Increased progression of carotid intima media thickness in thyroid peroxidase antibodies-positive rheumatoid arthritis patients
Increased progression of carotid intima media thickness in thyroid peroxidase antibodies-positive rheumatoid arthritis patients
复制标题
DOI：
10.1530/eje-13-0394
复制
发表时间：
2013-12-01
影响因子：
5.8
通讯作者：
Nurmohamed, M. T.
中科院分区：
文献类型：
--
作者：
Raterman, H. G.;Voskuyl, A. E.;Nurmohamed, M. T.
目的：自身免疫性疾病如类风湿关节炎（RA）和甲状腺功能减退倾向于聚集，这种共存放大了RA的心血管风险升高。甲状腺过氧化物酶抗体（TPOabs）是否与心血管疾病（CVD）风险增加相关尚未得到广泛研究。因此，本研究首先确定tpoab在RA中的患病率，其次确定tpoab是否与CVD相关。此外，本研究还探讨了tpoab是否与RA特征相关。设计和方法：CARRE研究的数据是一项正在进行的研究，调查类风湿性心血管疾病及其危险因素（n=322），用于确定类风湿性关节炎患者中tpoab的患病率。此外，比较tpoab阳性和阴性患者在基线和3年后第二次就诊时的心血管和RA疾病特征。结果：47/322 (15%)RA患者中存在tpoab， tpoab阳性患者TSH水平（1.40 mU/l）高于tpoab阴性患者（1.26 mU/l， P=0.048）。在基线和3年后，未观察到TPOabs与CVD（危险因素）之间的关联。回归分析显示，与cIMT进展的危险因素无关，tpoab阳性患者的颈动脉内膜中膜厚度（cIMT; β =0.13 mm）的进展明显大于tpoab阴性患者。tpoab阳性患者的RA疾病活动性评分（DAS28）高于tpoab阴性患者（4.4 vs 3.8 P=0.018）。结论：tpoab与cIMT进展增加相关。此外，还观察到TPOabs与DAS28之间存在关联。因此，TPOabs似乎在RA患者心血管风险放大中起作用。
Objective: Autoimmune diseases such as rheumatoid arthritis (RA) and hypothyroidism tend to cluster, and this coexistence amplifies the elevated cardiovascular risk in RA. Whether thyroid peroxidase antibodies (TPOabs) are associated with increased cardiovascular disease (CVD) risk has not been studied extensively. Therefore, this study determined firstly the prevalence of TPOabs in RA and secondly whether TPOabs were associated with CVD. Moreover, this study explored whether TPOabs were related to RA characteristics.Design and methods: Data from the CARRE Study, an ongoing study investigating CVDs and its risk factors in RA (n=322), was used to ascertain the prevalence of TPOabs in RA patients. In addition, cardiovascular and RA disease characteristics were compared between TPOabs-positive and -negative patients at baseline and at a second visit after 3 years.Results: TPOabs were present in 47/322 (15%) RA patients and TSH levels were higher in TPOabs-positive patients (1.40 mU/l) compared with TPOabs-negative patients (1.26 mU/l, P=0.048). At baseline and after 3 years no association was observed between TPOabs and (risk factors for) CVD. Regression analyses revealed a significantly larger progression of carotid intima media thickness (cIMT; beta=0.13 mm) in TPOabs-positive compared with TPOabs-negative patients independent of risk factors for cIMT progression. RA disease activity scores (DAS28) were higher in TPOabs-positive compared with TPOabs-negative patients (4.4 vs 3.8 P=0.018).Conclusions: TPOabs were associated with increased cIMT progression. Moreover, an association between TPOabs and DAS28 was observed. Hence, TPOabs seems to have a role in the amplified cardiovascular risk in RA patients.