenuates impaired oxygen metabolism and contractile function induced by an acute exposure to air particulate matter

AJP Heart and Circulatory Physiology ◽

10.1152/ajpheart.00359.2015 ◽

2015 ◽

Vol 309 (10) ◽

pp. H1621-H1628 ◽

Cited By ~ 16

Author(s):

Timoteo Marchini ◽

Verónica D'Annunzio ◽

Mariela L. Paz ◽

Lourdes Cáceres ◽

Mariana Garcés ◽

...

Keyword(s):

Particulate Matter ◽

Saline Solution ◽

Contractile Function ◽

Left Ventricular ◽

Acute Exposure ◽

Control Group ◽

Contractile Reserve ◽

Mice Model ◽

Cardiovascular Morbidity And Mortality ◽

Tnf Α

Inflammation plays a central role in the onset and progression of cardiovascular diseases associated with the exposure to air pollution particulate matter (PM). The aim of this work was to analyze the cardioprotective effect of selective TNF-α targeting with a blocking anti-TNF-α antibody (infliximab) in an in vivo mice model of acute exposure to residual oil fly ash (ROFA). Female Swiss mice received an intraperitoneal injection of infliximab (10 mg/kg body wt) or saline solution, and were intranasally instilled with a ROFA suspension (1 mg/kg body wt). Control animals were instilled with saline solution and handled in parallel. After 3 h, heart O2 consumption was assessed by high-resolution respirometry in left ventricle tissue cubes and isolated mitochondria, and ventricular contractile reserve and lusitropic reserve were evaluated according to the Langendorff technique. ROFA instillation induced a significant decrease in tissue O2 consumption and active mitochondrial respiration by 32 and 31%, respectively, compared with the control group. While ventricular contractile state and isovolumic relaxation were not altered in ROFA-exposed mice, impaired contractile reserve and lusitropic reserve were observed in this group. Infliximab pretreatment significantly attenuated the decrease in heart O2 consumption and prevented the decrease in ventricular contractile and lusitropic reserve in ROFA-exposed mice. Moreover, infliximab-pretreated ROFA-exposed mice showed conserved left ventricular developed pressure and cardiac O2 consumption in response to a β-adrenergic stimulus with isoproterenol. These results provides direct evidence linking systemic inflammation and altered cardiac function following an acute exposure to PM and contribute to the understanding of PM-associated cardiovascular morbidity and mortality.

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High Fiber Caribbean Diets with Low-Intermediate GI Improve Glycemic Control, Cardiovascular and Inflammatory Indicators in Overweight Persons with Type 2 Diabetes: A Randomized Control Study

Current Research in Nutrition and Food Science Journal ◽

10.12944/crnfsj.3.1.05 ◽

2015 ◽

Vol 3 (1) ◽

pp. 36-45 ◽

Cited By ~ 1

Author(s):

Perceval Singh ◽

Cliff K Riley ◽

Andrew Wheatley ◽

Michael Boyne ◽

Errol Morrison ◽

...

Keyword(s):

Type 2 Diabetes ◽

Fasting Blood Glucose ◽

Intervention Group ◽

Dietary Treatment ◽

Treatment Modalities ◽

Control Group ◽

Haemoglobin A1c ◽

High Fiber ◽

Hs Crp

This study focused on the effect of consumption of indigenous Caribbean foods with low and intermediate glycemic index (GI) high fiber contents on glycated haemoglobin (A1c), insulin, fasting blood glucose, homocysteine (tHCY), high sensitivity C-reactive protein (hs-CRP), HOMA-IR and lipoprotein profile levels in overweight persons with type 2 diabetes. The methodology followed a randomized controlled parallel design, which compared two dietary treatment modalities in adult Jamaicans who were overweight and diagnosed with type 2 diabetes (mean age 42.5 ± 2.0 years, 55% females, mean A1c 9.30 ± 0.56%) over six months. The intervention group (n=32) underlined the consumption of low-intermediate-GI foods, whereas the control group (n = 33) were not so advised and consumed a high-GI diet. Attempts were made to ensure that both groups were isocaloric with 45-50% of energy from carbohydrates. Consumption of low-intermediate GI foods resulted in significant reductions (p<0.005) in A1C compared to participants who consumed high GI foods (-0.84 ± 0.26 vs. -0.35 ± 0.04%), hs-CRP (-0.52 ± 0.17 vs. -0.17 ± 0.31 mg/dL) and tHCY (-1.32 ± 0.39 vs. -0.59 ± 0.38 µmol/L). Insulin sensitivity, HDL-C and triglycerides significantly improved in participants who consumed the low-intermediate-GI diet. The data strengthen the metabolic benefits of meal plans that emphasize the consumption of low and intermediate GI high fiber foods, particularly, indigenous Caribbean complex starchy foods.

