Circulating Concentrations of the Novel Adipokine Chemerin Are Associated with Cardiovascular Disease Risk in Rheumatoid Arthritis

2014 ◽  
Vol 41 (9) ◽  
pp. 1746-1754 ◽  
Author(s):  
Patrick H. Dessein ◽  
Linda Tsang ◽  
Angela J. Woodiwiss ◽  
Gavin R. Norton ◽  
Ahmed Solomon

Objective.Depending on physiological context, the adipokine chemerin can reduce or enhance cardiovascular risk. We investigated whether chemerin concentrations represent cardiovascular disease risk in rheumatoid arthritis (RA).Methods.We assessed ELISA-determined chemerin concentrations and those of 4 early endothelial activation molecules as well as angiopoietin 2, which mediates angiogenesis and thereby contributes to advanced atherosclerosis, the common carotid artery intima-media thickness (cIMT), and carotid artery plaque by ultrasound in 236 patients (114 black and 122 white) with RA. Relationships were identified in potential confounder and mediator-adjusted mixed regression models.Results.Mean (SD) chemerin and median (interquartile range) angiopoietin 2 concentrations were 114 (35) ng/ml and 2560 (2044–3341) pg/ml, respectively; the mean (SD) cIMT was 0.708 (0.110) mm, and 40.3% of patients had plaque. Chemerin concentrations were not related to those of early endothelial activation molecules, but associated with those of angiopoietin 2 [β SE = 0.002 (0.0004), p < 0.0001] and plaque [OR 1.006 (95% CI 1.00–1.013), p = 0.05] in all patients. The presence of major conventional cardiovascular risk factors, generalized and abdominal obesity, and RA severity markers modified the independent chemerin-cardiovascular risk relations (interaction p < 0.05). Consequently, chemerin concentrations were associated with cIMT in those with but not without overweight or generalized obesity and abdominal obesity [β SE = 0.001 (0.0003), p = 0.005 and 0.001 (0.0001), p = 0.001 vs −0.001 (0.0004), p = 0.2 and −0.0002 (0.0004), p = 0.6, respectively], and with plaque in those without but not with generalized obesity [OR 1.008 (95% CI) 1.000–1.016, p = 0.03 vs 1.003 (0.990–1.017), p = 0.6, respectively]. The β (SE) for the chemerin-intima-media thickness relations in patients with overweight or generalized obesity and abdominal obesity were larger than in those without these characteristics (p < 0.0001 and = 0.04, respectively).Conclusion.Chemerin is associated with endothelial activation and atherosclerosis in RA. Adiposity influences the chemerin-atherosclerotic phenotype relations in RA.

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Sanne A Peters ◽  
Karlijn A Groenewegen ◽  
Hester M den Ruijter ◽  
Michiel L Bots

Background Vascular age is the chronological age of an individual adjusted by their level of atherosclerosis. Vascular age can be used as understandable communication tool towards patients. It has been proposed that carotid intima-media thickness (CIMT) could be used to estimate the vascular age in individuals. The issue on how to best estimate vascular age remains an unanswered question and was evaluated in this study. Methods Data were used from the USE-IMT study collaboration, a global individual patient data meta-analysis including 14 population-based cohorts contributing data for 45 828 individuals. We used two methods to define vascular age. First, vascular age was the age at which a participant’s CIMT value would be at the 50th percentile of the age-and sex specific reference values of the healthy USE-IMT subpopulation (VA50). Second, vascular age was the age at which the estimated cardiovascular risk equals the risk of the observed CIMT value (VArisk). Results Mean (+/- standard deviation [SD]) chronological age, VA50, and VArisk were 58 (9), 63 (19), and 59 (7) years, respectively. VArisk was 0.24 yrs higher in women and 1.5 yrs higher in men than chronological age whereas VA50 was 4.4 yrs higher in women and 5.8 yrs higher in men than chronological age. After adjustment for traditional cardiovascular risk factors, a SD increase in VA50 and VArisk was associated with a 15% (95% confidence interval [CI]: 1.12; 1.19) and 22% (95% CI: 1.17; 1.28) higher risk of cardiovascular disease. For comparison, a SD increase in mean common CIMT increased the risk of cardiovascular disease with 15% (95% CI: 1.12; 1.19). Conclusion We presented two distinct measures a vascular age: VA50, and VArisk. VA50 is a straightforward translation of CIMT and is a measure of the age at which the average person would be expected to have a certain CIMT. In contrast, VArisk incorporates information about expected cardiovascular risk and is the chronological age of a person that conveys the same risk as the CIMT. VA50 and VArisk might provide a convenient transformation of CIMT to a scale that is more easily understood by patients and clinicians.


