Plasma Apolipoprotein B48 Levels in Patients with Rheumatoid Arthritis: Evaluating Novel Cardiovascular Risk Factors

Deborah van Breukelen-van der Stoep¹, Derkjen van Zeben¹, Marijke de Vries², Boudewijn Klop², Noelle van der Meulen², Gert Jan van de Geijn³, Hans Janssen³, Pedro Valdivielso⁴, José Rioja⁴, José Ramirez-Bollero⁴, Mieke Hazes⁵, Erwin Birnie^6,7 and Manuel Castro Cabezas⁸, ¹Department of Rheumatology, Sint Franciscus Gasthuis, Rotterdam, Netherlands, ²Department of Internal Medicine, Sint Franciscus Gasthuis, Rotterdam, Netherlands, ³Department of Clinical Chemistry, Sint Franciscus Gasthuis, Rotterdam, Netherlands, ⁴Department of Internal Medicine and Dermatology, Hospital Virgen de la Victoria, Malaga, Spain, ⁵Department of Rheumatology, Erasmus Medical Centre Rotterdam, Rotterdam, Netherlands, ⁶Statistics and Education, Sint Franciscus Gasthuis, Rotterdam, Netherlands, ⁷Insitute of Health Policy and Management, Erasmus University, Rotterdam, Netherlands, ⁸Department of Internal Medicine, Sint Francicscus Gasthuis, Rotterdam, Netherlands

Meeting: 2015 ACR/ARHP Annual Meeting

Date of first publication: September 29, 2015

Keywords: Atherosclerosis, Cardiovascular disease and rheumatoid arthritis (RA)

Session Information

Date: Monday, November 9, 2015

Title: Rheumatoid Arthritis - Clinical Aspects Poster II

Session Type: ACR Poster Session B

Session Time: 9:00AM-11:00AM

Background/Purpose: Chylomicrons, with apolipoprotein (apo) B48 as a structural protein, induce leukocyte and complement activation and contribute to atherosclerosis. ApoB48 is higher in conditions associated with a higher degree of systemic inflammation and apoB48 helps to identify patients at increased cardiovascular risk. There are no data available on apoB48 levels in rheumatoid arthritis (RA) in relation to atherosclerosis. Since classical risk factors do not predict the cardiovascular risk well in RA, search for novel markers of risk is relevant. The objective of this study was to investigate the levels of apoB48 in RA patients compared to patients with coronary artery disease (CAD) and its association with metabolic and other lipid parameters, carotid intima media thickness (cIMT) and the estimated cardiovascular risk.

Methods: RA patients, without the presence of clinical cardiovascular disease or diabetes mellitus and participating in the FRANCIS study, were included. Also subjects with CAD (CAD+) and without RA were included. Blood samples were collected after an overnight fast and a complete lipid profile, including total plasma apoB and apoB48 (ELISA) were measured. cIMT was measured using ultrasound.

Results: 328 Patients with RA and 56 CAD+ patients were included. RA patients were younger (53±11 vs. 68±11 yrs; P<0.001), more often female (68% vs. 34%; P<0.001) and had lower remnant cholesterol (remnant-C) concentrations (0.52±0.26 vs. 0.75±34 mmol/l; P<0.001) and triglycerides (1.25±0.88 vs. 1.83±1.12 mmol/l; P<0.001) compared to CAD+ patients. Median apoB48 was significantly higher in RA patients compared to CAD+ patients (8.6 [IQR 5.2-12.5] vs. 7.1 [IQR 4.9-10.4] mg/L; P=0.026). In RA apoB48 correlated positively with triglycerides (r=0.616; P<0.001), remnant-C (r=0.479; P<0.001), LDL-cholesterol (r=0.123; P=0.03) and the cardiovascular risk score according to the SCORE model (r=0,141; P=0.011). No significant correlation between apoB48 and cIMT (r=0.103; P=0.07), BMI (r=0.014; P=0.81), systolic blood pressure (r=0.095; P=0.09), glucose (r=0.106; p=0.06)and RA DAS28 (-0.32; P=0.58) was found.

Conclusion: In RA apoB48 is associated with an increased cardiovascular risk score and may contribute to the increased atherogenesis of RA. Since apoB48 in RA was higher compared to CAD+ patients, despite lower triglycerides and remnant-C, chylomicron remnant clearance may be impaired in RA.

Disclosure: D. van Breukelen-van der Stoep, None; D. van Zeben, None; M. de Vries, None; B. Klop, None; N. van der Meulen, None; G. J. van de Geijn, None; H. Janssen, None; P. Valdivielso, None; J. Rioja, None; J. Ramirez-Bollero, None; M. Hazes, None; E. Birnie, None; M. Castro Cabezas, None.

To cite this abstract in AMA style:

van Breukelen-van der Stoep D, van Zeben D, de Vries M, Klop B, van der Meulen N, van de Geijn GJ, Janssen H, Valdivielso P, Rioja J, Ramirez-Bollero J, Hazes M, Birnie E, Castro Cabezas M. Plasma Apolipoprotein B48 Levels in Patients with Rheumatoid Arthritis: Evaluating Novel Cardiovascular Risk Factors [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/plasma-apolipoprotein-b48-levels-in-patients-with-rheumatoid-arthritis-evaluating-novel-cardiovascular-risk-factors/. Accessed .

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