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Chang CK, Chiang EPI, Chang KH, Tang KT, Chen PK, Yip HT, Chen CH, Chen DY. The Sizes and Composition of HDL-Cholesterol Are Significantly Associated with Inflammation in Rheumatoid Arthritis Patients. Int J Mol Sci 2023; 24:10645. [PMID: 37445823 DOI: 10.3390/ijms241310645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 06/19/2023] [Accepted: 06/22/2023] [Indexed: 07/15/2023] Open
Abstract
Rheumatoid arthritis (RA), a chronic inflammatory disease, carries a significant burden of atherosclerotic cardiovascular diseases (ASCVD). With their heterogeneous composition, high-density lipoprotein (HDL) particles have varied athero-protective properties, and some may even increase ASCVD risk. In this prospective and cross-sectional study, we aimed to examine the relationship between HDL sizes/metabolites and inflammation in RA. Using 1H-NMR-based lipid/metabolomics, differential HDL-related metabolites were identified between RA patients and healthy control (HC) subjects and between RA patients with and without anti-citrullinated peptide antibodies (ACPA). The correlation between the discriminative HDL-related metabolites and C-reactive protein (CRP) was evaluated in RA patients. RA patients demonstrated higher particle number, lipids, cholesterol, cholesterol ester, free cholesterol, and phospholipids in large/very large-sized HDLs. ACPA-positive patients had higher L-HDL-C and L-HDL-CE but lower small-/medium-sized HDL-TG levels than ACPA-negative patients. An inverse correlation was found between CRP levels and small-sized HDLs. Janus kinase inhibitor treatment was associated with increased serum small-sized HDL-related metabolites and decreased CRP levels. We are the first to reveal the significant associations between RA inflammation and HDL sizes/metabolites. A potential link between ACPA positivity and changes in serum levels of HDL-related metabolites was also observed in RA patients.
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Affiliation(s)
- Ching-Kun Chang
- Rheumatology and Immunology Center, China Medical University Hospital, Taichung 404, Taiwan
- Translational Medicine Laboratory, Rheumatology Research Center, China Medical University Hospital, Taichung 404, Taiwan
- College of Medicine, China Medical University, Taichung 404, Taiwan
| | - En-Pei Isabel Chiang
- Department of Food Science and Biotechnology, National Chung Hsing University, Taichung 402, Taiwan
- Innovation and Development Center of Sustainable Agriculture, National Chung Hsing University, Taichung 402, Taiwan
| | - Kuang-Hsi Chang
- Department of Medical Research, Tungs' Taichung Metroharbor Hospital, Taichung 435, Taiwan
- Center for General Education, China Medical University, Taichung 404, Taiwan
- General Education Center, Jen-Teh Junior College of Medicine, Nursing and Management, Miaoli 356, Taiwan
| | - Kuo-Tung Tang
- Division of Allergy, Immunology and Rheumatology, Taichung Veterans General Hospital, Taichung 407, Taiwan
- Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
| | - Po-Ku Chen
- Rheumatology and Immunology Center, China Medical University Hospital, Taichung 404, Taiwan
- Translational Medicine Laboratory, Rheumatology Research Center, China Medical University Hospital, Taichung 404, Taiwan
- College of Medicine, China Medical University, Taichung 404, Taiwan
| | - Hei-Tung Yip
- College of Medicine, China Medical University, Taichung 404, Taiwan
- Management Office for Health Data, China Medical University Hospital, Taichung 404, Taiwan
| | - Chu-Huang Chen
- Vascular and Medicinal Research, Texas Heart Institute, Houston, TX 77030, USA
- Institute for Biomedical Sciences, Shinshu University, Nagano 390-8621, Japan
| | - Der-Yuan Chen
- Rheumatology and Immunology Center, China Medical University Hospital, Taichung 404, Taiwan
- Translational Medicine Laboratory, Rheumatology Research Center, China Medical University Hospital, Taichung 404, Taiwan
- College of Medicine, China Medical University, Taichung 404, Taiwan
- College of Medicine, National Chung Hsing University, Taichung 402, Taiwan
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Dessie G. Association of atherogenic indices with C-reactive protein and risk factors to assess cardiovascular risk in rheumatoid arthritis patient at Tikur Anbessa Specialized Hospital, Addis Ababa. PLoS One 2022; 17:e0269431. [PMID: 35657933 PMCID: PMC9165848 DOI: 10.1371/journal.pone.0269431] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 05/21/2022] [Indexed: 11/19/2022] Open
Abstract
