title: Increased progression of carotid intima media thickness in thyroid peroxidase antibodies-positive rheumatoid arthritis patients.
abstract: OBJECTIVE
  Autoimmune diseases such as rheumatoid arthritis (RA) and hypothyroidism tend to cluster, and this coexistence amplifies the elevated cardiovascular risk in RA. Whether thyroid peroxidase antibodies (TPOabs) are associated with increased cardiovascular disease (CVD) risk has not been studied extensively. Therefore, this study determined firstly the prevalence of TPOabs in RA and secondly whether TPOabs were associated with CVD. Moreover, this study explored whether TPOabs were related to RA characteristics.
  
  
  METHODS
  Data from the CARRÉ Study, an ongoing study investigating CVDs and its risk factors in RA (n=322), was used to ascertain the prevalence of TPOabs in RA patients. In addition, cardiovascular and RA disease characteristics were compared between TPOabs-positive and -negative patients at baseline and at a second visit after 3 years.
  
  
  RESULTS
  TPOabs were present in 47/322 (15%) RA patients and TSH levels were higher in TPOabs-positive patients (1.40 mU/l) compared with TPOabs-negative patients (1.26 mU/l, P=0.048). At baseline and after 3 years no association was observed between TPOabs and (risk factors for) CVD. Regression analyses revealed a significantly larger progression of carotid intima media thickness (cIMT; β=0.13 mm) in TPOabs-positive compared with TPOabs-negative patients independent of risk factors for cIMT progression. RA disease activity scores (DAS28) were higher in TPOabs-positive compared with TPOabs-negative patients (4.4 vs 3.8 P=0.018).
  
  
  CONCLUSIONS
  TPOabs were associated with increased cIMT progression. Moreover, an association between TPOabs and DAS28 was observed. Hence, TPOabs seems to have a role in the amplified cardiovascular risk in RA patients.
authors.affiliation: Departments of Rheumatology.
authors.forename: H G
authors.initials: HG
authors.lastname: Raterman
authors.forename: A E
authors.initials: AE
authors.lastname: Voskuyl
authors.forename: S
authors.initials: S
authors.lastname: Simsek
authors.forename: M W J
authors.initials: MW
authors.lastname: Schreurs
authors.forename: I M W
authors.initials: IM
authors.lastname: van Hoogstraten
authors.forename: M J L
authors.initials: MJ
authors.lastname: Peters
authors.forename: V P
authors.initials: VP
authors.lastname: van Halm
authors.forename: B A C
authors.initials: BA
authors.lastname: Dijkmans
authors.forename: P
authors.initials: P
authors.lastname: Lips
authors.forename: W F
authors.initials: WF
authors.lastname: Lems
authors.forename: M T
authors.initials: MT
authors.lastname: Nurmohamed
mesh_terms: D000368:Aged; D001172:Arthritis, Rheumatoid / Q000097:blood / Q000150:complications* / Q000276:immunology; D001323:Autoantibodies / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000097:blood / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology*; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging / Q000473:pathology*; D059168:Carotid Intima-Media Thickness; D018450:Disease Progression; D005260:Female; D006801:Humans; D007037:Hypothyroidism / Q000097:blood / Q000150:complications* / Q000276:immunology; D007453:Iodide Peroxidase / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013963:Thyroid Hormones / Q000097:blood*
chemical_list: D001323:Autoantibodies; D015415:Biomarkers; D013963:Thyroid Hormones; D007453:Iodide Peroxidase