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Preliminary Results on the Effectiveness of a Nutrition Intervention in Lowering Diabetes Risk in Prediabetic People Living with HIV (PLWH) in MASH Cohort (OR36-06-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz035.or36-06-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Author(s):

Alicia Sneij Perez ◽

Adriana Campa ◽

Leslie Seminario ◽

Sabrina Martinez ◽

Fatma Huffman ◽

...

Keyword(s):

Blood Glucose ◽

Fasting Blood Glucose ◽

Intervention Group ◽

Nutrition Intervention ◽

Control Group ◽

Reactive Protein ◽

Research Initiative ◽

Significant Difference ◽

Hs Crp

Abstract Objectives The objective of this study is to assess the effectiveness of a 6-month nutrition intervention to improve glycemic parameters and inflammation in prediabetic PLWH on stable ART with undetectable HIV viral load. Methods A 6-month randomized, controlled nutrition intervention was conducted in prediabetic PLWH. The study participants for the intervention were recruited from the Miami Adult Studies for HIV (MASH) cohort at the FIU-Borinquen Research Clinic. Upon their consent, the participants were randomized into the intervention group or the control group. Participants randomized in the intervention group met once a month for approximately 1 hour where they received medical nutrition therapy, nutrition counseling and nutrition education; participants randomized into the control group received educational material at baseline. Blood was drawn at baseline and at 6-month to measure fasting blood glucose (FBG) and high sensitivity C-reactive protein (hs-CRP). Results A total of 38 participants were recruited and randomized into either the intervention group (n = 20) or the control group (n = 18). We found that the FBG for the 6-month follow-up for the intervention group was significantly lower than the baseline FBG values of the same study group (paired t-test; P = 0.031). No significant difference was found in the control group between the baseline and 6-month fasting blood glucose values (P = 0.068). Moreover, no significant difference was found in pre/post C-reactive protein (CRP) levels in the intervention or control group (paired t-test; P = 0.404 and P = 0.117 respectively). There was a significant difference in CRP levels at baseline (P = 0.028) between the study groups but no difference at the 6-month follow up (Mann Whitney U test: P = 0.430). Conclusions The results from this intervention support the notion that a nutrition intervention is effective in prediabetic PLWH to lower diabetes risk by significantly lowering fasting blood glucose and may be implemented into larger scale interventions; however, no significant changes was seen in hs-CRP values between the 2 groups. Funding Sources National Institute of General Medical Sciences (NIGMS): Research Initiative for Scientific Enhancement (RISE), Biomedical Research Initiative (BRI) Grant, National Institute on Drug Abuse 5U01DA040381-03 and FIU-Dissertation Funding.

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Accelerated diastolic dysfunction in premenopausal women with rheumatoid arthritis

Arthritis Research & Therapy ◽

10.1186/s13075-021-02629-1 ◽

2021 ◽

Vol 23 (1) ◽

Author(s):

Gee Hee Kim ◽

Yune-Jung Park

Keyword(s):

