Decreased flow-mediated dilatation in patients with rheumatoid arthritis: a meta-analysis.
OBJECTIVE
To derive a more precise comparison of flow-mediated dilatation (FMD%) of the brachial artery between patients with rheumatoid arthritis (RA) and normal controls by performing a meta-analysis of appropriate studies.


METHODS
PubMed and EMBASE databases were searched for all relevant articles. STATA (V.12.0) software was used to perform the meta-analysis. Quality estimation of all appropriate studies was evaluated according to the Newcastle-Ottawa Scale (NOS). Standardised mean difference (SMD) with 95% CIs were calculated with a random-effects model. The Cochrane Q test and I2statistic were used to evaluate the heterogeneity. Funnel plot and Egger's test were conducted to assess the publication bias.


RESULTS
In total, 464 articles were obtained after searching the two databases. Ten studies were included in the meta-analysis on the basis of the inclusion and exclusion criteria. Significant heterogeneity was observed among these 10 studies (Q=102.89, p<0.001, I2=91.3%) with random-effects modelling. The results showed that the RA group had significantly lower FMD% (SMD: -1.405; 95% CI -1.992 to -0.817; p<0.001) than the control group. Egger's test (p=0.004) indicated that the funnel plot showed a skewed or asymmetrical shape and publication bias existed. Sensitivity analyses suggested the robustness and credibility of our results.


CONCLUSIONS
FMD% in patients with RA is significantly decreased compared with healthy controls. FMD% is an important early marker of atherosclerosis. It may be used as a parameter to forecast cardiovascular disease in patients with RA.
Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China.|Anhui Provincial Laboratory of Population Health & Major Disease Screening and Diagnosis, Anhui, China.
Shu-Zhen
SZ
Xu
Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China.|Anhui Provincial Laboratory of Population Health & Major Disease Screening and Diagnosis, Anhui, China.
Peng
P
Wang
Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China.|Anhui Provincial Laboratory of Population Health & Major Disease Screening and Diagnosis, Anhui, China.
Shi-Yang
SY
Guan
Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China.|Anhui Provincial Laboratory of Population Health & Major Disease Screening and Diagnosis, Anhui, China.
Hong-Miao
HM
Li
Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China.|Anhui Provincial Laboratory of Population Health & Major Disease Screening and Diagnosis, Anhui, China.
Rui-Xue
RX
Leng
Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China.|Anhui Provincial Laboratory of Population Health & Major Disease Screening and Diagnosis, Anhui, China.
Hai-Feng
HF
Pan
Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China.|Anhui Provincial Laboratory of Population Health & Major Disease Screening and Diagnosis, Anhui, China.
Dong-Qing
DQ
Ye
D001172:Arthritis, Rheumatoid / Q000503:physiopathology*; D001783:Blood Flow Velocity; D001916:Brachial Artery / Q000503:physiopathology*; D006801:Humans; D018570:Risk Assessment; D012307:Risk Factors; D014652:Vascular Diseases / Q000503:physiopathology*; D014664:Vasodilation
flow-mediated dilitation; inflammation; meta-analysis; rheumatoid arthritis