Background Rheumatoid arthritis (RA) is an autoimmune systemic chronic inflammatory disorder, which is characterized by joint stiffness, damage, and destruction of bone. In RA patients, the risk of cardiovascular disease is increased by 2–3 folds as compared to the general population. The major burden of RA is the development of cardiovascular diseases, including congestive heart failure, stroke, and myocardial infarction. Objectives Assessment of the association of atherogenic indices with C-reactive protein to evaluate CVD risk was one of the purposes of this study. In addition, the association of atherogenic indices with elevated levels of cardiovascular risk factors (LDL-C and TG) was another aim of this study. Methods The preferred study design for this study was a hospital based comparative cross-sectional study method. Data were cleaned, coded, and entered into Epi Data version 4.6 software, and exported to SPSS version 20 for further analysis of atherogenic indices, C-reactive protein, and risk factors. The comparison of atherogenic indices and other variables among the case and control groups was estimated by the independent t-test statistical analysis method. All variables with a p-value less than 0.2 during binary linear regression analysis were selected for multinomial logistic regression analysis. The association of atherogenic indices with C-reactive protein and risk factors was computed using multiple logistic regressions. The data were presented using tables and figures for clarification of the study. Results The levels of atherogenic indices were computed for both RA patients and the control group. The values of atherogenic indices were significantly associated with cardiovascular risk factor (CRP ≥ 2mg/L). Atherogenic index of plasma (AIP) and TC/HDL-C ratio had a statistically significant association with an elevated levels of triglycerides (P<0.01). The TC/HDL-Cratio value of the patient had 2.38 folds more likely to have an elevated low density lipoprotein level. In addition, AIP of RA patients had 57.51 and 23.65 folds more to have elevated low density lipoprotein and triglycerides respectively. Conclusions The result of this study showed that TC/HDL-C, LDL/HDL-C ratio values, and atherogenic index of plasma had a statistically significant association with elevated level of low density lipoprotein and triglycerides. In addition to this, they have a statistically significant association with the level of C-reactive protein. There was a highly significant statistical association between atherogenic indices, elevated low density lipoprotein, and triglycerides values. Therefore, the result of this finding confirmed that atherogenic indices have a potential role in the prediction and management of CVD risk in RA patients.
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Affiliation(s)
- Gashaw Dessie
- Department of Biochemistry, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- * E-mail:
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Onder ME, Orucoglu N, Omar F, Canataroglu A. C-Reactive Protein-to-Albumin Ratio: A Novel Inflammatory Marker and
Disease Activity Sign in Early Rheumatoid Arthritis. AKTUEL RHEUMATOL 2021. [DOI: 10.1055/a-1653-1172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Abstract
Objective A novel inflammation-based score, C-reactive protein
(CRP)-to-albumin ratio (CAR), has been shown to have an association with the
inflammatory status in several diseases. We aimed to analyse the association
between CAR and disease activity in patients with early rheumatoid arthritis
(RA) and to determine the cut-off value of CAR in early and established RA.
Methods A total of 177 patients with RA and 111 age and gender-matched
healthy controls were included in this study. Cases with a disease duration of
less than 1 year were classified as early RA. Serum albumin, CRP, erythrocyte
sedimentation rate (ESR), Disease Activity Score-28 (DAS-28-ESR), Clinical
Disease Activity Index (CDAI) and Health Assessment Questionnaire (HAQ) scores
were recorded.
Results CAR was 2.44 (0.21–30.83) in the RA group and 0.45
(0.21–10.47) in the control group (p<0.001). Eighty-seven
(49.15%) of the RA cases were classified as early RA. The analyses
indicated that the ESR, CRP and CAR values were higher in patients with early RA
than in those with established RA and controls. CAR was correlated with albumin,
CRP, ESH, DAS-28 and HAQ scores in both early RA and established RA groups. The
receiver operating characteristic curves revealed a CAR cut-off value of 2.67
(80% sensitivity and 85% specificity) and 1.63 (77%
sensitivity and 72% specificity) for the prediction of early and
established RA, respectively.
