title: Urinary albumin excretion is increased in patients with rheumatoid arthritis and associated with arterial stiffness.
abstract: OBJECTIVE
  Rheumatoid arthritis (RA) is associated with increased risk of cardiovascular disease (CVD). High urinary albumin excretion is a risk factor for CVD in the general population, but its role in atherosclerosis in patients with RA is not well defined.
  
  
  METHODS
  We determined the urine albumin to creatinine ratio (UACR) in 136 patients with RA and 79 controls. Individuals with diabetes or a clinical history of CVD were excluded. We measured coronary artery calcium (CAC) with electron beam computer tomography and augmentation index (AIx) using pulse wave analysis. In patients with RA, erythrocyte sedimentation rate and concentrations of vascular cell adhesion protein-1 (VCAM-1), interleukin 10 (IL-10), C-reactive protein, IL-6, tumor necrosis factor-α, and cystatin-C were measured and results correlated with UACR.
  
  
  RESULTS
  Patients with RA had higher UACR [median (interquartile range): 7.6 (4.0-15.5) mg/g] than control subjects: 5.6 (3.3-9.0) mg/g; p = 0.02. The presence of CAC was not associated with UACR in RA or control subjects. In patients with RA, UACR was significantly correlated with AIx (rho = 0.24, p = 0.01), higher levels of VCAM-1 (rho = 0.2, p = 0.01), and lower levels of IL-10 (rho = -0.2, p = 0.02). The association between AIx and higher UACR remained significant in multivariate analysis [β coefficient of 1.5 (95% CI 0.1-2.8), p = 0.03 that adjusted for age, sex, and race].
  
  
  CONCLUSIONS
  Urinary albumin excretion was higher in patients with RA than controls and correlated with increased arterial stiffness, higher VCAM-1, and lower IL-10 concentrations.
authors: From the Department of Medicine, Vanderbilt University, Nashville, Tennessee, USA; the Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.K. Becetti, MD; A. Oeser, BS; M.J. Ormseth, MD, MSci; J.F. Solus, PhD, Department of Medicine, Vanderbilt University; P. Raggi, MD, Department of Medicine, University of Alberta; C.M. Stein, MD; C.P. Chung, MD, MPH, Department of Medicine, Vanderbilt University.
authors: Karima
authors: K
authors: Becetti
authors: From the Department of Medicine, Vanderbilt University, Nashville, Tennessee, USA; the Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.K. Becetti, MD; A. Oeser, BS; M.J. Ormseth, MD, MSci; J.F. Solus, PhD, Department of Medicine, Vanderbilt University; P. Raggi, MD, Department of Medicine, University of Alberta; C.M. Stein, MD; C.P. Chung, MD, MPH, Department of Medicine, Vanderbilt University.
authors: Annette
authors: A
authors: Oeser
authors: From the Department of Medicine, Vanderbilt University, Nashville, Tennessee, USA; the Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.K. Becetti, MD; A. Oeser, BS; M.J. Ormseth, MD, MSci; J.F. Solus, PhD, Department of Medicine, Vanderbilt University; P. Raggi, MD, Department of Medicine, University of Alberta; C.M. Stein, MD; C.P. Chung, MD, MPH, Department of Medicine, Vanderbilt University.
authors: Michelle J
authors: MJ
authors: Ormseth
authors: From the Department of Medicine, Vanderbilt University, Nashville, Tennessee, USA; the Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.K. Becetti, MD; A. Oeser, BS; M.J. Ormseth, MD, MSci; J.F. Solus, PhD, Department of Medicine, Vanderbilt University; P. Raggi, MD, Department of Medicine, University of Alberta; C.M. Stein, MD; C.P. Chung, MD, MPH, Department of Medicine, Vanderbilt University.
authors: Joseph F
authors: JF
authors: Solus
authors: From the Department of Medicine, Vanderbilt University, Nashville, Tennessee, USA; the Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.K. Becetti, MD; A. Oeser, BS; M.J. Ormseth, MD, MSci; J.F. Solus, PhD, Department of Medicine, Vanderbilt University; P. Raggi, MD, Department of Medicine, University of Alberta; C.M. Stein, MD; C.P. Chung, MD, MPH, Department of Medicine, Vanderbilt University.
authors: Paolo
authors: P
authors: Raggi
authors: From the Department of Medicine, Vanderbilt University, Nashville, Tennessee, USA; the Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.K. Becetti, MD; A. Oeser, BS; M.J. Ormseth, MD, MSci; J.F. Solus, PhD, Department of Medicine, Vanderbilt University; P. Raggi, MD, Department of Medicine, University of Alberta; C.M. Stein, MD; C.P. Chung, MD, MPH, Department of Medicine, Vanderbilt University.
authors: C Michael
authors: CM
authors: Stein
authors: From the Department of Medicine, Vanderbilt University, Nashville, Tennessee, USA; the Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.K. Becetti, MD; A. Oeser, BS; M.J. Ormseth, MD, MSci; J.F. Solus, PhD, Department of Medicine, Vanderbilt University; P. Raggi, MD, Department of Medicine, University of Alberta; C.M. Stein, MD; C.P. Chung, MD, MPH, Department of Medicine, Vanderbilt University. c.chung@vanderbilt.edu.
authors: Cecilia P
authors: CP
authors: Chung
mesh_terms: D000328:Adult; D000368:Aged; D000419:Albuminuria / Q000097:blood / Q000503:physiopathology / Q000652:urine*; D001172:Arthritis, Rheumatoid / Q000097:blood / Q000503:physiopathology / Q000652:urine*; D002097:C-Reactive Protein / Q000378:metabolism; D003404:Creatinine / Q000652:urine; D005260:Female; D006801:Humans; D016753:Interleukin-10 / Q000097:blood; D008297:Male; D008875:Middle Aged; D014409:Tumor Necrosis Factor-alpha / Q000097:blood; D019010:Vascular Cell Adhesion Molecule-1 / Q000097:blood; D059289:Vascular Stiffness / Q000502:physiology*
chemical_list: D014409:Tumor Necrosis Factor-alpha; D019010:Vascular Cell Adhesion Molecule-1; D016753:Interleukin-10; D002097:C-Reactive Protein; D003404:Creatinine
keywords: ARTERIAL STIFFNESS; ATHEROSCLEROSIS; MICROALBUMINURIA; RHEUMATOID ARTHRITIS
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