Arias de la Rosa Iván, Font Pilar, Escudero-Contreras Alejandro, López-Montilla María Dolores, Pérez-Sánchez Carlos, Ábalos-Aguilera María Carmen, Ladehesa-Pineda Lourdes, Ibáñez-Costa Alejandro, Torres-Granados Carmen, Jimenez-Gomez Yolanda, Patiño-Trives Alejandra, Luque-Tévar María, Castro-Villegas María Carmen, Calvo-Gutiérrez Jerusalem, Ortega-Castro Rafaela, López-Pedrera Chary, Collantes-Estévez Eduardo, Barbarroja Nuria
Medicine Department, University of Cordoba, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), Reina Sofia University Hospital, Cordoba, Spain.
Rheumatology service, IMIBIC, Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain.
Ther Adv Chronic Dis. 2020 Oct 21;11:2040622320965067. doi: 10.1177/2040622320965067. eCollection 2020.
To analyze the relationship between complement component 3 (C3) and the prevalence of cardiometabolic risk factors and disease activity in the rheumatic diseases having the highest rates of cardiovascular morbidity and mortality: rheumatoid arthritis (RA), psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA).
This is a cross-sectional study including 200 RA, 80 PsA, 150 axSpA patients and 100 healthy donors. The prevalence of cardiometabolic risk factors [obesity, insulin resistance, type 2 diabetes mellitus, hyperlipidemia, apolipoprotein B/apolipoprotein A (apoB/apoA) and atherogenic risks and hypertension] was analyzed. Serum complement C3 levels, inflammatory markers and disease activity were evaluated. Cluster analysis was performed to identify different phenotypes. Receiver operating characteristic (ROC) curve analysis to assess the accuracy of complement C3 as biomarker of insulin resistance and disease activity was carried out.
Levels of complement C3, significantly elevated in RA, axSpA and PsA patients, were associated with the prevalence of cardiometabolic risk factors. Hard clustering analysis identified two distinctive phenotypes of patients depending on the complement C3 levels and insulin sensitivity state. Patients from cluster 1, characterized by high levels of complement C3 displayed increased prevalence of cardiometabolic risk factors and high disease activity. ROC curve analysis showed that non-obesity related complement C3 levels allowed to identify insulin resistant patients.
Complement C3 is associated with the concomitant increased prevalence of cardiometabolic risk factors in rheumatoid arthritis and spondyloarthritis. Thus, complement C3 should be considered a useful marker of insulin resistance and disease activity in these rheumatic disorders.
分析补体成分3（C3）与心血管发病率和死亡率最高的风湿性疾病（类风湿关节炎（RA）、银屑病关节炎（PsA）和中轴型脊柱关节炎（axSpA））中心血管代谢危险因素的患病率及疾病活动度之间的关系。
这是一项横断面研究，纳入200例RA患者、80例PsA患者、150例axSpA患者和100名健康对照者。分析心血管代谢危险因素（肥胖、胰岛素抵抗、2型糖尿病、高脂血症、载脂蛋白B/载脂蛋白A（apoB/apoA）及致动脉粥样硬化风险和高血压）的患病率。评估血清补体C3水平、炎症标志物及疾病活动度。进行聚类分析以识别不同表型。采用受试者工作特征（ROC）曲线分析评估补体C3作为胰岛素抵抗和疾病活动度生物标志物的准确性。
RA、axSpA和PsA患者的补体C3水平显著升高，且与心血管代谢危险因素的患病率相关。硬聚类分析根据补体C3水平和胰岛素敏感性状态识别出两种不同的患者表型。第1组患者以补体C3水平高为特征，其心血管代谢危险因素的患病率增加且疾病活动度高。ROC曲线分析表明，与肥胖无关的补体C3水平可用于识别胰岛素抵抗患者。
补体C3与类风湿关节炎和脊柱关节炎中心血管代谢危险因素患病率的同时增加相关。因此，在这些风湿性疾病中，补体C3应被视为胰岛素抵抗和疾病活动度的有用标志物。