Conclusion CAR, a formulated ratio, has been described as a predictor for
disease activity in patients with early RA as well as in those with established
RA. However, CAR has higher sensitivity and specificity for early RA than for
established RA.
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Affiliation(s)
| | - Nurdan Orucoglu
- Rheumatology, Mersin University Faculty of Medicine, Mersin,
Turkey
| | - Firat Omar
- Rheumatology, Mersin University Faculty of Medicine, Mersin,
Turkey
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Ferreira HB, Melo T, Paiva A, Domingues MDR. Insights in the Role of Lipids, Oxidative Stress and Inflammation in Rheumatoid Arthritis Unveiled by New Trends in Lipidomic Investigations. Antioxidants (Basel) 2021; 10:antiox10010045. [PMID: 33401700 PMCID: PMC7824304 DOI: 10.3390/antiox10010045] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 12/28/2020] [Accepted: 12/29/2020] [Indexed: 02/07/2023] Open
Abstract
Rheumatoid arthritis (RA) is a highly debilitating chronic inflammatory autoimmune disease most prevalent in women. The true etiology of this disease is complex, multifactorial, and is yet to be completely elucidated. However, oxidative stress and lipid peroxidation are associated with the development and pathogenesis of RA. In this case, oxidative damage biomarkers have been found to be significantly higher in RA patients, associated with the oxidation of biomolecules and the stimulation of inflammatory responses. Lipid peroxidation is one of the major consequences of oxidative stress, with the formation of deleterious lipid hydroperoxides and electrophilic reactive lipid species. Additionally, changes in the lipoprotein profile seem to be common in RA, contributing to cardiovascular diseases and a chronic inflammatory environment. Nevertheless, changes in the lipid profile at a molecular level in RA are still poorly understood. Therefore, the goal of this review was to gather all the information regarding lipid alterations in RA analyzed by mass spectrometry. Studies on the variation of lipid profile in RA using lipidomics showed that fatty acid and phospholipid metabolisms, especially in phosphatidylcholine and phosphatidylethanolamine, are affected in this disease. These promising results could lead to the discovery of new diagnostic lipid biomarkers for early diagnosis of RA and targets for personalized medicine.
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Affiliation(s)
- Helena Beatriz Ferreira
- Mass Spectrometry Center & QOPNA/LAQV-REQUIMTE, Department of Chemistry, Campus Universitário de Santiago, University of Aveiro, 3810-193 Aveiro, Portugal;
| | - Tânia Melo
- Mass Spectrometry Center & QOPNA/LAQV-REQUIMTE, Department of Chemistry, Campus Universitário de Santiago, University of Aveiro, 3810-193 Aveiro, Portugal;
- CESAM, Centre for Environmental and Marine Studies, Department of Chemistry, Campus Universitário de Santiago, University of Aveiro, 3810-193 Aveiro, Portugal
- Correspondence: (T.M.); (M.d.R.D.); Tel.: +351-234-370-698 (M.d.R.D.)
| | - Artur Paiva
- Unidade de Gestão Operacional em Citometria, Centro Hospitalar e Universitário de Coimbra (CHUC), 3004-561 Coimbra, Portugal;
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, 3000-370 Coimbra, Portugal
- Instituto Politécnico de Coimbra, ESTESC-Coimbra Health School, Ciências Biomédicas Laboratoriais, 3046-854 Coimbra, Portugal
| | - Maria do Rosário Domingues
- Mass Spectrometry Center & QOPNA/LAQV-REQUIMTE, Department of Chemistry, Campus Universitário de Santiago, University of Aveiro, 3810-193 Aveiro, Portugal;
- CESAM, Centre for Environmental and Marine Studies, Department of Chemistry, Campus Universitário de Santiago, University of Aveiro, 3810-193 Aveiro, Portugal
- Correspondence: (T.M.); (M.d.R.D.); Tel.: +351-234-370-698 (M.d.R.D.)
