INFLUENCE OF RENAL DYSFUNCTION ON THE LEVEL OF SERUM ANGIOPOIETIN-LIKE PROTEINS AND ANTI-PHOSPHOLIPID ANTIBODIES IN PATIENTS WITH RHEUMATOID ARTHRITIS AND METABOLIC SYNDROME

Rheumatoid arthritis (RA) is a frequent background for the development of renal pathology. Chronic kidney disease (CKD) is determined in more than 30% of patients with RA. Along with inflammation and other factors in the progression of the underlying disease, the development of renal damage in RA is facilitated by the presence of metabolic syndrome (MetS).The aim of this study is to assess the relationship of serum concentrations of angiopoietin-like proteins (ANGPTL) and antiphospholipid antibodies (aPL) with the development of renal dysfunction in patients with RA.We examined 158 patients with RA (91.8% – women and 8.2% – men) aged 21 to 80 years old and an average duration of the disease – 9 (4-15) years. The majority of patients were seropositive for rheumatoid factor and for antibodies to cyclic citrullinated peptide, with an advanced clinical stage and moderate activity (3.2 < DAS28 ≤ 5.1) of the pathological process.The ELISA test was used for the quantitative determination of angiopoietin-like protein type 3 and type 4 and antibodies to phospholipids (aРL-IgG/IgM) for total detection of antibodies to cardiolipin, phosphatidylserine, phosphatidylinositol, phosphatidylic acid and a complex of negatively charged phospholipid and β2-glycoprotein-I.More than half of the examined RA patients had the calculated glomerular filtration rate (eGFR) ranging from 89 to 60 ml/min/1.73 m2 (allocation by CKD stages: C1 – 21.5%; C2 – 58.9%; C3 – 19.6%). Signs of MetS (a combination of increased blood pressure, increased triglyceride levels and carbohydrate metabolism disorders against the background of central obesity) were diagnosed in 68 (43%) RA patients. Multivariable analysis of variance was performed to compare the studied parameters (ANGPTL3, ANGPTL4, aPL) depending on eGFR in groups of RA patients without signs of metabolic syndrome and RA patients with MetS. Significant differences in the level of ANGPTL3 (F = 8.86, p = 0.0034) and ANGPTL4 (F = 29.6, p < 0.001), but not aPL (p > 0,05) were found between RA patients with varying degrees of severity of metabolic disorders.Multivariable analysis of variance showed a significant increase in ANGPTL4 in the blood serum of RA patients with reduced eGFR (< 89 ml/min) (F = 18.5, p < 0.001) and pronounced metabolic changes (F = 24.2, p < 0.001). Thus, only two factors (renal dysfunction and the presence of MetS) had a direct effect on the ANGPTL4 content in RA patients, which could describe the variability of this sign in more than 30% of cases. The squared multiple correlation coefficient (R2 ) in this model was 0.33. ANGPTL type 4 should be considered as a key factor linking the development of renal dysfunction and metabolic changes caused by rheumatoid inflammation.

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POS0546 RENAL DYSFUNCTION AND METABOLIC CHANGES IN PATIENTS WITH RHEUMATOID ARTHRITIS ARE ASSOCIATED WITH ANGIOPOIETIN-LIKE PROTEIN TYPE 4

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.2657 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 507.2-508

Author(s):

V. Aleksandrov ◽

A. Aleksandrov

Keyword(s):

