Accelerated atherosclerosis in pre-menopausal female patients with rheumatoid arthritis.
Increased mortality due to cardiovascular disease in rheumatoid arthritis (RA) patients was reported. Using B-mode ultrasonography we compared intima-media thickness (IMT) and plaque occurrence (indicators of asymptomatic atherosclerosis) in the carotid arteries in 70 pre-menopausal, female RA patients and 40 controls. Correlations with different risk factors were evaluated. The IMT values were higher in RA patients (0.59 mm vs. 0.47 mm, P < 0.0001) and they had more plaques (P = 0.023). In RA patients higher levels of sensitive CRP (P < 0.0001), ICAM (P < 0.0001), VCAM (P < 0.0001), IL-2 (P < 0.001), IL-6 (P = 0.009) and TNF-alfa (P < 0.01) were found. A correlation between IMT and triglycerides (P = 0.018) and a negative correlation between IMT and HDL cholesterol (P = 0.037) were found. With multiple regression analysis the association between IMT and sensitive CRP (P = 0.027) and presence of plaques and apolipoprotein B (P = 0.028) was established. The results indicate that even pre-menopausal, female RA patients had accelerated atherosclerosis. Chronic systemic inflammation may play an important role in atherogenesis.
Pahor
A
A
Department of Rheumatology, Clinical Department of Internal Medicine, University Hospital Maribor, Ljubljanska 5, 2000 Maribor, Slovenia. artur.pahor@sb-mb.si
Hojs
R
R
Gorenjak
M
M
Rozman
B
B
D000328:Adult; D001172:Arthritis, Rheumatoid / Q000150:complications*; D050197:Atherosclerosis / Q000150:complications* / Q000503:physiopathology; D015415:Biomarkers; D002097:C-Reactive Protein / Q000276:immunology; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000473:pathology*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007249:Inflammation / Q000150:complications; D008875:Middle Aged; D017697:Premenopause; D012307:Risk Factors; D017539:Tunica Intima / Q000473:pathology*; D014463:Ultrasonography
D015415:Biomarkers; D002097:C-Reactive Protein