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Atherosclerosis assessment and rheumatoid arthritis

Beurteilung der Arteriosklerose bei rheumatoider Arthritis

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Abstract

Background and aim

Rheumatoid arthritis is associated with increased morbidity and mortality due to atherosclerotic cardiovascular diseases. Lipoprotein-associated phospholipase A2 (Lp-PLA2) is an enzyme of phospholipase A2; it plays an important role in inflammation and atherosclerosis. Herein we aimed to investigate whether Lp-PLA2 activity is associated with atherosclerosis in patients with rheumatoid arthritis and compare the Lp-PLA2 activity with carotid intima media thickness (CIMT).

Patients and methods

25 patients with rheumatoid arthritis and 40 controls (20 patients with type 2 diabetes mellitus [DM] and 20 healthy controls) were included in the study. Frozen serum samples were used for analyzing Lp-PLA2 activity. Disease activity was calculated with DAS28 (Disease Activity Score 28) in the rheumatoid arthritis group. The mean CIMT was calculated in all participants.

Results

Lp-PLA2 activity was significantly higher in the DM group (p = 0.006) and LDL (Low density cholesterol levels) were lower in rheumatoid arthritis and healthy control groups compared with diabetics (p = 0.001 and p = 0.029, respectively). The mean CIMT was significantly higher in patients with type 2 DM (p = 0.047).

Conclusion

Lp-PLA2 activity was not increased in the rheumatoid arthritis group when compared with healthy controls and the DM group. This result may be associated with low disease activity scores in patients with rheumatoid arthritis.

Zusammenfassung

Hintergrund und Ziel

Die rheumatoide Arthritis geht mit erhöhter Morbidität und Mortalität aufgrund arteriosklerotisch bedingter kardiovaskulärer Erkrankungen einher. Die lipopoproteinassoziierte Phospholipase A2 (Lp-PLA2) stellt eines der Enzyme der Gruppe der Phospholipasen A2 dar und spielt eine bedeutende Rolle bei Entzündungsprozessen und Arteriosklerose. Ziel der vorliegenden Arbeit war es, einen möglichen Zusammenhang zwischen der Lp-PLA2-Aktivität mit einer Arteriosklerose bei Patienten mit rheumatoider Arthritis zu ermitteln und die Lp-PLA2-Aktivität mit der Intima-Media-Dicke der A. carotis („carotid intima media thickness“, CIMT) zu vergleichen.

Patienten und Methoden

In die vorliegende Studie wurden 25 Patienten mit rheumatoider Arthritis und 40 Kontrollen – 20 Patienten mit Diabetes mellitus (DM) Typ 2 und 20 gesunde Kontrollen – aufgenommen. Zur Analyse der Lp-PLA2-Aktivität wurden gefrorene Serumproben verwendet. Die Krankheitsaktivität wurde anhand des DAS28 (Disease Activity Score) in der Gruppe mit rheumatoider Arthritis bestimmt. Bei sämtlichen Teilnehmern wurde die durchschnittliche CIMT berechnet.

Ergebnisse

In der Gruppe mit DM war die Lp-PLA2-Aktivität signifikant höher als bei den übrigen Teilnehmern (p = 0,006), und der Wert für das Low-Density-Lipoprotein(LDL)-Cholesterin war bei Patienten mit rheumatoider Arthritis und den gesunden Kontrollen im Vergleich zu den Patienten mit DM niedriger (p = 0,001 bzw. p = 0,029). Die durchschnittliche CIMT war bei Patienten mit DM vom Typ 2 signifikant höher als bei den anderen Teilnehmern (p = 0,047).

Schlussfolgerung

Im Vergleich zu gesunden Kontrollen und der Gruppe mit DM war die Lp-PLA2-Aktivität in der Gruppe mit rheumatoider Arthritis nicht erhöht. Dieses Ergebnis steht möglicherweise mit niedrigeren Werten für die Krankheitsaktivität bei Patienten mit rheumatoider Arthritis in Zusammenhang.

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Authors and Affiliations

  1. Medical Faculty Department of Rheumatology, Abant Izzet Baysal University, Bolu, Turkey

    C. Bes M.D. & M. Soy

  2. Medical Faculty Department of Radiology, Abant Izzet Baysal University, Bolu, Turkey

    S. Gürel

  3. Medical Faculty Department of Biochemistry, Abant Izzet Baysal University, Bolu, Turkey

    G. Buğdaycı

  4. Medical Faculty Department of Endocrinology and Metabolism, Abant Izzet Baysal University, Bolu, Turkey

    O. Dikbaş

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  1. C. Bes M.D.
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  2. S. Gürel
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Correspondence to C. Bes M.D..

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Conflict of interest

C. Bes, S. Gürel, G. Buğdaycı, O. Dikbaş, and M. Soy declare that they have no competing interests.

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

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U. Müller-Ladner, Bad Nauheim

U. Lange, Bad Nauheim

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Bes, C., Gürel, S., Buğdaycı, G. et al. Atherosclerosis assessment and rheumatoid arthritis. Z Rheumatol 77, 330–334 (2018). https://doi.org/10.1007/s00393-016-0239-3

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