Rheumatoid Arthritis ◽

Renal Function ◽

Multivariate Analysis ◽

Renal Dysfunction ◽

Analysis Of Variance ◽

Metabolic Disorders ◽

Significant Proportion ◽

Metabolic Changes ◽

Moderate Activity ◽

Multivariate Analysis Of Variance

Background:Along with chronic inflammation, the development of renal damage in rheumatoid arthritis (RA) is promoted by the presence of metabolic syndrome (MS), which may be an independent risk factor for the progression of chronic kidney disease.Objectives:To establish a correlation between serum angiopoietin-like protein type 4 (ANGPTL4) and the presence of renal dysfunction and metabolic disorders in RA patients.Methods:We examined 158 patients with RA (91.8% - women and 8.2% - men) aged 21 to 80 years old with an average duration of the disease - 9 [4; 15] years. The majority of patients were seropositive for RF-IgM (57.6%) and for anti-citrullinated protein antibody (ACPA) (60.1%), with an advanced clinical stage (45.6%) and moderate activity (3.2 <DAS28 ≤ 5.1) of the pathological process (58.2%).The laboratory examination included the determination of serum concentrations of angiopoietin-like protein type 3 (Human Angiopoietin-like Protein 3 ELISA, Bio Vendor, Czech Republic) and type 4 (RayBio Human ANGPTL4 ELISA Kit; RayBiotech, USA).To assess renal function in RA patients, the estimated glomerular filtration rate (GFR) was used according to the 2009 CKD-EPI formula. On the basis of GFR measurements, the patients were divided into three groups: I - optimal renal function (> 90 ml / min); II - a slight decrease in renal function (89-60 ml / min); III - reduced renal function (<59 ml / min).A combination of the increased blood pressure (≥140 / 90 mmHg), the increased triglyceride levels (≥1.7 mmol / L), and the impaired carbohydrate metabolism (increased fasting plasma glucose ≥6.1 mmol / L) with a background of central obesity (waist circumference> 94 cm in men and> 80 cm in women) served as the basis for inclusion into the group of RA patients with signs of MS.Results:A multivariate analysis of variance was performed comparing ANGPTL indices depending on GFR in the groups of RA patients without signs of MS and RA patients with MS. It was revealed that there are significant differences in the level of both ANGPTL3 (F = 8.86, p = 0.0034) and ANGPTL4 (F = 29.6, p <0.001) between RA patients with varying severity of metabolic disorders.The study of the influence of several factors (MS and renal dysfunction) on the content of ANGPTL in RA patients showed that the presence of metabolic disorders had an insignificant effect on the parameters of ANGPTL3 in the groups of patients with optimal and slightly reduced GFR, acquiring significance only with a more intense decrease in GFR (<59 ml / min / 1.73 m2). These factors and their interactions explain the insignificant share of the variability in ANGPTL3 (R2 = 0.11), which indicates a low quality of the model.There was a more pronounced difference in the level of ANGPTL4 in the presence of metabolic disorders in the groups of RA patients with varying degrees of renal dysfunction. The factors under consideration and their interactions do not make this model significant (p = 0.1), although they can explain a significant proportion of the variability in ANGPTL4 (R2 = 0.32).We differentiated RA patients into patients with high or optimal GFR (≥89 ml / min) and patients with reduced GFR (<89 ml / min) when combining groups of RA patients with varying degrees of renal dysfunction (group II and group III). Multivariate analysis of variance using the new characteristics showed a significant increase in ANGPTL 4 in the blood serum of RA patients with reduced GFR (F = 18.5, p <0.001) and severe metabolic changes (F = 24.2, p <0.001).Thus, the concentration of ANGPTL4 in RA patients is directly influenced by two factors (renal dysfunction and the presence of MS), which can describe the variability of this sign in more than 30% of cases. The squared multiple correlation coefficient (R2) in this model is 0.33.Conclusion:ANGPTL type 4 should be considered as a key factor linking the development of the renal dysfunction in RA patients and the metabolic changes caused by rheumatoid inflammation.Disclosure of Interests:None declared

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POS0040 THE DECREASE IN BONE MINERAL DENSITY DEPENDS ON THE CONCENTRATIONS OF ANGIOPOIETIN-LIKE PROTEIN TYPE 4 IN PATIENTS WITH RHEUMATOID ARTHRITIS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.2266 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 225.1-225

Author(s):

