Session Type: Abstract Submissions (ACR)
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.
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.
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.
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.
B. J. Sheane,
J. B. Walsh,
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/association-between-subclinical-atherosclerosis-and-bone-mineral-density-in-rheumatoid-arthritis/