Department of Cardiology, The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, China.
Department of Neurology, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China.
Clin Cardiol. 2023 Dec;46(12):1519-1529. doi: 10.1002/clc.24065. Epub 2023 Sep 4.
Immune and inflammatory responses have a pivotal role in the pathogenesis of rheumatoid arthritis (RA) and atherosclerotic cardiovascular disease (ASCVD). This study aims to explore the change of peripheral lymphocytes, especially the absolute and relative changes in peripheral T cells in RA patients with and without ASCVD.
The changes in the lymphocyte subsets were assessed to provide a novel insight in diagnosing and preventing ASCVD in patients with RA.
A propensity score matching system (1:1) was conducted to perform a matched case-control study with 169 pairs RA-ASCVD and RA participants. Univariate and multivariate analyses were performed to determine the association between peripheral lymphocytes and RA-ASCVD.
Multivariate logistic regression analysis demonstrated that Th17 cell absolute, Th17 cell Ratio, Th17/Treg were associated with a significantly higher risk of ASCVD after model adjustment. Then we focused on Th17/Treg, multivariate logistic analyses in tri-sectional Th17/Treg groups showed that the odds of ASCVD is gradually increasing with Th17/Treg rank's rising after model adjustment. Finally, the restricted cubic spline of Th17/Treg and odds ratio of RA-ASCVD was conducted. Interestingly, we found a critical point of Th17/Treg (critical point = 0.2399). Th17/Treg shows a protective role in the odds of ASCVD when Th17/Treg < 0.2399. With smaller Th17/Treg, the protective efficiency is more obvious when Th17/Treg < 0.2399.
Our study suggested that increasing absolute and percentage of Th17 cells in the peripheral blood of patients with RA was associated with the development of ASCVD. And Th17/Treg may be a promising biomarker for patients with RA in indicating comorbidity with ASCVD.
免疫和炎症反应在类风湿关节炎（RA）和动脉粥样硬化性心血管疾病（ASCVD）的发病机制中起关键作用。本研究旨在探讨 RA 患者伴或不伴 ASCVD 外周血淋巴细胞，尤其是外周 T 细胞的绝对和相对变化。
评估淋巴细胞亚群的变化，为 RA 患者 ASCVD 的诊断和预防提供新的思路。
采用倾向评分匹配系统（1:1）对 169 对 RA-ASCVD 和 RA 患者进行匹配病例对照研究。采用单因素和多因素分析方法确定外周血淋巴细胞与 RA-ASCVD 之间的关系。
多因素 logistic 回归分析表明，Th17 细胞绝对数、Th17 细胞比例、Th17/Treg 与 ASCVD 风险增加显著相关。然后我们关注 Th17/Treg，多因素 logistic 分析在三部分 Th17/Treg 组中显示，在模型调整后，随着 Th17/Treg 等级的升高，ASCVD 的发病几率逐渐增加。最后，进行了 Th17/Treg 的限制性立方样条和 RA-ASCVD 的比值比分析。有趣的是，我们发现了一个 Th17/Treg 的临界点（临界点=0.2399）。当 Th17/Treg<0.2399 时，Th17/Treg 对 ASCVD 发病几率具有保护作用。当 Th17/Treg<0.2399 时，Th17/Treg 越小，保护效率越明显。
本研究表明，RA 患者外周血中 Th17 细胞绝对值和百分比的增加与 ASCVD 的发生有关。Th17/Treg 可能是 RA 患者合并 ASCVD 的一个有前途的生物标志物。