V. Aleksandrov ◽

L. Shilova ◽

A. Aleksandrov ◽

G. Osmanova ◽

N. Aleksandrova ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Bone Mineral Density ◽

Bone Mineral ◽

Negative Correlation ◽

Fibroblast Growth Factor 23 ◽

Clinical Stage ◽

Test System ◽

Moderate Activity ◽

Mineral Density ◽

Advanced Clinical Stage

Background:New serological markers that can serve as objective indicators of osteoporotic changes in patients with rheumatoid arthritis (RA) are being currently searched [1, 2, 3, 4, 5].Objectives:To reveal the connection between the concentrations of serum angiopoietin-like protein type 4 (ANGPTL4) and the decrease in bone mineral density (BMD) in patients with RA.Methods:114 patients with reliable RA (90.4% of women, 9.6% of men) aged 21 to 80 years (mean age 55.4 ± 11.2 years old, disease duration - 11.18 ± 9.03 years, positive for rheumatoid factor (RF-IgM) - 63.2%, positive for anti-citrullinated protein antibody (ACPA) - 59.7%) were examined using a bone X-ray densitometer LUNAR DPX (GE, USA). Patients with an advanced clinical stage - 49%, moderate activity according to DAS28 - 58.8%, II-III radiological stage - 85.1% and functional class II - 64.9% prevailed. ANGPTL4 measurement in blood serum was carried out by enzyme immunoassay using a commercial test system “RayBio Human ANGPTL4 ELISA Kit” (RayBiotech, USA). ESR, RF, as well as C-reactive protein (CRP), ACPA, and antibodies to modified vimentin (anti-MCV) in an ELISA test were determined in all RA patients.Results:ANGPTL4 indices in RA patients correlated with the CRP level (r = 0.34, p = 0.001) and the DAS-28 (r = 0.29, p = 0.002). There was no correlation between the level of ANGPTL4 and the intake of glucocorticoids, both at the time of the study (p = 0.678) and with their long-term (more than 3 months) use (p = 0.097). There was a negative correlation of weak strength between ANGPTL4 and the dose of non-steroidal anti-inflammatory drugs (r = -0.21, p = 0.035). There was no correlation between ACPA, anti-MCV, and ANGPTL4 levels (p> 0.1 and p = 0.084). A direct correlation was found between the level of ANGPTL4 and the presence of osteopenia in RA patients (r = 0.43, p = 0.036), as well as a negative correlation between ANGPTL4 and bone mineral density in the spine (BMD L1-4, r = -0.631, p <0.001), but not in the femur (p> 0.05). Densitometry data also allowed to establish a negative correlation between low values of the T-criterion and increased titers of anti-MCV (r = -0.51, p = 0.029), but not ACPA (p = 0.276). It has previously been noted that anti-MCV are able to activate osteoclasts with a consequent decrease in periarticular BMD.Conclusion:The absence of a relationship between anti-MCV and the level of ANGPTL4 may indicate different mechanisms of osteoporosis development and localization of osteoporotic changes in groups of anti-MCV or ANGPTL4 positive patients with RA.References:[1]Ramli FF, Chin KY. A Review of the Potential Application of Osteocyte-Related Biomarkers, Fibroblast Growth Factor-23, Sclerostin, and Dickkopf-1 in Predicting Osteoporosis and Fractures. Diagnostics (Basel). 2020;10(3):145. doi: 10.3390/diagnostics10030145[2]Aleksandrov V., Aleksandrov A. Angiopoetin-like protein type 3 as an indicator of rheumatoid inflammation and resorption of bone tissue in rheumatoid arthritis. Ann Rheum Dis. 2020;79(s1):1340. doi: 10.1136/annrheumdis-2020-eular.2174[3]Nagy EE, Nagy-Finna C, Popoviciu H, Kovács B. Soluble Biomarkers of Osteoporosis and Osteoarthritis, from Pathway Mapping to Clinical Trials: An Update. Clin Interv Aging. 2020;15:501-518. doi: 10.2147/CIA.S242288[4]Aleksandrov A.V., Alekhina I.Y., Aleksandrova N.V., Shilova L.N., Aleksandrov V.A. High antibody titers to cyclic citrullinated vimentin promote the development of periarticular osteoporosis in patients with rheumatoid arthritis. Osteoporosis International. 2019; 30(s2):680.[5]Donati S, Ciuffi S, Palmini G, Brandi ML. Circulating miRNAs: A New Opportunity in Bone Fragility. Biomolecules. 2020;10(6):927. doi: 10.3390/biom10060927Disclosure of Interests:None declared.