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Afifi N, M Medhat B, Abdel Ghani AM, Mohamed Ali Hassan HGE, Behiry ME. Value of Albumin-Fibrinogen Ratio and CRP-Albumin Ratio as Predictor Marker of Disease Activity in Egyptian RA Patients, Correlated with Musculoskeletal Sonography. Open Access Rheumatol 2020; 12:241-248. [PMID: 33173359 PMCID: PMC7646446 DOI: 10.2147/oarrr.s268668] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Accepted: 09/25/2020] [Indexed: 01/04/2023] Open
Abstract
Purpose To evaluate the albumin-fibrinogen ratio (AFR) and C-reactive protein-albumin ratio (CAR) as inflammatory markers in rheumatoid arthritis (RA) and to investigate their association with disease activity correlating with musculoskeletal ultrasonographic findings. Patients and Methods A total of 125 cases of RA patients were consecutively enrolled in a multicenter cross-sectional study compared to 100 healthy controls, all subjects were investigated for fibrinogen, albumin, CRP, erythrocyte sedimentation rate, AFR, and CAR measurements. Patients' disease activity was assessed by disease activity score (DAS28-ESR), and they were subjected to high-frequency ultrasound both in greyscale and power Doppler. Results RA patients had lower AFR and higher CAR than those in the control group (P < 0.001). A positive correlation was demonstrated between CAR and DAS score (r=0.589, P = 0.0001), whilst there was a precise negative correlation between AFR and DAS 28-ESR (r=-0.74, p<0.001). ROC curve analyses revealed fibrinogen showed the best sensitivity (92.1%) for the area under the curve of 0.928, at a criterion of 2.47, while AFR has an area under the curve of 0.826 with sensitivity and specificity (86.84% and 75%, respectively) at cut-off value 1.46. Actively diseased patients had elevated CAR than those in remission (P < 0.001). Patients with synovial thickening and bone erosions had lower AFR than those without, CAR was higher in patients with power doppler changes than those without (p=0.015). Conclusion Higher CAR and lower AFR were expressed in active RA than those in remission. CAR and AFR could be useful markers of ongoing inflammation and joint affection detected by musculoskeletal ultrasonography.
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Affiliation(s)
- Naglaa Afifi
- Internal Medicine and Rheumatology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.,Internal Medicine, Armed Forces College of Medicine (AFCM), Cairo, Egypt
| | - Basma M Medhat
- Rheumatology and Rehabilitation, Faculty of Medicine, Cairo University, Cairo, Egypt
| | | | | | - Mervat E Behiry
- Internal Medicine, Armed Forces College of Medicine (AFCM), Cairo, Egypt.,Internal Medicine, and Rheumatology, Faculty of Medicine, Cairo University, Cairo, Egypt
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Jahid M, Rehan-Ul-Haq, Avasthi R, Ahmed RS. Interleukin10-1082 A/G polymorphism: Allele frequency, correlation with disease markers, messenger RNA and serum levels in North Indian rheumatoid arthritis patients. Clin Biochem 2018; 55:80-85. [PMID: 29621504 DOI: 10.1016/j.clinbiochem.2018.03.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 03/15/2018] [Accepted: 03/30/2018] [Indexed: 01/07/2023]
Abstract
BACKGROUND Rheumatoid arthritis (RA) is an autoimmune inflammatory disorder of unknown etiology. IL-10 stimulates B cell survival and is involved in antibody isotype switching. The serum IL-10 levels are increased in RA patients. Ethnicity influences polymorphisms in cytokine genes. Therefore, this study was designed to explore possible association, if any, between polymorphism of IL10-1082 A/G, serum cytokine levels, inflammatory markers and gene expression in RA patients of North India. METHODOLOGY A total of 187 RA patients classified according to American college of rheumatology 2010 criteria and 214 controls were included in the study. Levels of serum IL-10 and inflammatory markers were estimated by ELISA. PCR-RFLP was used to analyze IL10-1082 A/G polymorphism. Quantitative real time PCR was used to measure the mRNA expression of IL-10 gene. RESULTS The serum inflammatory markers were significantly higher in RA patients. Circulating IL-10 levels were positively and significantly correlated with RF (r = 0.28), anti-CCP (r = 0.26), CRP (r = 0.17) and mRNA expression levels (r = 0.59) among RA patients. Homozygous mutant variant (GG) and heterozygous mutant variant (AG) were associated with patients of RA (OR = 2.87 and 1.55, p < 0.05) as compared to controls. The association still persisted when the heterozygous and homozygous mutants (AG + GG) were clubbed together (OR = 1.67, p < 0.05). The mRNA expression of IL-10 was found to be 3.63 folds higher (housekeeping gene, β-actin) and 2.42 folds higher (housekeeping gene, 18S rRNA) in RA patients as compared to controls. CONCLUSION The results indicate that IL10-1082 A/G polymorphism is associated with genetic susceptibility/predisposition to RA in North Indian population.
