Arterial Inflammation Detected With 18F-Fluorodeoxyglucose-Positron Emission Tomography in Rheumatoid Arthritis
Arterial Inflammation Detected With 18F-Fluorodeoxyglucose-Positron Emission Tomography in Rheumatoid Arthritis
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DOI：
10.1002/art.40345
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发表时间：
2018-01-01
影响因子：
13.3
通讯作者：
Bathon, Joan M.
中科院分区：
文献类型：
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作者：
Geraldino-Pardilla, Laura;Zartoshti, Afshin;Bathon, Joan M.
目的除了传统的危险因素外，类风湿性关节炎（RA）中心血管疾病（CVD）的增加还归因于血管和/或全身炎症的增强。在几项使用 F-18-氟脱氧葡萄糖-正电子发射断层扫描/计算机断层扫描 (F-18-FDG-PET/CT) 直接评估血管炎症的小型研究中，RA 患者的 FDG 摄取量高于对照组。使用更大的 RA 患者样本，我们试图确定与血管 FDG 摄取独立相关的 RA 疾病特征。方法 RA 患者接受心脏 FDG-PET/CT，通过量化升主动脉中 FDG 的摄取来评估主动脉炎症，计算为整个升主动脉及其病变最严重的节段的平均值和最大标准化摄取值 (SUV) (SUV MDS)。构建单变量和多变量回归模型来模拟患者特征与主动脉 FDG 摄取的关联。结果对 91 名 RA 患者进行了扫描。在多变量模型中，除了高血压和体重指数与主动脉 FDG 摄取增加的独立关联外，类风湿结节的患病率与 SUV 平均值和 SUV MDS 平均值测量值相关，而抗环瓜氨酸肽（抗 CCP）抗体与这些测量值以及 SUV 最大值和 SUV MDS 最大值呈反比关系（P < 0.05）。观察到 RA 疾病活动性与主动脉 FDG 摄取存在显着相关性，但仅限于抗 CCP 血清阳性。结论：传统 CV 危险因素和 RA 疾病特征（类风湿结节和使用抗 CCP 抗体阳性个体中 C 反应蛋白水平的 28 个关节的疾病活动评分）与无临床 CVD 的 RA 患者的升主动脉 FDG 摄取独立相关。
ObjectiveIn addition to traditional risk factors, excess cardiovascular disease (CVD) in rheumatoid arthritis (RA) is attributed to enhanced vascular and/or systemic inflammation. In several small studies using F-18-fluorodeoxyglucose-positron emission tomography/computed tomography (F-18-FDG-PET/CT) to directly assess vascular inflammation, FDG uptake was higher in RA patients than in controls. Using a substantially larger sample of RA patients, we sought to identify RA disease characteristics independently associated with vascular FDG uptake.MethodsRA patients underwent cardiac FDG-PET/CT, with aortic inflammation assessed by quantification of FDG uptake in the ascending aorta, calculated as the mean and maximum (max) standardized uptake value (SUV) of the entire ascending aorta and of its most diseased segment (SUV MDS). Univariate and multivariable regression models were constructed to model the associations of patient characteristics with aortic FDG uptake.ResultsNinety-one RA patients were scanned. In multivariable models, in addition to the independent associations of hypertension and body mass index with increased aortic FDG uptake, the prevalence of rheumatoid nodules correlated with the SUV mean and SUV MDS mean measures, while anti-cyclic citrullinated peptide (anti-CCP) antibodies correlated inversely with these measures and with the SUV max and SUV MDS max (P < 0.05). A significant association of RA disease activity with aortic FDG uptake was observed but was restricted to anti-CCP seropositivity.ConclusionTraditional CV risk factors and RA disease characteristics (rheumatoid nodules and the Disease Activity Score in 28 joints using the C-reactive protein level in anti-CCP antibody-positive individuals) were independently associated with ascending aortic FDG uptake in RA patients without clinical CVD.