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THE ROLE OF ANGIOPOIETIN-LIKE PROTEINS IN THE DEVELOPMENT OF RENAL DYSFUNCTION IN PATIENTS WITH RHEUMATOID ARTHRITIS AND METABOLIC CHANGES

Journal of Volgograd State Medical University ◽

10.19163/1994-9480-2020-4(76)-37-41 ◽

2020 ◽

Vol 76 (4) ◽

pp. 37-41

Author(s):

V.A. Aleksandrov ◽

◽

L.N. Shilova ◽

A.V. Aleksandrov ◽

◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Renal Dysfunction ◽

Estimated Glomerular Filtration Rate ◽

Average Duration ◽

Metabolic Changes ◽

Average Strength ◽

Two Factors ◽

Key Factor ◽

The Relationship

The article is devoted to the assessment of the relationship between the serum concentrations of angiopoietin-like proteins of types 3 and 4 (ANGPTL 3 and 4) and the development of renal dysfunction in patients with rheumatoid arthritis (RA) with metabolic changes. We examined 158 patients with RA (91,8 % – women and 8,2 % – men) aged 21 to 80 years old with the average duration of diseases – 9 [4–15] years. Negative correlations of average strength between the indices of the estimated glomerular filtration rate (eGFR) according to the 2009 CKD-EPI formula and the level of ANGPTL 3 (r = –0,32, p < 0,001) and ANGPTL 4 (rS = –0,31, p < 0,001) were revealed. It was found that renal dysfunction and the presence of metabolic syndrome (R 2 = 0,33) are the two factors which have a direct effect on the ANGPTL 4 concentration in RA patients’ serum. ANGPTL type 4 should be considered as a key factor linking the development of renal dysfunction and metabolic changes caused by rheumatoid inflammation

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Cardiovascular risk factors and not disease activity, severity or therapy associate with renal dysfunction in patients with rheumatoid arthritis: Table 1

Annals of the Rheumatic Diseases ◽

10.1136/ard.2008.105049 ◽

2009 ◽

Vol 69 (3) ◽

pp. 517-521 ◽

Cited By ~ 27

Author(s):

D Daoussis ◽

V F Panoulas ◽

I Antonopoulos ◽

H John ◽

T E Toms ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Risk Factors ◽

Uric Acid ◽

Cardiovascular Risk ◽

Disease Activity ◽

Cardiovascular Risk Factors ◽

Renal Dysfunction ◽

Multivariable Analysis ◽

Related Factors ◽

Spearman Test

ObjectivesThe present study aimed to evaluate the prevalence and associations of renal dysfunction in patients with rheumatoid arthritis (RA). It specifically addressed the hypotheses that renal dysfunction in these patients may associate with the presence of insulin resistance, dyslipidaemia, uric acid levels and/or current levels of systemic inflammation.MethodsRenal function was assessed by estimated glomerular filtration rate (GFR) using the modification of diet in renal disease equation in 400 consecutive RA patients for this cross-sectional, single-centre study. Risk factors for renal dysfunction were recorded/measured in all participants. Correlations between GFR and other variables were analysed by Pearson or Spearman test as appropriate. Linear regression was used to test the independence of the associations between GFR and other variables.ResultsIn this RA patient cohort, 67.75% of patients had a reduced GFR of less than 90 ml/minute per 1.73 m2 and 12.75% had a GFR of less than 60 ml/minute per 1.73 m2. Multivariable analysis revealed significant associations between GFR and age (β = −0.370, p<0.001), female sex (β = −0.181, p=0.002), total cholesterol (β = −0.112, p=0.022), serum uric acid (SUA) (β = −0.425, p<0.001) and the presence of extra-articular disease, apart from sicca and/or nodules (β = −0.084, p=0.040).ConclusionsRenal dysfunction in RA is quite common and associates with classic cardiovascular risk factors such as advanced age and dyslipidaemia, levels of SUA and the presence of extra-articular disease. Renal dysfunction was not related to other RA-related factors including disease activity and duration, disability and past or present use of nephrotoxic medications.