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Affiliation(s)
- Mohd Jahid
- Department of Biochemistry, Dilshad Garden, Delhi 110095, India
| | - Rehan-Ul-Haq
- Department of Orthopedics, Dilshad Garden, Delhi 110095, India
| | - Rajnish Avasthi
- Department of Medicine University, College of Medical Sciences, GTB Hospital, University of Delhi, Dilshad Garden, Delhi 110095, India
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Wang Q, Meng Y, Cao W, Du W, Liu Y, Yan Y, Luo L, Ma X. Association of monocyte to high-density lipoprotein cholesterol ratio with carotid artery intima-media thickness in patients with systemic lupus erythematosus. Biomark Med 2018; 12:359-364. [PMID: 29569475 DOI: 10.2217/bmm-2016-0362] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
AIM The purpose of this study was to evaluate the relationship between monocyte to high-density lipoprotein cholesterol ratio (MHR) and carotid atherosclerostic plaque in patients with systemic lupus erythematosus (SLE). METHODS A total of 214 SLE patients were divided into two groups according to the results of ultrasonic examination: carotid arterial atherosclerotic plaque groups and noncarotid arterial atherosclerosis groups. RESULTS The values of monocyte to high-density lipoprotein-cholesterol ratio (MHR) increase in carotid arterial atherosclerotic plaque groups compared with noncarotid arterial atherosclerosis groups (0.32 ± 0.18 vs 0.26 ± 0.15; p = 0.015). There was a significant correlation between MHR and carotid artery intima-media thickness (r = 0.228; p = 0.001) in patients with SLE. CONCLUSION Our study suggests that the values of MHR could be a marker to assess carotid artery intima-media thickness in patients with SLE.
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Affiliation(s)
- Qian Wang
- State Key Laboratory Incubation Base of Xinjiang Major Diseases Research, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830011, PR China.,Clinical Laboratory Center, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, 830001, PR China
| | - Yan Meng
- State Key Laboratory Incubation Base of Xinjiang Major Diseases Research, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830011, PR China
| | - Wenyan Cao
- State Key Laboratory Incubation Base of Xinjiang Major Diseases Research, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830011, PR China
| | - Wenjing Du
- State Key Laboratory Incubation Base of Xinjiang Major Diseases Research, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830011, PR China
| | - Yumei Liu
- State Key Laboratory Incubation Base of Xinjiang Major Diseases Research, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830011, PR China
| | - Yi Yan
- Department of Basic Medicine, Xinjiang Medical University, Urumqi, 830011, PR China
| | - Li Luo
- State Key Laboratory Incubation Base of Xinjiang Major Diseases Research, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830011, PR China
| | - Xiumin Ma
- State Key Laboratory Incubation Base of Xinjiang Major Diseases Research, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830011, PR China.,Department of Basic Medicine, Xinjiang Medical University, Urumqi, 830011, PR China
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Jahid M, Rehan-Ul-Haq, Chawla D, Avasthi R, Ahmed RS. Association of polymorphic variants in IL1B gene with secretion of IL-1β protein and inflammatory markers in north Indian rheumatoid arthritis patients. Gene 2017; 641:63-67. [PMID: 29054755 DOI: 10.1016/j.gene.2017.10.051] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 07/04/2017] [Accepted: 10/16/2017] [Indexed: 01/17/2023]
Abstract
The proinflammatory cytokine interleukin-1beta (IL-1β) is a key mediator of inflammation which affects cell proliferation and differentiation. IL-1β is considered to contribute to the pathophysiology of rheumatoid arthritis (RA). Polymorphisms in cytokine genes are highly influenced by ethnicity. Hence, in this study polymorphism of the IL1B-511(C/T) within promoter region was analyzed by using polymerase chain reaction-restriction fragment length Polymorphism (PCR-RFLP) in 187 RA patients and 214 controls. The prevalence of different genotypes and allelic frequency distribution was compared in RA patients and controls. Levels of inflammatory markers and serum levels of IL-1β were estimated by