Cardiovascular risk in rheumatoid arthritis versus osteoarthritis: acute phase response related decreased insulin sensitivity and high-density lipoprotein cholesterol as well as clustering of metabolic syndrome features in rheumatoid arthritis.
Cardiovascular risk in rheumatoid arthritis versus osteoarthritis: acute phase response related decreased insulin sensitivity and high-density lipoprotein cholesterol as well as clustering of metabolic syndrome features in rheumatoid arthritis.
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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
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发表时间：
2002
期刊：
影响因子：
--
通讯作者：
Joffe, BI
中科院分区：
文献类型：
--
作者：
Dessein, PH;Stanwix, AE;Joffe, BI
风湿性关节炎（RA）患者经历显著增加的心血管疾病的频率。我们评估了79例RA患者和39例年龄和性别匹配的骨关节炎（OA）患者的心血管风险特征。实验室检查包括超敏C反应蛋白（CRP）和空腹血脂。所有OA患者和39例RA患者的胰岛素敏感性（IS）通过定量胰岛素敏感性检查指数（QUICKI）测定。10例RA患者正在使用糖皮质激素。RA患者的运动频率高于OA患者（χ2 = 3.9，P < 0.05）。9例RA和1例OA患者合并糖尿病（χ2 = 4.5，P < 0.05）。中位CRP、平均QUICKI和平均高密度脂蛋白（HDL）胆固醇为9 mg/l（范围，0.5-395毫克/升），0.344（95%置信区间[CI]，0.332-0.355）和1.40 mmol/l（95% CI，1.30-1.49 mmol/l），与2.7 mg/l相比（范围，0.3-15.9 mg/l），0.369（95% CI，0.356-0.383）和1.68 mmol/l（95% CI，1.50-1.85 mmol/l）。差异均有显著性（P < 0.05）。在控制CRP后，RA和OA患者的QUICKI相似（P = 0.07），而HDL胆固醇的差异有所减弱，但仍具有显著性（P = 0.03）。CRP与IS相关，而IS与RA患者的高HDL胆固醇和低甘油三酯相关，而与OA患者无关。高CRP（≥ 8 mg/l）与RA患者的高血压相关（χ2 = 7.4，P < 0.05）。糖皮质激素组与非糖皮质激素组IS、血脂水平无显著性差异（P > 0.05）。与OA患者相比，RA患者的心血管风险过高，包括RA患者IS和HDL胆固醇降低。后者仅部分归因于急性期反应。RA患者CRP、IS、HDL胆固醇、甘油三酯与高血压存在相关性，而OA患者无相关性。
Rheumatoid arthritis (RA) patients experience a markedly increased frequency of cardiovascular disease. We evaluated cardiovascular risk profiles in 79 RA patients and in 39 age-matched and sex-matched osteoarthritis (OA) patients. Laboratory tests comprised ultrasensitive C-reactive protein (CRP) and fasting lipids. Insulin sensitivity (IS) was determined by the Quantitative Insulin Sensitivity Check Index (QUICKI) in all OA patients and in 39 of the RA patients. Ten RA patients were on glucocorticoids. RA patients exercised more frequently than OA patients (χ2 = 3.9, P < 0.05). Nine RA patients and one OA patient had diabetes (χ2 = 4.5, P < 0.05). The median CRP, the mean QUICKI and the mean high-density lipoprotein (HDL) cholesterol were 9 mg/l (range, 0.5–395 mg/l), 0.344 (95% confidence interval [CI], 0.332–0.355) and 1.40 mmol/l (95% CI, 1.30–1.49 mmol/l) in RA patients, respectively, as compared with 2.7 mg/l (range, 0.3–15.9 mg/l), 0.369 (95% CI, 0.356–0.383) and 1.68 mmol/l (95% CI, 1.50–1.85 mmol/l) in OA patients. Each of these differences was significant (P < 0.05). After controlling for the CRP, the QUICKI was similar in RA and OA patients (P = 0.07), while the differences in HDL cholesterol were attenuated but still significant (P = 0.03). The CRP correlated with IS, while IS was associated with high HDL cholesterol and low triglycerides in RA patients and not in OA patients. A high CRP (≥ 8 mg/l) was associated with hypertension (χ2 = 7.4, P < 0.05) in RA patients. RA glucocorticoid and nonglucocorticoid users did not differ in IS and lipids (P > 0.05). Excess cardiovascular risk in RA patients as compared with OA patients includes the presence of decreased IS and HDL cholesterol in RA patients. The latter is only partially attributable to the acute phase response. The CRP, IS, HDL cholesterol, triglycerides and hypertension are inter-related in RA patients, whereas none of these relationships were found in OA patients.
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影响因子：
3.5
作者：
Björntorp, P;Holm, G;Rosmond, R
通讯作者：
Rosmond, R
影响因子：
--
作者：
SVENSON, KLG;LITHELL, H;VESSBY, B
通讯作者：
VESSBY, B
影响因子：
9.8
作者：
SVENSON, KLG;POLLARE, T;HALLGREN, R
通讯作者：
HALLGREN, R
影响因子：
37.8
作者：
Ridker, PM
通讯作者：
Ridker, PM
影响因子：
120.7
作者：
Cleeman, JI;Grundy, SM;Murray, EZ
通讯作者：
Murray, EZ