Arterial wall inflammation is increased in rheumatoid arthritis compared with osteoarthritis, as a marker of early atherosclerosis.
Arterial wall inflammation is increased in rheumatoid arthritis compared with osteoarthritis, as a marker of early atherosclerosis.
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DOI：
10.1093/rheumatology/keaa789
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发表时间：
2021-07-01
期刊：
影响因子：
--
通讯作者：
Nurmohamed MT
中科院分区：
文献类型：
--
作者：
Agca R;Blanken AB;van Sijl AM;Smulders YM;Voskuyl AE;van der Laken C;Boellaard R;Nurmohamed MT
RA与心血管（CV）疾病的高风险相关。持续的全身性炎症被认为通过增加动脉壁的炎症而加速动脉粥样硬化。然而，支持这一假设的证据有限。我们的目的是研究RA与OA的动脉壁炎症，及其与炎症标志物和CV危险因素的相关性。18-对RA（n = 61）和OA（n = 28）患者进行了18 F-FDG-PET/CT联合检查，以研究大动脉壁的炎症活动。在早期未经治疗的RA患者（n = 30）和确诊的RA患者（n = 31）与OA患者中进行次要分析。与OA患者相比，RA患者颈动脉壁（β 0.27，95%CI 0.11-0.44，P <0.01）和主动脉壁（β 0.47，95%CI 0.17-0.76，P <0.01）的18F-FDG摄取显著更高，在校正传统CV危险因素后仍持续存在。早期RA患者的18F-FDG摄取最高，其次分别为已确诊的RA和OA患者。28个关节的ESR和DAS值越高，所有动脉段的18F-FDG摄取越高。与OA患者相比，RA患者动脉壁18F-FDG摄取增加，这可能是早期动脉粥样硬化的标志。此外，较高水平的临床疾病活动和循环炎症标志物与较高的动脉18F-FDG摄取相关，这可能支持动脉壁炎症在RA患者血管并发症发病机制中的作用。
RA is associated with higher risk of cardiovascular (CV) disease. Ongoing systemic inflammation is presumed to accelerate atherosclerosis by increasing inflammation in the arterial wall. However, evidence supporting this hypothesis is limited. We aimed to investigate arterial wall inflammation in RA vs OA, and its association with markers of inflammation and CV risk factors. 18-fluorodeoxyglucose PET combined with CT (18F-FDG-PET/CT) was performed in RA (n = 61) and OA (n = 28) to investigate inflammatory activity in the wall of large arteries. Secondary analyses were performed in patients with early untreated RA (n = 30), and established RA, active under DMARD treatment (n = 31) vs OA. Patients with RA had significantly higher 18F-FDG uptake in the wall of the carotid arteries (beta 0.27, 95%CI 0.11—0.44, P <0.01) and the aorta (beta 0.47, 95%CI 0.17—0.76, P <0.01) when compared with OA, which persisted after adjustment for traditional CV risk factors. Patients with early RA had the highest 18F-FDG uptake, followed by patients with established RA and OA respectively. Higher ESR and DAS of 28 joints values were associated with higher 18F-FDG uptake in all arterial segments. Patients with RA have increased 18F-FDG uptake in the arterial wall compared with patients with OA, as a possible marker of early atherosclerosis. Furthermore, a higher level of clinical disease activity and circulating inflammatory markers was associated with higher arterial 18F-FDG uptake, which may support a role of arterial wall inflammation in the pathogenesis of vascular complications in patients with RA.
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