ELISA The serum inflammatory markers levels were significantly higher in RA patients as compared to controls (RF=127.3±21.3U/mL, Anti-CCP=17.8±8.3U/mL, CRP=17.86±7.1mg/L and IL-1β=21.25±4.19pg/mL in RA patients p<0.01). The frequency of heterozygous mutant (C/T) and homozygous mutant (T/T) variants were significantly higher in RA patients as compared to controls and the odds ratios by logistic regression were (OR=2.2, p<0.001) and (OR=3.21, p<0.01) respectively. The association persisted on combining the heterozygous mutant and homozygous mutant (CT+TT) together as compared to controls (OR=2.39; p<0.001). Positive and significant (p<0.05) correlation of circulating IL-1β levels with RF (r=0.232), anti-CCP (r=0.207) and CRP (r=0.166) among RA patients were found. The levels of anti-CCP were significantly higher in homozygous mutant variants (TT) as well as the heterozygous mutant variants (C/T) in comparison to the wild variants (CC) (p<0.01). The results of this study reveal that mutant allele (T) of IL1B-511 promoter SNP tends to be associated with elevated anti-CCP and IL-1β levels as observed in RA patients and hence disease susceptibility.
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Affiliation(s)
- Mohd Jahid
- Department of Biochemistry, University College of Medical Sciences and GTB Hospital (University of Delhi), Dilshad Garden, Delhi 110095, India
| | - Rehan-Ul-Haq
- Department of Orthopedics, University College of Medical Sciences and GTB Hospital (University of Delhi), Dilshad Garden, Delhi 110095, India
| | - Diwesh Chawla
- Central Research Laboratory, University College of Medical Sciences and GTB Hospital (University of Delhi), Dilshad Garden, Delhi 110095, India
| | - Rajnish Avasthi
- Department of Medicine, University College of Medical Sciences and GTB Hospital (University of Delhi), Dilshad Garden, Delhi 110095, India
| | - Rafat Sultana Ahmed
- Department of Biochemistry, University College of Medical Sciences and GTB Hospital (University of Delhi), Dilshad Garden, Delhi 110095, India.
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Tumor necrosis factor-α -308 polymorphism in North Indian rheumatoid arthritis patients and association with mRNA and serum TNF-α. Clin Rheumatol 2017; 36:2209-2216. [DOI: 10.1007/s10067-017-3774-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2017] [Revised: 07/12/2017] [Accepted: 07/18/2017] [Indexed: 10/19/2022]
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Batún Garrido JADJ, Olán F, Hernández Núñez É. [Dyslipidemia and atherogenic risk in patients with rheumatoid arthritis]. CLINICA E INVESTIGACION EN ARTERIOSCLEROSIS 2016; 28:123-31. [PMID: 27026386 DOI: 10.1016/j.arteri.2016.02.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Revised: 01/26/2016] [Accepted: 02/04/2016] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Dyslipidaemia is one of the main risk factors for atherosclerotic cardiovascular disease. Patients with rheumatoid arthritis have 2-3 times more cardiovascular risk, which is partly due to the pattern of lipids which increase the atherogenic index. METHODS A descriptive, cross-sectional, observational and prospective study was conducted on 82 patients, selected for their lipid profile. Variables associated with the disease and the drugs used were recorded. Atherogenic risk was calculated, with Chi square being used for categorical variables, and the Mann-Whitney test for the continuous ones. RESULTS The dyslipidaemia frequency was 54.9%. The most frequent age range of dyslipidaemia was between 51 and 60 years. Patients with type i obesity had a higher frequency of dyslipidaemia. Less dyslipidaemia was found with a lower rate of disease activity. Patients with cyclic citrullinated anti-peptide antibodies and positive rheumatoid factor, erythrocyte sedimentation rate>13mm or CRP>2mg/L had a higher frequency of dyslipidaemia. The mean Castelli atherogenic index was 4.36, the index of Kannel was 2.59, and triglycerides/HDL-c ratio was 3.83.Patients with dyslipidaemia showed a higher frequency of positive rheumatoid factor (P=.0008), and those patients who were taking hydroxychloroquine had a lower frequency of dyslipidaemia P=.03. CONCLUSIONS Patients with rheumatoid arthritis have a pro-atherogenic lipid profile. It is important to know this and treat it to reduce cardiovascular risk.
