Rheumatoid arthritis is associated with reduced adiposity but not with unfavorable major cardiovascular risk factor profiles and enhanced carotid atherosclerosis in black Africans from a developing population: a cross-sectional study.
Rheumatoid arthritis is associated with reduced adiposity but not with unfavorable major cardiovascular risk factor profiles and enhanced carotid atherosclerosis in black Africans from a developing population: a cross-sectional study.
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DOI：
10.1186/ar4276
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发表时间：
2013-08-22
影响因子：
4.9
通讯作者：
Solomon A
中科院分区：
文献类型：
--
作者：
Dessein PH;Woodiwiss AJ;Norton GR;Solomon A
风湿性关节炎（RA）的特征在于发炎的关节源性精氨酸介导的高度全身性炎症，其在发达人群中增加心血管代谢风险和疾病。我们研究了RA对心血管危险因素的潜在影响，包括全身炎症和动脉粥样硬化，以及它们在非洲黑人中的关系。我们评估了274名非洲黑人的人口统计学特征、肥胖指数、主要的传统心血管危险因素、循环C反应蛋白和白细胞介素-6浓度以及超声测定的颈动脉内膜中层厚度（cIMT）;其中115名已确诊为RA。在混杂调整的混合回归模型中分析数据。RA患者的体重指数和腰围身高比低于非RA患者（分别为29.2（6.6）比33.7（8.0），P < 0.0001和0.58（0.09）比0.62（0.1），P = 0.0003）。RA患者中血脂异常的患病率较低（比值比（OR）（95%置信区间（CI）= 0.54（0.30 - 1.00））;在进一步调整减少肥胖和使用氯喹后，这种差异不再显著。RA也与高血压、吸烟和糖尿病无关。主要传统风险因素的数量在RA状态下没有差异（1.1（0.8）vs 1.2（0.9），P = 0.7）。RA患者的循环C反应蛋白浓度相似，血清白细胞介素6浓度降低（分别为7.2（3.1）vs 6.7（3.1）mg/l，P = 0.7和3.9（1.9）vs 6.3（1.9）pg/ml，P < 0.0001）。RA和非RA受试者的cIMT分别为0.700（0.085）和0.701（0.111）mm（P = 0.7）。尽管82.6%的患者存在临床活动性疾病，但RA疾病活动性和严重程度参数始终与全身炎症无关。在所有受试者中，肥胖指数、吸烟和不使用血管紧张素转换抑制剂与全身炎症增加相关，全身炎症增加与更多致动脉粥样硬化脂质谱相关，循环低密度脂蛋白浓度与cIMT相关（部分R = 0.153，P = 0.032）; RA对这些关系没有影响（相互作用P ≥0.1）。在非洲黑人中，RA患者的总体和腹部肥胖减少，但没有增加主要的传统危险因素和动脉粥样硬化负担。这项研究进一步表明，炎症RA关节释放到循环中的白细胞介素-6的缺失可能是这种未改变的心血管疾病风险的原因。
Rheumatoid arthritis (RA) is characterized by inflamed joint-derived cytokine-mediated high-grade systemic inflammation that enhances cardiovascular metabolic risk and disease in developed populations. We investigated the potential impact of RA on cardiovascular risk factors including systemic inflammation and atherosclerosis, and their relationships in black Africans from a developing population. We evaluated demographic features, adiposity indices, major traditional cardiovascular risk factors, circulating C-reactive protein and interleukin-6 concentrations and ultrasound determined carotid intima-media thickness (cIMT) in 274 black Africans; 115 had established RA. Data were analyzed in confounder-adjusted mixed regression models. The body mass index and waist-height ratio were lower in RA compared to non-RA subjects (29.2 (6.6) versus 33.7 (8.0), P < 0.0001 and 0.58 (0.09) versus 0.62 (0.1), P = 0.0003, respectively). Dyslipidemia was less prevalent in patients with RA (odds ratio (OR) (95% confidence interval (CI) = 0.54 (0.30 to1.00)); this disparity was no longer significant after further adjustment for reduced adiposity and chloroquine use. RA was also not associated with hypertension, current smoking and diabetes. The number of major traditional risk factors did not differ by RA status (1.1 (0.8) versus 1.2 (0.9), P = 0.7). Circulating C-reactive protein concentrations were similar and serum interleukin-6 concentrations reduced in RA (7.2 (3.1) versus 6.7 (3.1) mg/l, P = 0.7 and 3.9 (1.9) versus 6.3 (1.9) pg/ml, P < 0.0001, respectively). The cIMT was 0.700 (0.085) and 0.701 (0.111) mm in RA and non-RA subjects, respectively (P = 0.7). RA disease activity and severity parameters were consistently unrelated to systemic inflammation, despite the presence of clinically active disease in 82.6% of patients. In all participants, adiposity indices, smoking and converting angiotensin inhibitor non-use were associated with increased systemic inflammation, which related to more atherogenic lipid profiles, and circulating low density lipoprotein concentrations were associated with cIMT (partial R = 0.153, P = 0.032); RA did not impact on these relationships (interaction P ≥0.1). Among black Africans, patients with established RA experience reduced overall and abdominal adiposity but no enhanced major traditional risk factor and atherosclerosis burden. This study further suggests that an absent interleukin-6 release by inflamed RA joints into the circulation may account for this unaltered cardiovascular disease risk.
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类风湿关节炎与骨关节炎的心血管风险：急性期反应相关的胰岛素敏感性降低和高密度脂蛋白胆固醇以及类风湿关节炎中代谢综合征特征的聚类。
DOI：
10.1186/ar428
发表时间：
2002
期刊：
ARTHRITIS RESEARCH
影响因子：
--
作者：
Dessein, PH;Stanwix, AE;Joffe, BI
通讯作者：
Joffe, BI
影响因子：
--
作者：
del Rincón, I;O'Leary, DH;Escalante, A
通讯作者：
Escalante, A
DOI：
10.1002/art.23719
发表时间：
2008-06-15
期刊：
ARTHRITIS & RHEUMATISM-ARTHRITIS CARE & RESEARCH
影响因子：
--
作者：
Giles, Jon T.;Ling, Shari M.;Bathon, Joan M.
通讯作者：
Bathon, Joan M.
影响因子：
5.3
作者：
Chung, Cecilia P.;Oeser, Annette;Stein, C. Michael
通讯作者：
Stein, C. Michael
影响因子：
24
作者：
Greenland, Philip;Alpert, Joseph S.;Whitman, Gayle R.
通讯作者：
Whitman, Gayle R.