Asanuma Yu, Chung Cecilia P, Oeser Annette, Solus Joseph F, Avalos Ingrid, Gebretsadik Tebeb, Shintani Ayumi, Raggi Paolo, Sokka Tuulikki, Pincus Theodore, Stein C Michael
Saitama Medical University, Saitama, Japan.
Atherosclerosis. 2007 Dec;195(2):e135-41. doi: 10.1016/j.atherosclerosis.2007.04.049. Epub 2007 Jun 14.
Osteoprotegerin (OPG), a soluble decoy receptor for receptor activator of nuclear factor kappaB 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.
骨保护素（OPG）是一种可溶性核因子κB受体活化因子配体的诱饵受体，与动脉粥样硬化的发病机制有关。类风湿关节炎（RA）患者存在炎症且动脉粥样硬化风险增加。我们检验了这样一个假设：RA患者的OPG浓度升高，且与冠状动脉粥样硬化相关。采用酶联免疫吸附测定法（ELISA）检测了157例RA患者和87例对照者的血清OPG浓度，并通过电子束计算机断层扫描检测冠状动脉钙化情况。病程较长的RA患者（n = 67）[中位数（四分位间距）]的OPG浓度为：[1895（1337 - 2847）pg/mL]，早期RA患者（n = 90）为：[1340（1021 - 1652）pg/mL]，均高于对照组的1068（692 - 1434）pg/mL；（p < 0.001）。在RA患者中，校正年龄和性别后，OPG浓度与红细胞沉降率（p < 0.001）、同型半胱氨酸（p = 0.001）、病程（p = 0.02）、冠状动脉钙化评分（p = 0.03）以及皮质类固醇累积剂量（p = 0.04）相关。在病程较长的RA患者中，OPG与冠状动脉钙化独立相关，不受心血管危险因素和疾病活动度影响[OPG每升高500 pg/mL的比值比=2.22（1.43 - 3.34），p < 0.001]。总之，RA患者的OPG浓度升高且与炎症相关。在病程较长的患者中，OPG与冠状动脉钙化独立相关。
