Is Lipoprotein-Associated Phospholipase A2 a Link between Inflammation and Subclinical Atherosclerosis in Rheumatoid Arthritis?
OBJECTIVE
Lipoprotein-associated phospholipase A2 (Lp-PLA2), a marker of vascular inflammation, is associated with cardiovascular disease. This prospective study of an inception cohort aimed to investigate whether the level of Lp-PLA2 is associated with subclinical atherosclerosis in patients with rheumatoid arthritis (RA).


METHODS
Patients from northern Sweden diagnosed with early RA were consecutively recruited into an ongoing prospective study. From these, all patients ≤60 years (n = 71) were included for measurements of subclinical atherosclerosis at inclusion (T0) and five years later (T5). Forty age- and sex-matched controls were included. The patients were clinically assessed, SCORE, Reynolds Risk Score, and Larsen score were calculated, and blood samples were drawn from all individuals at T0 and T5.


RESULTS
There was no significant difference in the level of Lp-PLA2 between patients with RA and controls (p > 0.05). In simple linear regression models among patients with RA, Lp-PLA2 at T0 was significantly associated with intima media thickness (IMT) at T0 and T5, flow mediated dilation (FMD) at T0 and T5, ever smoking, male sex, HDL-cholesterol (inversely), non-HDL-cholesterol, SCORE, Reynolds Risk Score, and Larsen score (p < 0.05). CONCLUSION. In this cohort of patients with early RA, the concentration of Lp-PLA2 was associated with both subclinical atherosclerosis and disease severity.
Department of Public Health and Clinical Medicine/Rheumatology, University of Umeå, 901 87 Umeå, Sweden.
Anna
A
Södergren
Department of Surgical and Perioperative Sciences, University of Umeå, 901 87 Umeå, Sweden.
Kjell
K
Karp
Department of Public Health and Clinical Medicine/Rheumatology, University of Umeå, 901 87 Umeå, Sweden ; Department of Rheumatology, Östersund Hospital, 831 27 Östersund, Sweden.
Christine
C
Bengtsson
Department of Rheumatology, Sunderby Hospital, 971 89 Luleå, Sweden.
Bozena
B
Möller
Department of Public Health and Clinical Medicine/Rheumatology, University of Umeå, 901 87 Umeå, Sweden.
Solbritt
S
Rantapää-Dahlqvist
Department of Public Health and Clinical Medicine/Rheumatology, University of Umeå, 901 87 Umeå, Sweden.
Solveig
S
Wållberg-Jonsson
D043203:1-Alkyl-2-acetylglycerophosphocholine Esterase / Q000378:metabolism*; D001172:Arthritis, Rheumatoid / Q000201:enzymology* / Q000453:epidemiology; D050197:Atherosclerosis / Q000201:enzymology* / Q000453:epidemiology; D005260:Female; D006801:Humans; D007249:Inflammation / Q000201:enzymology* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
D043203:1-Alkyl-2-acetylglycerophosphocholine Esterase