Rheumatoid Arthritis ◽

Risk Factors ◽

Diastolic Dysfunction ◽

Age Of Onset ◽

Systolic Heart Failure ◽

Premenopausal Women ◽

Incidence Rates ◽

Left Ventricular ◽

Control Group ◽

Early Screening

Abstract Background Disturbances of diastolic function precede systolic heart failure and, although clinically silent, represent the earliest sign of cardiac involvement. Diastolic dysfunction (DD) is associated with age, gender (female), and hypertension. However, little is known about the age-specific incidence rates and risk factors for DD in patients with rheumatoid arthritis (RA). Methods We used standard two-dimensional/Doppler echocardiography to screen for the presence of diastolic dysfunction in 61 patients with RA and 107 healthy subjects. All participants were premenopausal women with no history of hypertension. DD includes an impaired relaxation with or without increased left ventricular (LV) filling pressures, pseudonormal filling, and restrictive filling based on parameters measured using echocardiography. Results The two groups were similar with respect to age (P=0.269). Patients with RA had significantly higher LV mass index, LV filling pressure, and lower E/A velocity than controls. All patients had preserved ejection fraction (EF ≥50%). DD was more common in patients with RA at 47% compared to 26% in the controls (P=0.004). Women with RA in the 30- to 49-year age range were over 3.5 times more likely to have DD than those of similar age in the control group (OR=3.54; 95% CI 1.27 to 9.85). Among patients with RA, high CRP levels were independently associated with DD even after adjustment for cardiovascular risk factors (P=0.009). Conclusions In premenopausal women with RA, DD is much more common and the age of onset is reduced. Early screening of myocardial function may provide an opportunity for preventing future cardiovascular disease.

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IL-22 and ACPA Levels and their Relationship to the Disease Activity in Rheumatoid Arthritis Patients

Open Access Journal of Microbiology & Biotechnology ◽

10.23880/oajmb-16000185 ◽

2021 ◽

Vol 6 (1) ◽

pp. 1-7

Author(s):

Khater ES

Keyword(s):

Rheumatoid Arthritis ◽

Disease Activity ◽

Solid Phase ◽

Sandwich Elisa ◽

Control Group ◽

Erosive Disease ◽

Das 28 ◽

Significant Difference ◽

Hs Crp ◽

And Control

Aim: to determine ACPA IgG and IL-22 levels in RA patients and their relationship to the disease activity Place and duration of the study: A cross sectional study and prospective cohort study was performed from August 2020 to January 2021 in rheumatology outpatient clinic and laboratory of Al- Quwayiyah General hospital. Methodology: Forty five rheumatoid arthritis patients were included and 35 healthy participants free of any diseases considered as control group. The patients in this study met the American College of Rheumatology's 2010 guidelines. RA Disease activity was assessed for rheumatoid patients using DAS28 scoring. Serum samples collected from the patients and control to perform ESR, Hs-CRP, RF factors and also IL22 and ACPA IgG which were detected using sandwich ELISA and indirect solid phase enzyme immunoassay techniques respectively. Results: Out of the 45 RA patients, 34(75.6%) were females and 11(24.4%) were males aged from (28-67years) with median patient age 42 years. There was no statistically significant difference regarding age and sex between RA patients and control. Thirty (66.7%) of the 45 RA patients had low disease activity or remission, while 15 (33.3%) had moderate to extreme disease activity. Thirty two 32(71.1%) patients of the 45 RA patients had erosive disease. The level of ESR, hs-CRP and RF are increased in the patient group than control, in spite that there were significant differences in the Mean± SD among RA group and control group regarding RF, there was no significant statistical differences ESR, hs-CRP. in the study there was an increase in ACPA and IL-22 levels in patients suffering of RA; 21.52±1.29 U/ml and 71.22±10.63 pg\ml. respectively. While among control there was low serum levels; 14.06±2.01U/ml 33.25±2.41pg\ml and respectively. Significant statistical difference was observed regarding IL-22 and ACPA IgG levels among RA patients and control (P=0.038 and P=0.019 respectively). There is a significant positive relationship (positive correlation) detected between ACPA and IL-22 levels, (r=-0.810; p=0.597). The levels of IL-22 and ACPA were significantly associated with DAS 28. Their relationship was strong as the r value was 0.427 and 0.411 respectively. Conclusion: IL-22 and ACPA IgG levels were highly increased among RA patients in comparison to the control group. The IL-22 and ACPA IgG levels were strongly correlated with the rheumatoid disease activity, DAS 28. These results suggest that Il-22 can be used in association with ACPA IgG level as diagnostic and prognostic markers of rheumatoid arthritis

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INSULIN SENSITIVITY AND CARBOHYDRATE METABOLISM OF RATS WITH HYPOTHALAMIC OBESITY