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Affiliation(s)
- José Antonio de Jesús Batún Garrido
- Servicio de Medicina Interna, Hospital Regional de Alta Especialidad Dr. Gustavo A. Rovirosa Pérez, El Recreo, Villahermosa, Tabasco, México.
| | - Francisco Olán
- Servicio de Medicina Interna, Hospital Regional de Alta Especialidad Dr. Gustavo A. Rovirosa Pérez, El Recreo, Villahermosa, Tabasco, México
| | - Éufrates Hernández Núñez
- Servicio de Medicina Interna, Hospital Regional de Alta Especialidad Dr. Gustavo A. Rovirosa Pérez, El Recreo, Villahermosa, Tabasco, México
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Forero E, Chalem M, Vásquez G, Jauregui E, Medina LF, Pinto Peñaranda LF, Medina J, Medina Y, Jaimes D, Arbelaez AM, Domínguez AM, Fernández A, Felipe-Díaz OJ, Chalem P, Caballero Uribe CV, Jannaut MJ, García I, Bautista W, Ramírez Figueroa J, Cortés J, Quintero J, Rodríguez N. Gestión de riesgo para la prescripción de terapias biológicas. ACTA ACUST UNITED AC 2016. [DOI: 10.1016/j.rcreu.2016.02.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Vinapamula KS, Pemmaraju SVLN, Bhattaram SK, Bitla AR, Manohar SM. Serum Adenosine Deaminase as Inflammatory Marker in Rheumatoid Arthritis. J Clin Diagn Res 2015; 9:BC08-10. [PMID: 26500897 DOI: 10.7860/jcdr/2015/14296.6483] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Accepted: 08/02/2015] [Indexed: 12/19/2022]
Abstract
BACKGROUND Rheumatoid arthritis (RA) is a prototypical inflammatory joint disease. The degree of inflammation is reflected in the extent of joint damage, which further has influence on the quality of life of patients with RA, including risk of atherosclerosis. Hence, besides clinical indices, estimation of degree of inflammation using biochemical markers helps in effecting optimum treatment strategies. C-reactive protein (CRP) is established as an inflammatory marker in patients with RA. Adenosine deaminase (ADA), an enzyme of purine metabolism is considered as a marker of cell mediated immunity and has also been suggested as a marker of inflammatory process in RA. The present study attempts to study the efficacy of serum ADA activity as an inflammatory marker in RA. MATERIALS AND METHODS Forty six RA patients and forty six age and sex matched healthy controls were included in the study. ADA activity and high sensitivity C-reactive protein (hsCRP) levels in serum were measured in all the subjects. Statistical analyses were done using Medcalc statistical software version 12.2.2. RESULTS ADA activity and hsCRP levels were increased in RA patients compared to controls (p<0.0001 and 0.0001 respectively). Significant positive correlation was obtained between hsCRP and ADA in patients (r=0.316, p=0.033). Receiver operating characteristic (ROC) curve analysis revealed statistically significant area under curve (AUC) for ADA that is comparable to that obtained for hsCRP (0.776, p<0.0001 for ADA, 0.726, p<0.0001 for hsCRP). Similar diagnostic utility was obtained with ROC generated cut-off value of 25.3 IU/L (82.6% sensitivity and 65.2% specificity) and with control mean value of 23.48 IU/L (86.96% sensitivity and 54.35% specificity) for ADA. CONCLUSION Findings of the present study indicate the importance of ADA as a marker of inflammation. Considering the higher sensitivity obtained, we propose control mean (23.48 IU/L) as a cut-off for serum ADA activity as an inflammatory marker. Owing to the simplicity and also the cost effectiveness of ADA assay, ADA may be recommended as a marker of inflammation in patients with RA. However, further larger and well controlled studies are needed to establish its role as inflammatory marker.
