Koren Krajnc Metka, Hojs Radovan, Holc Iztok, Knez Željko, Pahor Artur
Division of Internal Medicine, Department of Rheumatology, University Medical Centre Maribor, Maribor, Slovenia; Medical Faculty, University of Maribor, Maribor, Slovenia.
Medical Faculty, University of Maribor, Maribor, Slovenia; Division of Internal Medicine, Department of Nephrology, University Medical Centre Maribor, Maribor, Slovenia.
Bosn J Basic Med Sci. 2021 Aug 1;21(4):477-483. doi: 10.17305/bjbms.2020.5176.
Rheumatoid arthritis (RA) is a chronic inflammatory disease associated with increased mortality and morbidity due to the higher cardiovascular risk in these patients. Traditional risk factors are not the only answer for the accelerated atherosclerosis. In a long-term prospective study, we investigated the relationship between asymptomatic atherosclerosis and traditional risk factors and inflammatory markers in patients with RA and matched healthy controls. We studied the laboratory test results, the concentrations of inflammatory mediators, matrix metalloproteases (MMP), and inflammation markers in a total of 70 (60 at follow-up) premenopausal healthy women with RA and 40 (34 at follow-up) matched controls. We used the B-mode ultrasound imaging of carotid arteries for the detection of asymptomatic atherosclerosis. Correlation with different factors was evaluated. Statistically significant higher values of inflammatory markers such as selective adhesion molecules ICAM and VCAM, interleukin 6 (IL-6), tumor necrosis factor alpha (TNF-alpha), and MMP-3 in the patients group were found in the follow-up study. More plaques were found in the patients group (42.4% vs. 12.9%; p=0.005), as compared with the controls group. The patients had also higher values of cIMT (p=0.001). Using bivariate regression analysis only VCAM was found as a prognostic factor for plaque occurrence (r= 0. 341, p=0.016), but not for cIMT (r= -0.130, p=0.327) in premenopausal female patients with RA after the follow-up. Therefore, asymptomatic atherosclerosis is accelerated in premenopausal women with RA. The results of our follow-up study showed the association between inflammation and accelerated atherosclerosis. Furthermore, VCAM was found to have a statistically significant correlation with plaque occurrence in these patients.
类风湿性关节炎（RA）是一种慢性炎症性疾病，由于这些患者心血管风险较高，其死亡率和发病率也随之增加。传统风险因素并非加速动脉粥样硬化的唯一原因。在一项长期前瞻性研究中，我们调查了RA患者和匹配的健康对照者中无症状动脉粥样硬化与传统风险因素及炎症标志物之间的关系。我们研究了70名（随访时60名）绝经前患RA的健康女性和40名（随访时34名）匹配对照者的实验室检查结果、炎症介质、基质金属蛋白酶（MMP）和炎症标志物的浓度。我们使用颈动脉B型超声成像来检测无症状动脉粥样硬化。评估了与不同因素的相关性。在随访研究中发现，患者组中炎症标志物如选择性黏附分子ICAM和VCAM、白细胞介素6（IL-6）、肿瘤坏死因子α（TNF-α）和MMP-3的值在统计学上显著更高。与对照组相比，患者组发现更多斑块（42.4%对12.9%；p=0.005）。患者的颈动脉内膜中层厚度（cIMT）值也更高（p=0.001）。使用双变量回归分析，在随访后的绝经前患RA的女性患者中，仅发现VCAM是斑块发生的预后因素（r = 0.341，p = 0.016），但不是cIMT的预后因素（r = -0.130，p = 0.327）。因此，绝经前患RA的女性中无症状动脉粥样硬化加速。我们随访研究的结果显示了炎症与加速动脉粥样硬化之间的关联。此外，发现VCAM与这些患者的斑块发生具有统计学上的显著相关性。
