Serum osteoprotegerin is increased and independently associated with coronary-artery atherosclerosis in patients with rheumatoid arthritis

Serum osteoprotegerin is increased and independently associated with coronary-artery atherosclerosis in patients with rheumatoid arthritis
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DOI:
10.1016/j.atherosclerosis.2007.04.049
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发表时间:
2007-12-01
期刊:
影响因子:
5.3
通讯作者:
Stein, C. Michael
Stein, C. Michael
中科院分区:
医学2区
文献类型:
--
作者:
Asanuma, Yu;Chung, Cecilia P.;Stein, C. Michael

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护骨素(OPG)是核因子-kappaB受体激活剂的诱骗受体,参与动脉粥样硬化的发病过程。类风湿性关节炎(RA)患者有炎症和动脉粥样硬化增加。我们验证了类风湿性关节炎患者OPG浓度升高并与冠状动脉粥样硬化相关的假说。采用双抗体夹心法测定157例类风湿关节炎患者和87例正常对照的血清骨钙素水平,并用电子束计算机断层扫描法测定冠状动脉钙化程度。长期RA患者(67例)[中位数(四分位数范围)][1,895(1,337-2,847)pg/mL]和早期类风湿性关节炎(n=90)患者[1,340(1,021-1,652)pg/m L,高于对照组1,068(6,92-1,434)pg/m L;(p<0.001)]。在RA患者中,在调整年龄和性别后,OPG浓度与血沉(p<0.001)、同型半胱氨酸(p=0.001)、病程(p=0.02)、冠状动脉钙化积分(p=0.03)和皮质类固醇累积剂量(p=0.04)相关。在长期存在的RA患者中,OPG与冠状动脉钙化相关,与心血管危险因素和疾病活动性无关[OPG每增加500pg/mL,OR=2.22(1.43-3.34),p<0.001]。总而言之,类风湿关节炎患者的OPG浓度升高,并与炎症有关。在患有长期疾病的患者中,OPG与冠状动脉钙化独立相关。(C)2007爱思唯尔爱尔兰有限公司。保留所有权利。
Osteoprotegerin (OPG), a soluble decoy receptor for receptor activator of nuclear factor kappa B ligand, is implicated in the pathogenesis of atherosclerosis. Patients with rheumatoid arthritis (RA) have inflammation and increased atherosclerosis. We examined the hypothesis that OPG concentrations are increased in patients with RA and are associated with coronary-artery atherosclerosis. Serum OPG concentrations were measured by ELISA and coronary-artery calcification by electron-beam computer tomography in 157 patients with RA and 87 control subjects. OPG concentrations were higher in patients with long-standing RA (n = 67) [median (interquartile range)]: [1895 (1337-2847) pg/mL, and early RA (n = 90): [1340 (1021-1652) pg/mL, than controls 1068 (692-1434) pg/mL; (p < 0.001)]. In patients with RA, OPG concentrations were associated with erythrocyte sedimentation rate (p < 0.001), homocysteine (p = 0.001), disease duration (p = 0.02), coronary calcium score (p = 0.03), and cumulative dose of corticosteroids (p = 0.04) after adjustment for age and sex. In patients with long-standing RA, OPG was associated with coronary-artery calcification independently of cardiovascular risk factors and disease activity [OR for every increase in 500 pg/mL of OPG = 2.22 (1.43-3.34), p < 0.001]. In conclusion, OPG concentrations are increased in patients with RA and are associated with inflammation. In patients with long-standing disease, OPG is independently associated with coronary-artery calcification. (C) 2007 Elsevier Ireland Ltd. All rights reserved.