Background/Purpose

GlycA is a novel inflammatory biomarker measured from the nuclear magnetic resonance (NMR) spectra obtained for lipoprotein particle analysis. It represents a distinct peak composed primarily of glycosylated acute phase proteins. Glyc A is associated with inflammatory markers, and development of cardiovascular disease. We hypothesized that GlycA is a biomarker of disease activity and systemic inflammation in rheumatoid arthritis (RA).

Methods

We conducted a cross-sectional study including 166 patients with RA and 90 control subjects. GlycA was measured using a previously validated algorithm from the NMR lipoprotein particle profile which quantifies the NMR signal originating from N-acetylglucosamine and N-acetylgalactosamine residues on carbohydrate side chains of circulating glycoproteins. Disease activity of RA was quantified by DAS28 score and functional capacity by the modified health assessment questionnaire. Markers of inflammation including erythrocyte sedimentation rate (ESR), high sensitivity C-reactive protein (CRP), interleukin 6 (IL-6) and tumor necrosis factor alpha (TNF-α) were measured. GlycA concentrations were compared between patients with RA and control subjects and correlated with disease activity and markers of inflammation in RA.

Results

Patients with RA had higher GlycA concentration (median [interquartile range]: 398 μmol/l [348, 473 μmol/L]) compared to control subjects (344 μmol/l [314, 403 μmol/l], P<0.001). Among patients with RA GlycA was strongly correlated with DAS28 and its components including tender and swollen joint count, global health visual analog scale score and acute phase reactants CRP and ESR (P < 0.001, Table). Similarly, GlycA was strongly associated with proinflammatory cytokines, IL-6 and TNF-α, and RA functional capacity (P ≤ 0.002, Table).

Table: Association between GlycA and RA disease activity and inflammation

	Spearman Rho	P value
DAS28	0.576	<0.001
Tender joints	0.283	<0.001
Swollen joints	0.288	<0.001
Global health	0.304	<0.001
CRP	0.614	<0.001
ESR	0.643	<0.001
IL-6	0.388	<0.001
TNF-α	0.245	0.002
mHAQ	0.235	0.002

Conclusion

GlycA is a novel inflammatory marker that is useful for assessment of disease activity and systemic inflammation in patients with RA.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/utility-of-glyca-a-novel-inflammatory-marker-for-assessment-of-rheumatoid-arthritis-disease-activity/