Journal of Endocrinology ◽

10.1677/joe.0.0330437 ◽

1965 ◽

Vol 33 (3) ◽

pp. 437-446 ◽

Cited By ~ 11

Author(s):

JANET TUCKER ◽

J. TRETHEWEY ◽

G. A. STEWART ◽

R. W. J. NEVILLE ◽

T. HANLEY

Keyword(s):

Body Weight ◽

Adipose Tissue ◽

Blood Glucose ◽

Insulin Sensitivity ◽

Fasting Blood Glucose ◽

Diaphragm Muscle ◽

Fixed Dose ◽

Insulin Dosage ◽

Control Group ◽

Hypothalamic Obesity

SUMMARY A fixed dose of glucose, irrespective of body weight, used for i.v. glucose tolerance tests in rats with hypothalamic obesity and in non-obese control rats caused almost identical blood glucose increments in both kinds of rats, and the K values (coefficients of glucose assimilation) were not significantly different. Glucose doses proportional to body weight caused much larger increments of blood glucose in the obese animals but the K value was not significantly different from that for the controls. On the other hand, the insulin sensitivity of obese rats was found to be less than that of control rats when a fixed dose of the hormone was given. When the insulin dosage was proportional to body weight, the fall of fasting blood glucose produced in the obese animals was not significantly different from that in the control group. In vitro, the diaphragm muscle of the obese animals was insensitive to the action of insulin as compared with controls. There was no evidence of insulin insensitivity of the obese animals' adipose tissue; the very low metabolic activity of the adipose tissue of both the control and obese animals may have been responsible. The interpretation of these findings is discussed in the light of similar work in human obesity.

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Left ventricular myocardial strain assessed by cardiac magnetic resonance feature tracking in patients with rheumatoid arthritis

Insights into Imaging ◽

10.1186/s13244-020-00948-6 ◽

2021 ◽

Vol 12 (1) ◽

Author(s):

Wojciech Tański ◽

Paweł Gać ◽

Angelika Chachaj ◽

Grzegorz Mazur ◽

Rafał Poręba ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Cardiac Magnetic Resonance ◽

Magnetic Resonance ◽

Feature Tracking ◽

Myocardial Strain ◽

Radial Strain ◽

Left Ventricular ◽

Control Group ◽

Cyclic Citrullinated Peptide ◽

Citrullinated Peptide

Abstract Purpose The aim of the study was to assess a relationship between the occurrence of rheumatoid arthritis (RA) and its selected clinical parameters, and left ventricular myocardial strain. Material and methods Fifty-six subjects were qualified for the study: 30 RA patients and 26 subjects without rheumatoid diseases. The study design included taking medical history, assessment of the disease activity using selected scales of activity, collecting samples of venous blood to assess selected laboratory parameters and the assessment of cardiac magnetic resonance (CMR). Using the feature tracking method, the following parameters of the left ventricular myocardial strain were assessed: longitudinal strain (LS), radial strain (RS) and circumferential strain (CS). Results Regarding global values, peak LS and peak CS were statistically significantly lower in RA patients than in the control group. In the whole study group, the factors independently related to low global LS peaks were as follows: occurrence of RA, occurrence of arterial hypertension, increased activity of antibodies against cyclic citrullinated peptide and increased concentration of neutrophil gelatinase-associated lipocalin. The occurrence of RA, occurrence of diabetes, tobacco smoking, higher activity of antibodies against cyclic citrullinated peptide and current use of methotrexate are the risk factors for low peak of global CS. The current use of steroids constitutes a protecting factor against low global CS peaks. Conclusion In subjects with no clinically manifested cardiac damage, RA is associated with a deteriorated left ventricular systolic function assessed by left ventricular myocardial strain measured by CMR feature tracking.

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Supplementation of Non-Dairy Creamer-Enriched High-Fat Diet with D-Allulose Ameliorated Blood Glucose and Body Fat Accumulation in C57BL/6J Mice

Applied Sciences ◽

10.3390/app9132750 ◽

2019 ◽

Vol 9 (13) ◽

pp. 2750 ◽

Cited By ~ 1

Author(s):

Ga Young Do ◽

Eun-Young Kwon ◽

Yun Jin Kim ◽

Youngji Han ◽

Seong-Bo Kim ◽

...