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IMBALAN DAN GAYA KEPEMIMPINAN PENGARUHNYA TERHADAP KEPUASAN KERJA KARYAWAN DI BALAI BESAR INDUSTRI HASIL PERTANIAN BOGOR

Jurnal Ilmiah Binaniaga ◽

10.33062/jib.v1i01.146 ◽

2018 ◽

Vol 1 (01) ◽

pp. 17

Author(s):

Ramlan Ruvendi

Keyword(s):

Job Satisfaction ◽

Multiple Regression ◽

Correlation Coefficient ◽

Analysis Of Variance ◽

Partial Correlation ◽

Multiple Correlation Coefficient ◽

Multiple Correlation ◽

Average Value ◽

Partial Correlation Coefficient

The study was carried out to find out whether there were influence and correlation bet-ween : a) Reward received by the IRDABI’s employees on their job satisfaction. b) style of the leader-ship on the job satisfaction. c) Reward together with style of leadership on the job satisfaction of IR-DABI’s employees.The result of the study showed that there was significant correlation and influence between the reward on the job satisfaction with was shown by the value of partial correlation coefficient of 0.6185 and coefficient of multiple regression for reward variable (β1) of 0.412. The influence of variable for style of leadership on the job satisfaction was also significant with the partial correlation coefficient of 0.5495 and coefficient of multiple regression (β2) of 0.355.In the test of Analysis of Variance (ANOVA) on the equation of multiple regression show that F-value was bigger that F-table (F = 58.97 > F-table = 3.098) or the Probability Value smaller than 0.05. At showed that there was significant correlation and influence between reward variables all together with style of leadership on the job satisfaction of employees. The value of multiple correlation coefficient (R) was 0.751 and R Square (R2) was 0.564. Value of R Square (0.564) meant that 56.5% of variation pro-portion total of job satisfaction can be eliminated of equation of multiple regression was used as the es-timator rather than using average value of job satisfaction as the estimator.

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POS0581 PERIODONTAL DISEASE IN RHEUMATOID ARTHRITIS: RESULTS FROM A COHORT AT TREATMENT WITH BIOLOGICAL, CLASSICAL AND TARGETED SYNTHETIC DMARDs

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.3970 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 524.1-524

Author(s):

R. Dos-Santos ◽

F. Otero ◽

E. Perez-Pampín ◽

A. Mera Varela

Keyword(s):

