Université Clermont Auvergne, CHU Clermont-Ferrand, INSERM, Neuro-Dol, 63000, Clermont-Ferrand, France.
Service de Rhumatologie, CHU Clermont-Ferrand, 63000, Clermont-Ferrand, France.
Rheumatol Int. 2023 Nov;43(11):2065-2072. doi: 10.1007/s00296-023-05405-3. Epub 2023 Aug 11.
It is clear that there is an increased cardiovascular (CV) risk in rheumatoid arthritis (RA) as a result of systemic inflammation. Hand osteoarthritis (HOA) patients, also have an increased CV risk, but the causes are still debated. Our objective was to compare CV risk factors and risk scores between HOA and RA patients. Thirty-five HOA patients were matched by age (< 3 years) and sex to 35 RA patients in a case-control study. We compared their CV risk profiles and their risk of occurrence of CV events at 10 years using the risk equations SCORE1, SCORE2, and QRISK3. There was a significant increase in SCORE1, SCORE2, but not in QRISK3 in the RA group compared to the HOA group, provided that the multiplication coefficient for RA was applied. This increase was found to no longer be significant for SCORE1 when RA patients have low disease activity (DAS28 ≤ 3.2; n = 8). There was no difference between groups in the frequency of metabolic syndrome, blood pressure, abdominal circumference, body mass index, uricemia, triglyceridemia, HDL cholesterolemia, or pain intensity. Conversely, HOA patients had higher LDL cholesterol and fasting blood glucose levels, in the main analysis and in the subgroup of moderate/high RA activity patients (DAS28 > 3.2; n = 26). We found a higher CV risk in RA compared to HOA patients with moderate/high disease activity. The increased CV risk reported in OA remains to be confirmed in HOA, but these patients appear to have a pro-atherogenic lipid and glycemic profile.
很明显,类风湿关节炎(RA)患者由于全身炎症而存在心血管(CV)风险增加。手骨关节炎(HOA)患者也存在 CV 风险增加,但原因仍存在争议。我们的目的是比较 HOA 和 RA 患者的 CV 危险因素和风险评分。在一项病例对照研究中,我们将 35 名 HOA 患者按年龄(<3 岁)和性别与 35 名 RA 患者相匹配。我们比较了他们的 CV 风险概况以及使用 SCORE1、SCORE2 和 QRISK3 风险方程预测 10 年内发生 CV 事件的风险。与 HOA 组相比,RA 组的 SCORE1、SCORE2 显著增加,但 QRISK3 没有增加,如果应用 RA 的倍增系数。当 RA 患者疾病活动度低(DAS28≤3.2;n=8)时,SCORE1 的这种增加不再具有统计学意义。两组之间代谢综合征、血压、腰围、体重指数、血尿酸、三酰甘油、高密度脂蛋白胆固醇或疼痛强度的频率没有差异。相反,在主要分析和中度/高度 RA 活动患者亚组(DAS28>3.2;n=26)中,HOA 患者的 LDL 胆固醇和空腹血糖水平较高。我们发现,与中度/高度疾病活动的 HOA 患者相比,RA 患者的 CV 风险更高。OA 中报告的增加的 CV 风险仍需在 HOA 中得到证实,但这些患者似乎具有致动脉粥样硬化的脂质和血糖特征。