Xu Chuanhui, Khin Lay Wai, Tam Hui Zhen, Goh Liuh Ling, Koh Ee Tzun, Dalan Rinkoo, Leong Khai Pang
Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore, Singapore.
Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.
Front Med (Lausanne). 2024 Dec 17;11:1442858. doi: 10.3389/fmed.2024.1442858. eCollection 2024.
Traditional risk factors do not fully explain the increased risk of cardiovascular disease (CVD) in patients with rheumatoid arthritis (RA). The 2-2 genotype confers a lower anti-oxidant and higher inflammatory effect on the vasculature compared to the non- 2-2 genotype. This study investigates the association of the genotype with CVD in patients with RA.
Data from 69 RA patients with CVD and 207 sex- and ethnicity-matched RA patients without CVD, collected from 1 January 2000 to 31 December 2020, were retrieved from the Tan Tock Seng Hospital RA Registry. CVD was examined against demographics, clinical and laboratory variables in univariate models. Associations between the genotypes and CVD were analyzed using conditional logistic regression.
We studied 276 patients (65.2% female, 82.6% Chinese, median age 60.9 years). Most participants were in low disease activity or remission (79.3%). The 2-2 genotype was present in 49.6% (137/276). In the group with CVD, the prevalence of the 2-2 genotype was 50.9% (29/57) in the Chinese, 100% (5/5) in the Indians, and 28.6% (2/7) in the Malays. In the non-CVD group, the respective prevalence was 46.8% (80/171), 66.7% (10/15), and 52.4% (11/21). In univariate analysis, the matched odds ratio (OR) of the 2-2 genotype for CVD in RA was 1.34 [95% confidence interval (CI): 1.22-1.47; < 0.001]. The 2-2 genotype was significantly associated with CVD (adjusted matched OR: 1.13; 95% CI: 1.01-1.27; = 0.033) in the multivariate logistic regression model after adjusting the confounding factors, including age, smoking, diabetes, hypertension, hyperlipidemia, anti-CCP autoantibodies, and disease activity.
The 2-2 genotype is associated with an increased risk of CVD in patients with RA in this multi-ethnic cohort.
传统风险因素并不能完全解释类风湿关节炎（RA）患者心血管疾病（CVD）风险增加的原因。与非2-2基因型相比，2-2基因型对血管系统具有较低的抗氧化作用和较高的炎症作用。本研究调查了2-2基因型与RA患者CVD之间的关联。
从2000年1月1日至2020年12月31日收集的69例患有CVD的RA患者和207例性别和种族匹配的无CVD的RA患者的数据，取自陈笃生医院RA登记处。在单变量模型中，针对人口统计学、临床和实验室变量检查CVD情况。使用条件逻辑回归分析2-2基因型与CVD之间的关联。
我们研究了276例患者（65.2%为女性，82.6%为华裔，中位年龄60.9岁）。大多数参与者处于低疾病活动度或缓解期（79.3%）。2-2基因型的比例为49.6%（137/276）。在患有CVD的组中，华裔中2-2基因型的患病率为50.9%（29/57），印度裔中为100%（5/5），马来裔中为28.6%（2/7）。在无CVD的组中，相应的患病率分别为46.8%（80/171）、66.7%（10/15）和52.4%（11/21）。在单变量分析中，RA患者中2-2基因型患CVD的匹配优势比（OR）为1.34 [95%置信区间（CI）：1.22 - 1.47；P < 0.001]。在调整了包括年龄、吸烟情况、糖尿病、高血压、高脂血症、抗环瓜氨酸肽自身抗体和疾病活动度等混杂因素后，多变量逻辑回归模型显示2-2基因型与CVD显著相关（调整后的匹配OR：1.13；95% CI：1.01 - 1.27；P = 0.033）。
在这个多民族队列中，2-2基因型与RA患者CVD风险增加有关。