Rheumatoid Arthritis ◽

Oral Health ◽

Periodontal Disease ◽

Disease Activity ◽

Health Problem ◽

Multivariable Analysis ◽

Testing Time ◽

Univariable Analysis ◽

Clinical Attachment Loss ◽

Attachment Loss

Background:Periodontal disease (PD) has been widely studied in the pathogenesis of rheumatoid arthritis (RA). As well, its relationship with severity and disease activity, has also been investigated with ambiguous results. It has been suggested that the improvement of oral health could enhance disease activity scores.1 PD prevalence worldwide stands around 60% in older adults (>65 years) and its frequency increases with aging.2Objectives:To asses oral health in RA patients and to identify predictors of PD in this population.Methods:Patients diagnosed of RA at treatment with biological, classical or targeted synthetic disease modifying anti-rheumatic drugs (b/cs/tsDMARDs) in the aforementioned hospital during 2020 performed a dental review with a specialized periodontal odontologist. Oral health patterns were given for all patients, following criteria of American Academy of Periodontology, and reevaluation of disease activity was made 2 months later.Clinical, demographic and treatment data were collected from participants.Univariable logistic regression was performed to identify predictors of PD. Variables with p<0.20 were selected for multivariable analysis.Stata 15.1 was used to perform statistical analysis.Results:81 patients were recruited. 82.72% were female. Mean age was 56.17 years (SD 14.15) and mean time since diagnosis was 15.58 years (SD 8.17). 25% were current or past smokers. 21 patients had comorbidities (arterial hypertension the most frequent). 66.67% were rheumatoid factor (RF) positive and 72.73% anti-citrullinated peptide autoantibody (ACPA) positive. Median erythrocyte sedimentation rate (ESR) was 12 mm (IQR 6;23) and mean C-reactive protein (CRP) was 0.48 mg/dl (SD 1.18). Mean disease activity score (DAS28-VSG) at the testing time was 2.62 (SD 1.21) and after 2 months was 2.39 (SD 0.97). 96.30% of patients were at treatment with csDMARDs, 64.20% with glucocorticoids, 96.30% with bDMARDs and 6 patients with tsDMARDs.Univariable analysis identified higher age, at least one autoantibody positive and ESR/CRP as potential predictors of medium/severe PD (p<0.20). Multivariable testing including these variables pointed out higher age, lower ESR and at least one autoantibody positive (OR 1.09 [CI95% 1.04-1.14] p=0.001, OR 0.18 [CI95% 0.04-0.95] p=0.044 and OR 0.94 [CI95% 0.88-1.00] p=0.042, respectively) as predictors of medium or severe PD (≥3 mm interdental clinical attachment loss).Univariable analysis identified higher age, the presence of any comorbidity and anti tumour-necrosis factor alpha treatment (anti-TNF) as potential predictors of severe PD (p<0.20). Multivariable testing including these variables pointed out higher age (OR 1.15 [CI95%1.02-1.30] p=0.026) as predictor of severe PD (≥5 mm interdental clinical attachment loss).Conclusion:Periodontal disease is still an extended health problem among the entire population. Its prevalence in RA is increased, therefore higher age and RF or ACPA positive are risk factors for developing severe PD. This analysis might suggest that an aggressive management of PD could implement better responses in DAS28. Also anti-TNF treatment could delimit a “penumbra” group of patients at risk of developing severe PD, where intensive manage could modify the final outcome.References:[1]C O Bingham, M Moni. Periodontal disease and rheumatoid arthritis: the evidence accumulates for complex pathobiologic interactions. Curr Opin Rheumatol. 2013;25(3):345-353.[2]P Carvajal. Periodontal disease as a public health problem: the challenge for primary health care. Rev Clin Periodoncia inplantol. 2016;9(2):177-183.Disclosure of Interests:None declared

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Rind from Purple Mangosteen (Garcinia mangostana) Attenuates Diet-Induced Physiological and Metabolic Changes in Obese Rats

Nutrients ◽

10.3390/nu13020319 ◽

2021 ◽

Vol 13 (2) ◽

pp. 319

Author(s):

Oliver D. John ◽

Peter Mouatt ◽

Sunil K. Panchal ◽

Lindsay Brown

Keyword(s):

