scholarly journals Osteoprotegerin And MTHFR Gene Variations In Rheumatoid Arthritis: Association With Disease Susceptibility And Markers of Subclinical Atherosclerosis

2021 ◽  
Author(s):  
Aikaterini Arida ◽  
Adrianos Nezos ◽  
Ioanna Papadaki ◽  
Petros P. Sfikakis ◽  
Clio P. Mavragani
Keyword(s):  
Rheumatoid Arthritis ◽  
Methylenetetrahydrofolate Reductase ◽  
Clinical Laboratory ◽  
Subclinical Atherosclerosis ◽  
Intima Media Thickness ◽  
Mthfr Gene ◽  
High Serum ◽  
Plaque Formation ◽  
Carotid Imt ◽  
Traditional Risk Factors

Abstract Objective: To explore whether the osteoprotegerin (OPG) rs2073618 gene variant and the methylenetetrahydrofolate reductase (MTHFR) rs1801131 and rs1801133 polymorphisms contribute to rheumatoid arthritis (RA) susceptibility and RA related subclinical atherosclerosis.Methods: 283 RA patients and 595 healthy controls (HC) were genotyped for OPG and MTHFR gene variants using PCR based assays. Clinical, laboratory parameters and markers of subclinical atherosclerosis (Carotid/Femoral intima media thickness/plaque formation) along with traditional risk factors for atherosclerosis were assessed in RA patients and 280HC.Results: Increased prevalence of the rs2073618CC genotype was detected in RA patients vs HC (p=0.04), especially in RA patients with high serum titers of rheumatoid factor (RF) or anti-cyclic citrullinated peptide (anti-CCP) antibodies compared to HC (p-values:0.0029 and 0.0077, respectively). This genotype was also associated with higher carotid-IMT scores (p=0.01) and marginally with higher rates of carotid plaque formation (p=0.06). MTHFR 1298CC genotype was more prevalent in the anti-CCP positive group compared to HC, with no associations detected with markers of subclinical atherosclerosis. Reduced rates of carotid/femoral plaque formation were detected among RA patients harboring the MTHFR 677TT genotype (p=0.009).Conclusion: OPG and MTHFR gene variations seem to increase susceptibility for seropositive RA and potentially contribute to subclinical atherosclerosis linked to RA.

scholarly journals AB0186 AT WHAT LEVEL SHOULD WE MEASURE INTIMA-MEDIA THICKNESS IN RHEUMATOID ARTHRITIS?

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1117.3-1118
Author(s):  
L. Nacef ◽  
H. Ferjani ◽  
H. Riahi ◽  
K. Maatallah ◽  
Y. Mabrouk ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Internal Carotid ◽  
Subclinical Atherosclerosis ◽  
Intima Media Thickness ◽  
University Hospital ◽  
External Carotid ◽  
Media Thickness ◽  
The Mean ◽  
The Right ◽  
Score Index

