Association between carotid atherosclerosis and markers of inflammation in rheumatoid arthritis patients and healthy subjects
Association between carotid atherosclerosis and markers of inflammation in rheumatoid arthritis patients and healthy subjects
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DOI：
10.1002/art.11078
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发表时间：
2003-07-01
影响因子：
--
通讯作者：
Escalante, A
中科院分区：
文献类型：
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作者：
del Rincón, I;Williams, K;Escalante, A
客观的。研究类风湿性关节炎（RA）患者和健康对照者全身炎症标志物与颈动脉粥样硬化之间的关系。方法。使用高分辨率 B 型超声测量 204 名年龄 40-85 岁的 RA 患者和 102 名年龄和性别匹配的健康人的颈动脉内膜中层厚度 (IMT) 和颈动脉斑块。两组中都没有人吸烟过。红细胞沉降率（ESR）和C反应蛋白（CRP）用于测量全身炎症。检查颈动脉 IMT 和颈动脉斑块与炎症标志物的关系，调整年龄、性别、RA 与对照状态以及心血管 (CV) 危险因素高胆固醇血症、收缩压、糖尿病和体重指数 (BMI)。 结果。颈动脉 IMT 增加的显着线性趋势与 ESR 和 CRP 类别的增加相关（ESR 为 r = 0.16，P = 0.004，CRP 为 r = 0.13，P = 0.02）。这些趋势在 RA 病例和对照之间没有差异，并且与年龄、性别和心血管危险因素无关。最低和最高 ESR 类别之间颈动脉 IMT 的差异为 0.221 mm（95% 置信区间 [95% CI] 0.767-1.020，P = 0.02）。极端 CRP 类别之间的差异为 0.275 mm（95% CI 0.039-0.509，P = 0.02）。 CV 风险因素调整后，两者仍然显着。颈动脉斑块与炎症标志物显示出类似的关系。结论。颈动脉 IMT 增加和颈动脉斑块的存在与 RA 患者和健康受试者的全身炎症标志物相关。这一观察结果与动脉粥样硬化中全身炎症发挥作用的假设一致，并且可能对 RA 和其他慢性炎症性疾病有影响。
Objective. To examine the relationship between markers of systemic inflammation and carotid atherosclerosis in patients with rheumatoid arthritis (RA) and healthy controls.Methods. Carotid artery intima-media thickness (IMT) and carotid plaque were measured using high-resolution B-mode ultrasound in 204 patients with RA, ages 40-85, and 102 age- and sex-matched healthy persons. No subject in either group had ever smoked cigarettes. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were used to measure systemic inflammation. The relationship of the carotid artery IMT and carotid plaque to inflammation markers was examined, adjusting for age, sex, RA versus control status, and the cardiovascular (CV) risk factors hypercholesterolemia, systolic blood pressure, diabetes mellitus, and body mass index (BMI).Results. A significant linear trend for increased carotid artery IMT was associated with increasing ESR and CRP categories (r = 0.16, P = 0.004 for ESR, and r = 0.13, P = 0.02 for CRP). These trends did not differ among RA cases and controls, and were independent of age, sex, and CV risk factors. The difference in carotid artery IMT between the lowest and highest categories of ESR was 0.221 mm (95% confidence interval [95% CI] 0.767-1.020, P = 0.02). The difference between extreme CRP categories was 0.275 mm (95% CI 0.039-0.509, P = 0.02). Both remained significant after CV risk factor adjustment. Carotid plaque displayed a similar relationship to markers of inflammation.Conclusion. Increased carotid artery IMT and the presence of carotid plaque are associated with markers of systemic inflammation in patients with RA and in healthy subjects. This observation is consistent with hypotheses that assign a role to systemic inflammation in atherosclerosis, and may have implications regarding RA and other chronic inflammatory diseases.