Keyword(s):

Adipose Tissue ◽

Lipid Metabolism ◽

Blood Glucose ◽

Body Fat ◽

High Fat Diet ◽

Fasting Blood Glucose ◽

Control Group ◽

High Fat ◽

Food Component ◽

Fat Accumulation

D-allulose, which has 70% of the sweet taste of sucrose but nearly no calories, has been reported to inhibit the absorption of lipids and suppress body weight gain in obese mice. Fats in non-dairy creamer consist of highly saturated fatty acids, which can cause various lipid disorders when consumed over a long period. We investigated whether D-allulose supplementation alleviates the effects of a non-dairy creamer-enriched high-fat diet on lipid metabolism. High-fat diets enriched with non-dairy creamer were administered to C57BL/6J mice with or without D-allulose supplementation for eight weeks by the pair-feeding design. Lipid metabolic markers were compared between the non-dairy creamer control group (NDC) and non-dairy creamer allulose group (NDCA). Body, adipose tissue, and liver weights, and fasting blood glucose levels, were significantly lower in the NDCA group than in the NDC group. Fecal fatty acid and triglyceride levels were significantly higher in the NDCA group than in the NDC group. Supplementing a non-dairy creamer-enriched high-fat diet with D-allulose improved overall lipid metabolism, including the plasma and hepatic lipid profiles, hepatic and adipose tissue morphology, and plasma inflammatory adipokine levels in mice. These results suggest that D-allulose can be used as a functional food component for preventing body fat accumulation from a high-fat diet that includes hydrogenated plant fats.

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AB0178 COMORBIDITIES IN RHEUMATOID ARTHRITIS: DO THEY INTERFERE WITH MYOCARDIAL FUNCTION?

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.3650 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 1114.3-1115

Author(s):

R. Dhahri ◽

W. Lahmar ◽

Y. Ben Abderrazek ◽

M. Slouma ◽

B. Louzir ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Diabetes Mellitus ◽

Longitudinal Strain ◽

Myocardial Dysfunction ◽

Global Longitudinal Strain ◽

Left Ventricular ◽

Control Group ◽

Healthy Controls ◽

Increased Risk ◽

History Of

Background:Patients with rheumatoid arthritis are at increased risk for cardiovascular disease (CVD).The early myocardial dysfunction in RA patients may be detectable sooner using speckle-tracking echocariodgraphy to evaluate ventricular strain especially the global longitudinal strain (GLS), this has provided more comprehensive information on ventricular dysfunction in these patients.Objectives:In the present study, we evaluated comorbidities that interfered the most with the GLS in rheumatoid arthritis patients.Methods:The study population was comprised of a case group (36 patients with rheumatoid arthritis with no history of CVD and normal LVEF in the outpatient population of the Rheumatology department in the military hospital of Tunis) and a matched control group (individuals without a history of rheumatoid arthritis or cardiac abnormalities referred for clinical check-ups). In both groups, 2D and 3D echocardiographic examinations were performed by a single cardiologist to assess cardiac functional parameters.Results:Anemia (36%) was found to be the most common comorbidity followed by diabetes mellitus (25%), arterial hypertension (17%) and dyslipidemia (17%).Myocardial deformation study revealed that rheumatoid arthritis patients had a significantly worse global longitudinal strain than healthy controls (18.99±2.81% vs 20.42±1.33%; P=.015). Moreover, a third of the rheumatoid arthritis patients (and no healthy controls) exhibited subclinical left ventricular systolic dysfunction (GLS<18%).Anemia (r=−0.368, P=.027), Age (r=−0.365, P=.029), Diabetes mellitus (r=−0.540, P=.001) and E/A (r=0.351, P=.036) were significantly correlated with GLS in our univariate study. Receiver operating characteristic curve analysis revealed hemoglobin as the best predictor for subclinical LVSD (AUC=0.752, 95% CI: 0.577-0.927, P=.02) when compared to Age and E/A.Conclusion:This prospective comparative study highlighted the diabetes mellitus and anemia burden on myocardial dysfunction in RA patients.Disclosure of Interests:None declared

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