2014 ◽  
Vol 41 (3) ◽  
pp. 429-436 ◽  
Author(s):  
Patrick H. Dessein ◽  
Raquel López-Mejias ◽  
Carlos González-Juanatey ◽  
Fernanda Genre ◽  
José A. Miranda-Filloy ◽  
...  

Objective.Osteoprotegerin (OPG) may contribute to the link between systemic inflammation and increased cardiovascular risk. We investigated the relationship of OPG concentrations with endothelial activation and carotid atherosclerosis in rheumatoid arthritis (RA).Methods.OPG concentrations and those of endothelial activation molecules were measured by using ELISA in 34 patients who were treated with infliximab (IFX), both immediately before and after an IFX infusion. Carotid intima-media thickness (CIMT) and plaque were determined by ultrasound in 27 of the study participants.Results.Median (interquartile range) OPG concentrations decreased from 4.8 pmol/l (2.8–6.5) to 4.4 pmol/l (2.9–6.1; p = 0.04) upon IFX infusion. Baseline OPG concentrations were inversely associated with those of total and low-density lipoprotein (LDL) cholesterol (partial R = −0.50, p = 0.004, and R = −0.48, p = 0.007, respectively). Prior to IFX administration, OPG concentrations were associated with those of intercellular adhesion molecule (ICAM)-1 (partial R = 0.34, p = 0.05), CIMT (partial R = 0.51 to 0.52, p < 0.009), and plaque (OR = 1.52, 95% CI 1.01–2.29 to OR = 1.61, 95% CI 1.03–2.51; p < 0.04), independent of conventional risk factors and C-reactive protein concentrations or disease activity. Except for the OPG concentrations-plaque association (p = 0.09), these relationships remained significant subsequent to IFX administration (p < 0.05). Reductions in OPG levels related to those in vascular cell adhesion molecule (VCAM)-1 concentrations (partial R = 0.35, p = 0.04) and had borderline significance (p = 0.09) with those in ICAM-1 (partial R = 0.29) concentrations.Conclusion.OPG concentrations are independently associated with endothelial activation and carotid atherosclerosis in RA. Reductions in OPG concentrations upon IFX administration are associated with decreased endothelial activation. OPG may be involved in increased cardiovascular disease risk and may improve its stratification in patients with RA.


Author(s):  
Susan A. Everson‐Rose ◽  
Emma J. M. Barinas‐Mitchell ◽  
Samar R. El Khoudary ◽  
Hsin‐Hui Huang ◽  
Qi Wang ◽  
...  

Background The menopausal transition is characterized by increased cardiovascular risk, weight gain, and increased adiposity for many women. The adipose‐derived secretory proteins adiponectin and leptin are associated with insulin resistance, metabolic syndrome, and cardiovascular disease but their role in subclinical atherosclerotic disease is unclear. This cross‐sectional study evaluated the associations of adiponectin and leptin with carotid artery intima‐media thickness, adventitial diameter, presence of carotid plaques, and brachial‐ankle pulse wave velocity (baPWV) in women aged 54 to 65 years. Methods and Results Participants were 1399 women from SWAN (Study of Women's Health Across the Nation), a community‐based study of women transitioning through menopause. Carotid ultrasound and baPWV measures were obtained at SWAN follow‐up visits 12 or 13, when 97% of participants were post‐menopausal. Adipokines were assayed from serum specimens obtained concurrently at these visits. Linear and logistic regression models were used to evaluate adiponectin or leptin, both log‐transformed attributable to skewness, in relationship to carotid artery intima‐media thickness, adventitial diameter, baPWV, and presence of carotid plaque. Covariates included age, race, study site, smoking, alcohol use, obesity, cardiovascular disease risk factors, and menopausal status. Lower levels of adiponectin were related to greater carotid artery intima‐media thickness, wider adventitial diameter, and faster baPWV; associations were attenuated after adjusting for cardiovascular disease risk factors. Higher levels of leptin were associated with greater carotid artery intima‐media thickness and wider adventitial diameter in minimally and fully adjusted models, and contrary to expectation, with slower baPWV, particularly among women with diabetes mellitus or obesity. Conclusions Adiponectin and leptin are 2 important inflammatory pathways that may contribute to adverse subclinical cardiovascular disease risk profiles in women at midlife.


