Session Information
Title: Rheumatoid Arthritis - Clinical Aspects II: Clinical Features & Comorbidity/Cardiovascular Disease
Session Type: Abstract Submissions (ACR)
Background/Purpose:
Rheumatoid arthritis (RA) is associated with a higher risk of osteoporosis (OP) and cardiovascular disease (CVD). This cross-sectional study was undertaken to identify links between the sub-clinical evidence of these processes.
Methods:
RA patients without known cardiovascular disease or diabetes were included. Measures of osteoporosis risk (DXA, bone turnover markers) and sub-clinical atherosclerosis (pulse wave analysis, carotid intimal-medial thickness (CIMT)) were recorded in addition to serum markers of systemic inflammation and lipid profiles. Data were analysed using SPSS 16.0 for Windows.
Results:
Seventy four RA patients and 26 controls were included in the analysis. Gender and age were similar between RA and controls and between sub-groups of RA duration. The RA group had significantly higher oxidized LDL titres (p<0.001), interleukin-6 (p<0.001), heat shock protein (HSP) 60 (p=0.008), and soluble ICAM-1 (p=0.016) compared with controls. HDL levels were significantly lower in those with RA for <10 years (p=0.026), while LDL (p = 0.014) and HSP60 levels (p = 0.024) were higher. Levels of vitamin D (p = 0.008), TNFα (0.016) and P1NP, a marker of bone formation (p = 0.03), were higher in those with long-standing RA.
In RA, femur T-scores were inversely related to mean CIMT (cc -0.3, p=0.02), mean common carotid artery IMT (cc -0.3, p=0.02), aortic augmentation index (AAIx) (cc -0.3, p=0.01), CRP (cc -0.4, p=0.002), oxLDL (cc -0.3, p=0.01) and anti-CCP antibody titre (cc -0.25, p=0.046). T-scores for the spine were also negatively correlated with AAIx (cc -0.4, p<0.001), anti-CCP antibody (cc -0.3, p=0.03), and oxLDL (cc -0.25, p=0.04). For those with osteoporosis, oxLDL was significantly higher compared to those with normal bone density (p=0.016). However, femur T-scores correlated positively with BMI (cc 0.5, p<0.001), waist (cc 0.4, p=0.002) and hip (cc 0.6, p<0.001) circumference, total fat mass (cc 0.4, p=0.01) and trunk fat mass (cc 0.4, p=0.02). T-scores for the spine also correlated with BMI (cc 0.3, p=0.008), waist (cc 0.4, p=0.002) and hip (cc 0.3, p=0.03) circumference.
Conclusion:
Disease duration in RA correlated significantly with risk factors for atherosclerosis, independent of age. Furthermore, reduced bone mineral density was associated with evidence of sub-clinical atherosclerosis. These results suggest that early recognition of such complications may help to improve quality of life and longevity in patients with RA.
Disclosure:
B. J. Sheane,
None;
R. Dunne,
None;
K. Scott,
None;
M. Hall,
None;
M. O’Connor,
None;
M. Healy,
None;
J. Feely,
None;
J. B. Walsh,
None;
G. Cunnane,
None.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/association-between-subclinical-atherosclerosis-and-bone-mineral-density-in-rheumatoid-arthritis/