Kang Yoon, Park Hee-Jin, Kang Mi-I, Lee Hyang-Sun, Lee Sang-Won, Lee Soo-Kon, Park Yong-Beom
Arthritis Res Ther. 2013;15(6):R194. doi: 10.1186/ar4384.
Cardiovascular (CV) morbidity and mortality are increased in patients with rheumatoid arthritis (RA). Inflammation is thought to be an important factor in accelerated atherosclerosis in RA, whereas insulin resistance is a known risk factor for atherosclerosis in RA. We hypothesised that adipokines could be a link between inflammation, insulin resistance, and atherosclerosis in RA.
The common carotid artery (CCA) intima-media thickness (IMT), CCA resistive index (RI), and carotid plaques were measured by ultrasonography in 192 patients with RA. Insulin resistance was assessed by the homeostasis model assessment for insulin resistance (HOMA-IR). Serum adiponectin, leptin, resistin, tumor necrosis factor-α, and interleukin (IL)-6 concentrations were determined.
The CCA RI was associated with CCA IMT and the estimated total plaque volume after adjustment for conventional CV risk factors. Among adipokines, resistin and IL-6 were correlated with inflammatory parameters. Leptin and leptin:adiponectin (L:A) ratio were correlated with metabolic risk factors, including HOMA-IR. And L:A ratio was related to the CCA RI after adjustment for conventional and nonconventional CV risk factors, including HOMA-IR, erythrocyte sedimentation rate and C-reactive protein.
L:A ratio was associated with HOMA-IR and carotid RI. L:A ratio might be an independent factor for predicting cardiovascular risk in patients with RA.
类风湿关节炎（RA）患者的心血管（CV）发病率和死亡率会升高。炎症被认为是RA中加速动脉粥样硬化的一个重要因素，而胰岛素抵抗是RA中动脉粥样硬化的一个已知危险因素。我们推测脂肪因子可能是RA中炎症、胰岛素抵抗和动脉粥样硬化之间的一个联系。
通过超声检查测量了192例RA患者的颈总动脉（CCA）内膜中层厚度（IMT）、CCA阻力指数（RI）和颈动脉斑块。通过稳态模型评估胰岛素抵抗（HOMA-IR）来评估胰岛素抵抗。测定血清脂联素、瘦素、抵抗素、肿瘤坏死因子-α和白细胞介素（IL）-6浓度。
在对传统CV危险因素进行校正后，CCA RI与CCA IMT和估计的总斑块体积相关。在脂肪因子中，抵抗素和IL-6与炎症参数相关。瘦素和瘦素：脂联素（L:A）比值与包括HOMA-IR在内的代谢危险因素相关。并且在对包括HOMA-IR、红细胞沉降率和C反应蛋白在内的传统和非传统CV危险因素进行校正后，L:A比值与CCA RI相关。
L:A比值与HOMA-IR和颈动脉RI相关。L:A比值可能是预测RA患者心血管风险的一个独立因素。