Background:Rheumatoid arthritis (RA) is chronic inflammatory rheumatism characterized by an independent cardiovascular (CV) risk. The screening of carotid intima-media thickness (IMT) in the common carotid artery appears to be a marker of atherosclerosis and is used as a specific tool for CV risk assessment.Objectives:The main of this study was to determine the most associated US sites with CV risk in RA.Methods:The present study is a prospective study conducted on Tunisian RA patients in rheumatology department of Mohamed Kassab University Hospital (March and December 2020). The characteristics of the patients and those of the disease were collected. The measurement of cIMTwas done using high-resolution B-mode carotid US with a Philips machine with the patient in supine position, according to AmericanSociety of Echocardiography guidelines.The carotid bulb below itsbifurcation and the internal and external carotid arteries were evaluated bilaterally with gray scale, spectral and color Doppler ultra-sonography using proprietary software for carotid arterymeasurements.IMT was measured using the two inner layers of the commoncarotid artery and an increased IMT was defined as ≥0.9 mm. The CV risk at 10 years was calculated by the SCORE index.Results:Forty-seven patients were collected, of which 78.7% were women. The mean age was 52.5 ±11.06 years. The rheumatoid factor (RF) was positive in 57.8% of cases, and anti-citrullinated peptide antibodies (ACPA) were positive in 62.2% of cases. RA was erosive in 81.6% of cases. Hypertension (hypertension) was present in 14.9% of patients and diabetes in 12.8% of patients. Nine patients were active smokers. The mean IMT in the left common carotid (LCC) was 0.069 ±0.015, in the left internal carotid (LIC) was 0.069 ±0.015, in the left external carotid (LEC) was 0.060 ±0.023. The mean IMT was 0.068 ±0.01 in the right common carotid (RCC), 0.062 ±0.02 in the right internal carotid (RIC), and 0.060 ±0.016 in the right external carotid (REC). The mean SCORE index of CV risk was 2±2.81 [0-11.6]. CV risk was significantly associated with the IMTs for LIC (p=0.029; r=0.374), LEC (p=0.04; r=0.480), and REC (p=0.016; r=0.408). No association was found between the IMT in the LCC (p=0,361; r=0,162), neither in the RCC (p=0,438; r=0,140) nor the RIC (p=0,670; r=0,077).Conclusion:In our study, IMT is strongly associated with score index, especially in carotid bifurcation. However, IMT measured in common carotid does not reflect a cardiovascular risk at 10-years.References:[1]S. Gunter and al. Arterial wave reflection and subclinical atherosclerosis in rheumatoid arthritis. Clinical and Experimental Rheumatology 2018; 36: Clinical E.xperimental.[2]Aslan and al. Assessment of local carotid stiffness in seronegative and seropositive rheumatoid arthritis. SCANDINAVIAN CARDIOVASCULAR JOURNAL, 2017.[3]Martin I. Wah-Suarez and al, Carotid ultrasound findings in rheumatoid arthritis and control subjects: A case-control study. Int J Rheum Dis. 2018;1–7.Disclosure of Interests:None declared

AB0277 Comparison between Intima-Media Thickness and Coronary Artery Tomography in Subclinical Atherosclerosis Detection in Rheumatoid Arthritis:

2016 ◽  
Vol 75 (Suppl 2) ◽  
pp. 994.2-994
Author(s):  
L. Riancho-Zarrabeitia ◽  
A. Corrales ◽  
J.A. Parra ◽  
M. Santos-Gόmez ◽  
V. Portilla ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Coronary Artery ◽  
Subclinical Atherosclerosis ◽  
Intima Media Thickness ◽  
Media Thickness

scholarly journals Subclinical atherosclerosis diagnostics as a component of a modern strategy for cardiovascular risk stratification

2012 ◽  
Vol 11 (2) ◽  
pp. 76-84 ◽  
Author(s):  
N. O. Katamadze ◽  
L. L. Berstein ◽  
Yu. N. Grishkin
Keyword(s):  
Cardiovascular Risk ◽  
Subclinical Atherosclerosis ◽  
Intima Media Thickness ◽  
Individual Risk ◽  
Extracranial Carotid Artery ◽  
Traditional Risk Factors ◽  
Prevention Of Atherosclerosis ◽  
Atherosclerotic Changes ◽  
Preclinical Atherosclerosis

Cardiovascular risk (CVR) stratification plays an important role in the primary prevention of atherosclerosis and associated disorders. The standard scales for CVR assessment (Framingham scale, SCORE scale, etc.) are focused on a limited number of traditional risk factors (RFs) and, therefore, neither produce precise individual risk estimates, nor increase the effectiveness of preventive interventions. One of the methods for CVR assessment optimisation is the diagnostics of subclinical atherosclerosis, based on the direct visualisation of preclinical atherosclerotic changes in arterial wall. Extracranial carotid artery (CA) ultrasound and assessment of the intima-media thickness (IMT) index or atherosclerotic plaque volume (PV) is an important method of the preclinical atherosclerosis diagnostics. The review discusses pathogenetic mechanisms of IMT increase, the standards of ultrasound IMT assessment and its interpretation, and the role of the information obtained for optimization of the CVR evaluation.

scholarly journals Postprandial Apolipoprotein B48 is Associated with Subclinical Atherosclerosis in Patients with Rheumatoid Arthritis