2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 606.1-607
Author(s):  
N. De Carvalho Sacilotto ◽  
A. Ozela Augusto ◽  
D. Alves Lucena ◽  
M. Roberto Godoy ◽  
R. Duque de Almeida ◽  
...  

Background:The increasing of the cardiovascular disease (CVD) in patients with rheumatoid arthritis (RA) is well know, even with the absence of traditional coronary risk factors. The ultrasound – duplex scan (USD) is a non invasive technique able to early detect atherosclerotic changes in the blood vessel, that gives the possibly to retard the development of symptomatic CVD.Objectives:To evaluate the cardiovascular (CVS) risk in patients with RA classificated as low risk by Framingham Score (FS), before and after the EULAR 1.5 multiplication factor and stratify with the carotid and femoral USD (intima-media thickness - IMT and atherosclerotic plaques - AP)Methods:Thirty-five female patients with RA and low CVS risk by FS and 35 healthy women with low CVS risk by FS (control group) were enrolled for the study. All of them submitted to carotid and femoral USDResults:The groups were homogenous by age and CVS comorbidities -Table 1. Mean age in the diagnosis was 44.57 years, mean disease duration was 12.11 years and mean disease activity was Disease Activity Score 28: 1,91 and Clinical Disease Activity Score: 6.176. In the RA patients group 46% showed changes in the carotid and/or femoral USD compared with 14% of the control group (p = 0,004) –Graphic 1. The USD with abnormalities in RA group 31% of the carotid USD and 81% of the femoral USD (p= 0,005) showed IMT and/or AP. After EULAR 1.5 multiplication factor, 66% remained low CVS risk. Where 35% of the RA patients showed changes in the carotid and/or femoral USD compared with 14% of the control group (p=0,07)Conclusion:The USD is able to early detect the CVD, special attention should be given to the femoral arteries, that are frequently affected. The Eular criteria is also effective and should be used in the clinical practiceReferences:[1]Mota LMH, Cruz BA, Brenol CV, et al. Diretrizes para o diagnóstico da artrite reumatoide.Rev. Bras. Reumatol 2013;53(2)[2]Charles-SchoemanC. Cardiovascular disease and Rheumatoid Arthritis: an update. CurrRheumatol Rep 2012;14(5): 455-62[3]Purcarea A, Sovaila S, Gheorghe A, et al. Cardiovascular disease risk scores in the current practice which to use in rheumatoid arthritis?Journal of Medicine and Life 2014;7(4):461-67[4]Agca R, Heslinga SC, Rollefstad S, etal.EULAR recommendations for cardiovascular disease risk management in patients with rheumatoid arthritis and other forms of inflammatory joint disorders: 2015/2016 update.AnnRheumDis 2016[5]Abu-Shakra M, Polychuck I, Szendro G, et al. Duplex Study of the Carotidand Femoral Arteries of Patients with Rheumatoid Arthritis: A Controlled Study.Seminars in Arthritis and Rheumatism 2005;35(1):18-23[6]Freire CMV, Alcantara ML, Santos SN, etal. Recomendação para a Quantificação pelo Ultrassom da Doença Aterosclerótica das Artérias Carótidas e Vertebrais: Grupo de Trabalho do Departamento de Imagem Cardiovascular da Sociedade Brasileira de Cardiologia.ArqBrasCardiol: Imagem cardiovasc. 2015;28:e1- e64[7]Helck A, Bianda N, Canton G et al. Intra-individual comparison of carotid and femoral atherosclerotic plaque features with in vivo MR plaque imaging.Int J Cardiovasc Imaging 2015;31(8):1611-8[8]Lucatelli P, Fagnani C, Tarnoki AD, et al, Genetic influence on femoral plaque and its relationship with carotid plaque an international study.Int J Cardiovasc Imaging 2018;34(4):531-41[9]Cournot M, Bura A, Cambou JP, et al. Arterial Ultrasound Screening as a Tool for Coronary Risk Assessmente in Asymptomatic Men and Women.Angiology 2012;63(4):282-88[10]Peters MJ, Symmons DP, McCarey D, et al.Eular evidence-based recommendations for cardiovascular risk management in patients with rheumatoid arthritis and other forms of inflammatory arthritis. Ann Rheum Dis 2010;69:325-3Figure 1.Graphic 1: USD abnormalitiesIMT - intima-media thickness; AP atherosclerotic plaquesDisclosure of Interests:None declared


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