De Pablo Paola, Dietrich Thomas, Karlson Elizabeth W
Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Arthritis Rheum. 2007 Aug 15;57(6):953-62. doi: 10.1002/art.22912.
To compare antioxidants and other novel and traditional cardiovascular disease (CVD) risk factors in participants with rheumatoid arthritis (RA) and non-RA controls in a large population sample.
The Third National Health and Nutrition Examination Survey (NHANES-III) was a cross-sectional population survey in which subjects ages >or=60 underwent a musculoskeletal examination. RA subjects were defined as those who met >or=3 of 6 available 1987 American College of Rheumatology (ACR) criteria. Non-RA subjects were defined as those who met no ACR criteria. We performed univariate and multivariate analyses of the association between RA and each novel and traditional CVD risk factor in RA versus non-RA subjects.
The sample included 5,302 subjects ages >or=60, with 131 (2.5%) RA and 4,444 (84%) non-RA participants. A total of 727 subjects were excluded. Plasma levels of antioxidants alpha-carotene, beta-cryptoxanthin, lutein/zeaxanthin, and lycopene were significantly lower in RA subjects compared with non-RA subjects in multivariate analysis adjusting for potential confounders. Compared with non-RA participants, RA subjects were more likely to have increased C-reactive protein (CRP) levels in multivariate analysis adjusting for potential confounders. RA and non-RA participants had similar prevalence of traditional CVD risk factors and previous CVD.
In this large population study, RA subjects had similar prevalence of previous CVD and traditional CVD risk factors as controls. Among novel CVD risk factors, plasma carotenoid levels were significantly lower and CRP level was significantly higher in RA compared with non-RA subjects after adjustment for potential confounders. Further research should evaluate whether these differences account for the observed increased incidence of CVD in individuals with RA.
在一个大型人群样本中，比较类风湿关节炎（RA）患者与非RA对照者的抗氧化剂及其他新型和传统心血管疾病（CVD）风险因素。
第三次全国健康与营养检查调查（NHANES-III）是一项横断面人群调查，其中年龄≥60岁的受试者接受了肌肉骨骼检查。RA受试者定义为符合1987年美国风湿病学会（ACR）6项可用标准中≥3项的患者。非RA受试者定义为不符合任何ACR标准的患者。我们对RA患者与非RA患者中RA与每种新型和传统CVD风险因素之间的关联进行了单变量和多变量分析。
样本包括5302名年龄≥60岁的受试者，其中131名（2.5%）为RA患者，4444名（84%）为非RA参与者。共有727名受试者被排除。在对潜在混杂因素进行调整的多变量分析中，RA患者血浆中抗氧化剂α-胡萝卜素、β-隐黄质、叶黄素/玉米黄质和番茄红素的水平显著低于非RA患者。在对潜在混杂因素进行调整的多变量分析中，与非RA参与者相比，RA患者更有可能出现C反应蛋白（CRP）水平升高。RA和非RA参与者传统CVD风险因素和既往CVD的患病率相似。
在这项大型人群研究中，RA患者既往CVD和传统CVD风险因素的患病率与对照组相似。在新型CVD风险因素中，在对潜在混杂因素进行调整后，RA患者的血浆类胡萝卜素水平显著低于非RA患者，而CRP水平显著高于非RA患者。进一步的研究应评估这些差异是否解释了RA患者中观察到的CVD发病率增加的现象。