2020 ◽  
Vol 9 (8) ◽  
pp. 2483
Author(s):  
Natalia Mena-Vázquez ◽  
Marta Rojas-Gimenez ◽  
Francisco Gabriel Jimenez Nuñez ◽  
Sara Manrique-Arija ◽  
José Rioja ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity Score ◽  
Plasma Lipids ◽  
Subclinical Atherosclerosis ◽  
Postprandial Lipemia ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Joint Disease ◽  
Negative Effect ◽  
Apolipoprotein B48

Objective: To describe postprandial lipemia in patients with rheumatoid arthritis (RA) and to analyze its association with subclinical atherosclerosis measured as carotid intima-media thickness (cIMT). Methods: We performed an observational study of 40 patients with RA and 40 sex and age-matched controls. Patients with dyslipidemia were excluded. Pathologically increased cIMT was defined as a carotid thickness greater than the 90th percentile (>p90) for age and sex. Fasting and postprandial plasma lipids, cholesterol, triglycerides, apolipoprotein B48 (ApoB48), and total ApoB were evaluated. The other variables included were clinical and laboratory values, Framingham score, and the 28-joint Disease Activity Score (DAS28). Two multivariate models were constructed to identify factors associated with pathologic cIMT in patients with RA. Results: Fasting lipid values were similar in patients with RA and controls, although those of postprandial ApoB48 were higher (median (IQR), 14.4 (10.8–12.1) vs. 12.1 (2.3–9,8); p = 0.042). Pathologic cIMT was recorded in 10 patients with RA (25%) and nine controls (22.5%). In patients with RA, pathologic cIMT was associated with postprandial ApoB48 (OR (95% CI), 1.15 (1.0–1.3)) and total ApoB (OR [95% CI], 1.12 [1.1–1.2]). The second model revealed a mean increase of 0.256 mm for cIMT in patients with elevated anticitrullinated protein antibodies (ACPAs). Conclusion: Postprandial ApoB48 levels in patients with RA are higher than in controls. Postprandial ApoB48 and total ApoB levels and markers of severity, such as ACPAs, are associated with pathologic cIMT in patients with RA. Our findings could indicate that these atherogenic particles have a negative effect on the endothelium.

scholarly journals Independent associations of urinary albumin-to-creatinine ratio and serum cystatin C with carotid intima-media thickness in community-living Taiwanese adults

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Chiu-Shong Liu ◽  
Chia-Ing Li ◽  
Yuh-Cherng Guo ◽  
Chih-Hsueh Lin ◽  
Wen-Yuan Lin ◽  
...  
Keyword(s):  
Physical Activity ◽  
Cystatin C ◽  
Subclinical Atherosclerosis ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Urinary Albumin ◽  
Creatinine Ratio ◽  
Carotid Imt ◽  
Low Hdl ◽  
Hs Crp

Abstract Background Renal function is a key factor of cardiovascular disease. Carotid intima-media thickness (IMT) has been widely used as a marker of early subclinical atherosclerosis. The determinants of cystatin C, a novel marker of renal function, have not been extensively studied in the Asian population. This study aimed to assess the determinants of cystatin C and explore whether carotid thickening was associated with urinary albumin-creatinine ratio and cystatin C in community-living Taiwanese adults. Methods A cross-sectional study was conducted on participants from Taichung City, Taiwan. All the participants underwent carotid ultrasonography. Carotid IMT-mean and IMT-maximum were derived. Kidney biomarkers were measured on the basis of urinary albumin-to-creatinine ratio (ACR) and cystatin C. Multiple linear regression analysis was used. Results A total of 1032 individuals were recruited, and 469 (45.44%) of them were men. An increased cystatin C level was significantly associated with older age, male gender, lack of physical activity, low HDL cholesterol, abdominal obesity, high hs-CRP, and high ACR. The multivariate-adjusted mean carotid IMT-mean and IMT-maximum values significantly increased by 80.49 and 195.23 μm for every one unit of increase in cystatin C level and by 0.07 and 0.14 μm for every one unit of increase in ACR, respectively (all p < 0.001 except ACR on IMT-maximum with p < 0.01). Lack of physical activity, low HDL, abdominal obesity, high hs-CRP, and high ACR were the determinants of cystatin C. Conclusion Cystatin C and ACR were strongly and linearly associated with carotid thickening, a marker of subclinical atherosclerosis.