Metabolic Syndrome ◽

Inflammatory Cells ◽

Left Ventricular ◽

Metabolic Changes ◽

Abdominal Circumference ◽

Whole Body ◽

Garcinia Mangostana ◽

Tropical Fruit ◽

Cardiovascular Parameters ◽

Left Ventricular Stiffness

The pulp of the purple mangosteen, Garcinia mangostana, is a popular tropical fruit but the rind containing xanthones such as α-mangostin together with procyanidins and anthocyanidins is usually discarded as waste. However, this rind has been used in South-East Asia for diarrhoea, dysentery, skin infections and wounds. As xanthones have reported anti-inflammatory and antioxidant responses, this study has determined the bioactive compounds and evaluated the effects of G. mangostana rind on physiological, metabolic, liver and cardiovascular parameters in rats with diet-induced metabolic syndrome. Rats fed a diet with increased simple sugars and saturated fats developed obesity, hypertension, increased left ventricular stiffness, dyslipidaemia and fatty liver. Administration of G. mangostana rind as 5% of the food to rats with diet-induced metabolic syndrome gave a dose of 168 mg/kg/day α-mangostin, 355 mg/kg/day procyanidins, 3.9 mg/kg/day anthocyanins and 11.8 mg/kg/day hydroxycitric acid for 8 weeks which reduced body weight and attenuated physiological and metabolic changes in rats including decreased abdominal fat deposition, decreased abdominal circumference and whole-body fat mass, improved liver structure and function and improved cardiovascular parameters such as systolic blood pressure, left ventricular stiffness and endothelial function. These responses were associated with decreased infiltration of inflammatory cells, decreased deposition of collagen in both heart and liver and decreased mean adipocyte size in retroperitoneal adipose tissues. We conclude that, in rats with diet-induced metabolic syndrome, chronic intake of G. mangostana rind decreased infiltration of inflammatory cells which decreased physiological, metabolic, liver and cardiovascular symptoms.

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AB0143 THE EFFECT OF RHEUMATOID ARTHRITIS AND SPONDILOARTHRITIS ON PREGNANCY: A LONGITUDINAL RETROSPECTIVE COHORT STUDY

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.3486 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 1099.1-1099

Author(s):

F. Pistillo ◽

A. La Rosa ◽

P. De Sandre ◽

E. Fracassi ◽

G. Scanelli ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Disease Activity ◽

Pregnancy Outcome ◽

Congenital Malformation ◽

Drug Exposure ◽

Neonatal Outcome ◽

Demographic Data ◽

Moderate Activity ◽

Moderate Disease ◽

Rheumatology Unit

Background:Many patients with rheumatoid arthritis (RA) and spondyloarthritis (SpA) are in their childbearing years. Concerns exist regarding the interplay between the rheumatic diseases and the pregnancy (1).Objectives:Actually, there are contradictory data regarding the pregnancy outcome in patients with RA and SpA (2). Thus, we performed this longitudinal retrospective study to evaluate the effect of RA and SpA on pregnancy outcome.Methods:The data of 78 pregnancies of 60 women followed from April 2017 to December 2020 at pregnancy clinic of Internal Medicine Unit, San Bortolo Hospital, Vicenza and Rheumatology Unit, University of Verona were reviewed. Fifty (64.1%) women were affected by RA and 28 (35.9%) by SpA. Information regarding demographic data, disease activity, drug exposure and maternal/foetal outcomes were collected in an electronic database. Details concerning pregnancy complications and congenital malformation were also collected. We compared pregnancy and foetal/neonatal outcome, medication use and disease activity between women affected by RA and SpA. Moreover, we evaluated the effect of disease activity on pregnancy outcome.Results:Overall, there were 70 (86.4%) live births, 10 (12.3%) miscarriages and 1 (1.2%) foetal death. There were three twin pregnancies. Even there was a higher rate of glucocorticoids and bDMARDs use in RA than in SpA group, respectively 40% vs 21% and 70% vs 57,1%, there were no statistical differences regarding drug exposure at conception. Moreover, there were no differences concerning disease activity at conception. Still, a higher rate of glucocorticoids and bDMARDs, respectively 26% vs 10.7% and 46% vs 39.3% were used in RA than in SpA patients during pregnancy. Furthermore, we did not find any statistical differences regarding maternal and foetal/neonatal outcome between pregnancies in the RA and those in the SpA groups. There were four (4.9%), congenital malformation, two (3.8%) in RA group and two (6.9%) in SpA group. About one-third of patients 24 (30.7%) presented a moderate disease activity at conception as evaluated by DAS28PCR and BASDAI. However, there were no significant differences, on maternal and foetal/neonatal outcome in patients with moderate activity disease with respect of those in clinical remission.Conclusion:Even a higher rate of glucocorticoids and bDMARDs were used in RA than in SpA patients, there was no differences on pregnancy outcome between them.References:[1]Ostensen M. Nat Rev Rheumatol. 2017;13:485-493. doi: 10.1038/nrrheum.2017.102.[2]Polachek et al. J Rheumatol 2020;47:161-163. doi: 10.3899/jrheum.190631.Disclosure of Interests:None declared

