Department of Rheumatology and Clinical Immunology, University Medical Center Groningen, P.O. Box 30001, Groningen, 9700 RB, The Netherlands.
Department of Internal Medicine, University Medical Center Groningen, Groningen, The Netherlands.
Rheumatol Int. 2024 Oct;44(10):2007-2016. doi: 10.1007/s00296-024-05659-5. Epub 2024 Jul 16.
To identify differences in levels of serum biomarkers associated with atherosclerosis between anti-citrullinated protein antibodies (ACPA) positive groups.
Cross-sectional data were used from the Dutch Lifelines Cohort Study combined with data derived from RA risk and early RA studies conducted at the University Medical Center Groningen (UMCG). Serum biomarkers of inflammation, endothelial cell activation, tissue remodeling and adipokine, which were previously associated with atherosclerosis, were measured with Luminex in four ACPA positive groups with different characteristics: without joint complaints, with joint complaints, RA risk and early RA groups.
Levels of C-reactive protein (CRP), Interleukin-6 (IL-6), Tumor Necrosis Factor Receptor 1 (TNFR1) and vascular endothelial growth factor (VEGF) were significantly higher in the RA risk and early RA groups compared to the joint complaints and the no joint complaints groups. The difference remained statistically significant after correcting for renal function, smoking and hypertension in multivariate logistic regression analysis, with focus on ACPA positive with joint complaints group versus RA risk group: CRP OR = 2.67, p = 0.033; IL-6 OR = 3.73, p = 0.019; TNFR1 OR = 1.003, p < 0.001; VGEF OR = 8.59, p = 0.019.
Individuals at risk for RA have higher levels of inflammatory markers and VEGF, which suggests that they might also have a risk of higher cardiovascular disease (CVD); however, this does not apply to individuals with ACPA positivity with self-reported joint complaints or without joint complaints only. Therefore, it is important that individuals with RA risk are referred to a rheumatologist to rule in or out arthritis/development of RA and discuss CVD risk.
确定抗瓜氨酸蛋白抗体（ACPA）阳性组之间与动脉粥样硬化相关的血清生物标志物水平的差异。
使用来自荷兰 Lifelines 队列研究的横断面数据，并结合格罗宁根大学医学中心（UMCG）进行的 RA 风险和早期 RA 研究的数据。使用 Luminex 测量了先前与动脉粥样硬化相关的炎症、内皮细胞激活、组织重塑和脂肪因子的血清生物标志物，在具有不同特征的四个 ACPA 阳性组中进行测量：无关节症状、有关节症状、RA 风险和早期 RA 组。
与有或无关节症状组相比，RA 风险和早期 RA 组的 C 反应蛋白（CRP）、白细胞介素-6（IL-6）、肿瘤坏死因子受体 1（TNFR1）和血管内皮生长因子（VEGF）水平显著更高。在多变量逻辑回归分析中，在调整肾功能、吸烟和高血压后，差异仍具有统计学意义，重点是有或无关节症状的 ACPA 阳性组与 RA 风险组相比：CRP OR=2.67，p=0.033；IL-6 OR=3.73，p=0.019；TNFR1 OR=1.003，p<0.001；VGEF OR=8.59，p=0.019。
RA 风险个体具有更高水平的炎症标志物和 VEGF，这表明他们可能也有更高的心血管疾病（CVD）风险；然而，这不适用于有或无关节症状的 ACPA 阳性个体。因此，重要的是将 RA 风险个体转介给风湿病专家，以排除或确诊关节炎/RA 的发展，并讨论 CVD 风险。