scholarly journals The Performance of Vascular Age in the Assessment of Cardiovascular Risk of Patients with Rheumatoid Arthritis

2020 ◽  
Vol 9 (12) ◽  
pp. 4065
Author(s):  
Iván Ferraz-Amaro ◽  
Alfonso Corrales ◽  
Juan Carlos Quevedo-Abeledo ◽  
Belén Atienza-Mateo ◽  
Diana Prieto-Peña ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Carotid Plaque ◽  
Prediction Models ◽  
Disease Risk ◽  
Absolute Risk ◽  
Subclinical Atherosclerosis ◽  
Area Under The Curve ◽  
Intima Media Thickness ◽  
Chronological Age ◽  
Vascular Age

Background. Cardiovascular (CV) disease risk prediction models developed for use in the general population have suboptimal performance in patients with rheumatoid arthritis (RA). Vascular age (VA) is a new concept that has been proposed as a measure of CV ‘relative’ risk instead of the ‘absolute’ risk that current prediction models provide. In the present study we aim to study the performance of vascular age (VA) in the assessment of CV risk in patients with RA. We additionally aimed to analyze its relation with subclinical atherosclerosis as measured through carotid plaque ultrasound. Methods. A total of 1173 non-diabetic RA patients without previous CV events were included. Disease characteristics, SCORE, VA determined on SCORE and on carotid intima media thickness (cIMT), and the presence of plaque through carotid ultrasound were assessed. The interrelations of VA with SCORE, and its associations with subclinical carotid atherosclerosis were studied. Results. On average, RA patients had both a SCORE determined VA (4.7 years) and a cIMT-based VA (2.4 years) significantly higher than the chronological age. When these differences were analyzed in different age intervals, while VA based on SCORE was significantly higher compared to chronological age in all age ranges, VA determined on cIMT was significantly elevated only in RA patients younger than 60 years. The area under the curve analysis for the association of SCORE and VA with the presence of carotid plaque disclosed no differences between both parameters. VA was associated with the presence of carotid plaque after multivariable regression analysis in patients younger than 60 years old. Conclusion. VA is significantly higher than chronological age in patients with RA. The performance of VA in its relation to carotid plaque is similar to that of the SCORE.

Predictors of atherosclerosis in rheumatoid arthritis

VASA ◽  
2012 ◽  
Vol 41 (5) ◽  
pp. 353-359 ◽  
Author(s):  
Ahmad ◽  
Garg ◽  
Dhar ◽  
Srivastava ◽  
Biswas ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Disease Duration ◽  
Early Stage ◽  
Subclinical Atherosclerosis ◽  
Disease Onset ◽  
Intima Media Thickness ◽  
Qt Dispersion ◽  
Control Group ◽  
Age And Sex

Background: Atherosclerosis is emerging as an important complication of rheumatoid arthritis (RA), with coronary artery disease being projected as the major cause of mortality in these patients.This study was undertaken to evaluate the presence of subclinical atherosclerosis and to identify the risk factors of atherosclerosis in patients with RA. Patients and methods: All consecutive in- and out-patients of rheumatoid arthritis (n = 100) irrespective of the disease duration were included in the study. A group of 100 age and sex matched controls were also studied. Increased carotid intima media thickness (beyond the 75th percentile for age and sex), presence of plaques, ankle brachial pressure index and QT dispersion were deemed as non-invasive measures of atherosclerotic burden. Results: Fifty patients (50.0 %) with RA had evidence of subclinical atherosclerosis as compared to the control group (n = 11, 11 %); plaques were observed in 26 patients. Eighteen (36 %) of these developed this evidence within 1 - 5 years of disease onset. Low HDL levels among the conventional risk factors and advanced patient age, longer disease duration, greater number of involved joint areas, steroid use and indices of inflammation in particular in RA, were associated with subclinical atherosclerosis. Sustained inflammation was observed throughout the sub-group with atherosclerosis irrespective of the disease duration. Conclusions: RA is a pro-atherogenic state with the process of atherosclerosis initiated in the early stage of the disease. Besides the traditional risk factors, sustained inflammation contributes to atherogenesis.