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Adiponectin Associates with Rheumatoid Arthritis Risk in Overweight and Obesity Independently of Other Adipokines

Journal of Clinical Medicine ◽

10.3390/jcm10132791 ◽

2021 ◽

Vol 10 (13) ◽

pp. 2791

Author(s):

Yuan Zhang ◽

Linda Johansson ◽

Johanna Andersson-Assarsson ◽

Magdalena Taube ◽

Markku Peltonen ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Multivariable Analysis ◽

Overweight And Obesity ◽

Northern Sweden ◽

Case Control Studies ◽

Rheumatoid Arthritis Risk ◽

Increased Risk ◽

Obese Subjects ◽

Nested Case Control

We recently reported that increased serum adiponectin was associated with rheumatoid arthritis (RA) risk in subjects with obesity. We hereby aim to determine if other adipokines associate with RA risk and if the association between adiponectin and RA is independent of other adipokines. Two nested-case control studies were performed in two different cohorts: 82 participants of the Swedish Obese Subjects (SOS) study who developed RA during follow-up matched with 410 controls, and 88 matched pairs from the Medical Biobank of Northern Sweden. Baseline levels of circulating adipokines were measured using ELISA. In a multivariable analysis in the SOS cohort, higher adiponectin was associated with an increased risk of RA independently of other adipokines (OR for RA risk: 1.06, 95% CI: 1.01–1.12, p = 0.02). No association between leptin, resistin, and visfatin levels and the risk of RA was detected. In the cohort from the Medical Biobank of Northern Sweden, higher adiponectin was associated with an increased risk of RA only in participants with overweight/obesity (OR: 1.17, 95% CI: 1.01−1.36, p = 0.03), independently of other adipokines. Our results show that in individuals with overweight/obesity, higher circulating levels of adiponectin, but not leptin, resistin, or visfatin, were associated with an increased RA risk.

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Preoperative clinical and tumor genomic features associated with pathologic lymph node metastasis in clinical stage I and II lung adenocarcinoma

npj Precision Oncology ◽

10.1038/s41698-021-00210-2 ◽

2021 ◽

Vol 5 (1) ◽

Author(s):

Raul Caso ◽

James G. Connolly ◽

Jian Zhou ◽

Kay See Tan ◽

James J. Choi ◽

...

Keyword(s):

Lung Adenocarcinoma ◽

Clinical Stage ◽

Multivariable Analysis ◽

Multivariable Logistic Regression Model ◽

Genomic Features ◽

Genome Doubling ◽

Whole Genome Doubling ◽

Metastatic Lung ◽

Treatment Naïve ◽

Patients At Risk

AbstractWhile next-generation sequencing (NGS) is used to guide therapy in patients with metastatic lung adenocarcinoma (LUAD), use of NGS to determine pathologic LN metastasis prior to surgery has not been assessed. To bridge this knowledge gap, we performed NGS using MSK-IMPACT in 426 treatment-naive patients with clinical N2-negative LUAD. A multivariable logistic regression model that considered preoperative clinical and genomic variables was constructed. Most patients had cN0 disease (85%) with pN0, pN1, and pN2 rates of 80%, 11%, and 9%, respectively. Genes altered at higher rates in pN-positive than in pN-negative tumors were STK11 (p = 0.024), SMARCA4 (p = 0.006), and SMAD4 (p = 0.011). Fraction of genome altered (p = 0.037), copy number amplifications (p = 0.001), and whole-genome doubling (p = 0.028) were higher in pN-positive tumors. Multivariable analysis revealed solid tumor morphology, tumor SUVmax, clinical stage, SMARCA4 and SMAD4 alterations were independently associated with pathologic LN metastasis. Incorporation of clinical and tumor genomic features can identify patients at risk of pathologic LN metastasis; this may guide therapy decisions before surgical resection.

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