title: Telomere length, endothelial activation and carotid atherosclerosis in black and white African patients with rheumatoid arthritis.
abstract: OBJECTIVE
  Our objective was to examine associations of traditional and non-traditional cardiovascular risk factors with relative leukocyte telomere length and confounder adjusted relationships of relative telomere length with endothelial activation and carotid atherosclerosis in black and white African patients with rheumatoid arthritis (RA).
  
  
  METHODS
  Relative telomere length of leukocyte DNA in whole blood was determined using quantitative RT-PCR in 205 (101 black) African patients with RA.
  
  
  RESULTS
  In demographic characteristic adjusted analysis, relative telomere length tended to be larger in black compared to white patients (median (IQR)=0.54 (0.42-0.54) and 0.48 (0.37-0.60) (p=0.07), respectively). In black patients, waist circumference, systolic, diastolic and mean blood pressure were associated with relative telomere length (β (SE)=-0.00270 (0.00114) (p=0.02), -0.00185 (0.00060) (p=0.003), -0.00243 (0.00112) (p=0.03) and -0.00225 (0.00075) (p=0.003), respectively); in white patients, age, anti-cyclic citrullinated antibody positivity, biologic agent use, a cholesterol-HDL cholesterol ratio of >4 and the number of major traditional risk factors were related to relative telomere length (β (SE) =-0.00242 (0.00113) (p=0.03), 0.06629 (0.03374) (p=0.05), -0.09321 (0.04310) (p=0.03), 0.08225 (0.03420) (p=0.02) and 0.04046 (0.01719) (p=0.02), respectively). One SD increase in relative telomere length was associated with carotid plaque (OR (95% CI)=1.65 (0.99-2.75) (p=0.05)) and vascular cell adhesion molecule-1 concentrations (β (SE)=-0.05031 (0.02480) (p=0.04)) in black and white patients, respectively.
  
  
  CONCLUSIONS
  This study disclosed paradoxically direct relationships between relative telomere length and cardiovascular risk factors in white and atherosclerosis in black African RA patients. The role of relative telomere length in cardiovascular risk and its stratification in RA requires longitudinal investigation.
authors.affiliation: Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
authors.forename: Andrew R
authors.initials: AR
authors.lastname: Raymond
authors.affiliation: Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
authors.forename: Richard L
authors.initials: RL
authors.lastname: Brooksbank
authors.affiliation: Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
authors.forename: Aletta M E
authors.initials: AM
authors.lastname: Millen
authors.affiliation: Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
authors.forename: Gavin R
authors.initials: GR
authors.lastname: Norton
authors.affiliation: Department of Rheumatology, Charlotte Maxeke Johannesburg Academic Hospital, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Solomon
authors.affiliation: Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
authors.forename: Angela J
authors.initials: AJ
authors.lastname: Woodiwiss
authors.affiliation: Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
authors.forename: Linda
authors.initials: L
authors.lastname: Tsang
authors.affiliation: Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, Univ.of the Witwatersrand, Johannesburg, South Africa; and Rheumatology Division, Universitair Ziekenhuis & Vrije Universiteit, Brussels, Belgium.
authors.forename: Patrick H
authors.initials: PH
authors.lastname: Dessein
authors.affiliation: Cardiovascular Pathophysiol. & Genomics Res. Unit, Univ.of the Witwatersrand, Johannesburg, South Africa; & Epidemiol., Genetics & Atherosclerosis Res., Systemic Inflammatory Dis, Rheumatol.Div., Hosp.Univ. Marques de Valdecilla, IDIVAL, Santander, Spain.
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Gonzalez-Gay
mesh_terms: D000368:Aged; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000097:blood / Q000188:drug therapy / Q000208:ethnology* / Q000235:genetics; D015415:Biomarkers / Q000097:blood; D044383:Black People / Q000235:genetics; D002317:Cardiovascular Agents / Q000627:therapeutic use; D002340:Carotid Artery Diseases / Q000097:blood / Q000188:drug therapy / Q000208:ethnology* / Q000235:genetics; D015897:Comorbidity; D015986:Confounding Factors, Epidemiologic; D003430:Cross-Sectional Studies; D004730:Endothelium, Vascular / Q000187:drug effects / Q000378:metabolism*; D005260:Female; D006304:Health Status; D006305:Health Status Indicators; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors; D013019:South Africa / Q000453:epidemiology; D016615:Telomere / Q000187:drug effects / Q000235:genetics / Q000378:metabolism*; D059505:Telomere Homeostasis / Q000187:drug effects; D019010:Vascular Cell Adhesion Molecule-1 / Q000097:blood; D044465:White People / Q000235:genetics
chemical_list: D018501:Antirheumatic Agents; D015415:Biomarkers; D002317:Cardiovascular Agents; D019010:Vascular Cell Adhesion Molecule-1