scholarly journals Low Levels of CD36 in Peripheral Blood Monocytes in Subclinical Atherosclerosis in Rheumatoid Arthritis: A Cross-Sectional Study in a Mexican Population

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Eduardo Gómez-Bañuelos ◽  
Beatriz Teresita Martín-Márquez ◽  
Erika Aurora Martínez-García ◽  
Mauricio Figueroa-Sanchez ◽  
Lourdes Nuñez-Atahualpa ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Peripheral Blood ◽  
Mononuclear Cells ◽  
Subclinical Atherosclerosis ◽  
Clinical Information ◽  
Intima Media Thickness ◽  
Blood Monocytes ◽  
Membrane Expression ◽  
Peripheral Blood Mononuclear ◽  
Cross Sectional

Patients with rheumatoid arthritis (RA) have a higher risk for atherosclerosis. There is no clinical information about scavenger receptor CD36 and the development of subclinical atherosclerosis in patients with RA. The aim of this study was to evaluate the association between membrane expression of CD36 in peripheral blood mononuclear cells (PBMC) and carotid intima-media thickness (cIMT) in patients with RA.Methods. We included 67 patients with RA from the Rheumatology Department of Hospital Civil “Dr. Juan I. Menchaca,” Guadalajara, Jalisco, Mexico. We evaluated the cIMT, considering subclinical atherosclerosis when >0.6 mm. Since our main objective was to associate the membrane expression of CD36 with subclinical atherosclerosis, other molecules related with cardiovascular risk such as ox-LDL, IL-6, and TNFαwere tested.Results. We found low CD36 membrane expression in PBMC from RA patients with subclinical atherosclerosis (P<0.001). CD36 mean fluorescence intensity had negative correlations with cIMT (r= −0.578,P<0.001), ox-LDL (r= −0.427,P= 0.05), TNFα(r= −0.729,P<0.001), and IL-6 (r= −0.822,P<0.001).Conclusion. RA patients with subclinical atherosclerosis showed low membrane expression of CD36 in PBMC and increased serum proinflammatory cytokines. Further studies are needed to clarify the regulation of CD36 in RA.

scholarly journals Carotid Intima Media Thickness and Endothelial Function: Useful Surrogate Markers for Cardiovascular Risk in Rheumatoid Arthritis Patients

2021 ◽  
pp. 38-48
Author(s):  
Riham A. El-Sehly ◽  
Abeer A. Shahba ◽  
Raghda G. Elsheik ◽  
Mahmoud F. Selim
Keyword(s):  
Rheumatoid Arthritis ◽  
Endothelial Function ◽  
Disease Activity ◽  
Brachial Artery ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
University Hospital ◽  
Control Group ◽  
Carotid Imt ◽  
Media Thickness

Introduction: Cardiovascular diseases (CVDs) are the main cause of morbidity and mortality in RA disease. In active RA patients, the majority of cardiovascular deaths result from accelerates atherosclerosis. Aim of the Work: The aim of this work is to assess carotid intima media thickness (C-IMT) and endothelial function by brachial artery flow mediated dilatation (FMD) in Rheumatoid arthritis patients and relation to the disease activity. Subjects and Methods: Our study included 50 RA patients, from Tanta University Hospital. 47 women and 3 men and their age ranged from 30-62 years.  They were divided into group 1:  25 active RA patients, group 2:  25 inactive RA patients who were   diagnosed by American College of Rheumatology (ACR) revised criteria for diagnosis of RA 1987 and disease activity was evaluated using disease activity score 28(DAS28). Group 3: 25 normal subjects as a control group.  We measured C-IMT and FMD in all groups. Results: By comparing the groups, we found that active RA patients had increased C-IMT compared to inactive rheumatoid arthritis patients and controls which is indicator of atherosclerosis. FMD of the brachial artery impaired in RA patients compared to controls which is indicator of endothelial dysfunction. There was highly statistically significant relation between duration, activity of RA disease and atherosclerosis in RA patients. Conclusion: With increasing the frequency of atherosclerosis in asymptomatic RA patients, carotid IMT increased and FMD impaired when compared with general population. Active RA patients have increased carotid IMT and impaired FMD compared with inactive RA patients.

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