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Affiliation(s)
- Kiranmayi S Vinapamula
- Assistant Professor, Department of Biochemistry, Sri Venkateswara Institute of Medical Sciences , Tirupati, Andhra Pradesh, India
| | - Srinivasarao V L N Pemmaraju
- Professor and Head, Department of Biochemistry, Sri Venkateswara Institute of Medical Sciences , Tirupati, Andhra Pradesh, India
| | - Siddartha Kumar Bhattaram
- Professor, Department of Medicine, Sri Venkateswara Institute of Medical Sciences , Tirupati, Andhra Pradesh, India
| | - Aparna R Bitla
- Associate Professor, Department of Biochemistry, Sri Venkateswara Institute of Medical Sciences , Tirupati, Andhra Pradesh, India
| | - Suchitra M Manohar
- Associate Professor, Department of Biochemistry, Sri Venkateswara Institute of Medical Sciences , Tirupati, Andhra Pradesh, India
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Serum levels of anticyclic citrullinated peptide antibodies, interleukin-6, tumor necrosis factor-α, and C-reactive protein are associated with increased carotid intima-media thickness: a cross-sectional analysis of a cohort of rheumatoid arthritis patients without cardiovascular risk factors. BIOMED RESEARCH INTERNATIONAL 2015; 2015:342649. [PMID: 25821796 PMCID: PMC4363501 DOI: 10.1155/2015/342649] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Revised: 08/18/2014] [Accepted: 08/19/2014] [Indexed: 01/22/2023]
Abstract
The main cause of death in rheumatoid arthritis (RA) is cardiovascular events. We evaluated the relationship of anticyclic citrullinated peptide (anti-CCP) antibody levels with increased carotid intima-media thickness (cIMT) in RA patients. Methods. Forty-five anti-CCP positive and 37 anti-CCP negative RA patients, and 62 healthy controls (HC) were studied. All groups were assessed for atherogenic index of plasma (AIP) and cIMT. Anti-CCP, C-reactive protein (CRP), and levels of tumor necrosis factor alpha (TNFα) and interleukin-6 (IL-6) were measured by enzyme-linked immunosorbent assay (ELISA). Results. The anti-CCP positive RA patients showed increased cIMT compared to HC and anti-CCP negative (P < 0.001). Anti-CCP positive versus anti-CCP negative RA patients, had increased AIP, TNFα and IL-6 (P < 0.01), and lower levels of high density lipoprotein cholesterol (HDL-c) (P = 0.02). The cIMT correlated with levels of anti-CCP (r = 0.513, P = 0.001), CRP (r = 0.799, P < 0.001), TNFα (r = 0.642, P = 0.001), and IL-6 (r = 0.751, P < 0.001). In multiple regression analysis, cIMT was associated with CRP (P < 0.001) and anti-CCP levels (P = 0.03). Conclusions. Levels of anti-CCP and CRP are associated with increased cIMT and cardiovascular risk supporting a clinical role of the measurement of cIMT in RA in predicting and preventing cardiovascular events.
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14
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Shrivastava AK, Singh HV, Raizada A, Singh SK, Pandey A, Singh N, Yadav DS, Sharma H. Inflammatory markers in patients with rheumatoid arthritis. Allergol Immunopathol (Madr) 2015; 43:81-7. [PMID: 24656623 DOI: 10.1016/j.aller.2013.11.003] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2013] [Revised: 10/30/2013] [Accepted: 11/07/2013] [Indexed: 01/13/2023]
Abstract
BACKGROUND Autoimmune diseases such as rheumatoid arthritis (RA) are the consequence of a persistent imbalance between pro- and anti-inflammatory immune mechanisms, leading to chronic inflammation. The objective of this study was to determine whether the high sensitive C-reactive protein (hs-CRP) and cytokines are elevated in RA patients and to investigate the relationship between these markers and disease activity in RA, measured by disease activity score 28 (DAS28). METHODS We studied 110 RA patients according to American College of Rheumatology revised criteria for RA, and 55 controls matched by age and sex. Serum levels of hs-CRP and cytokines interleukin (IL)-6, IL-10 and tumour necrosis factor-α (TNF-α) were estimated and correlated with the DAS28. Serum hs-CRP was assayed immunoturbidimetrically and cytokines were analysed by commercially available ELISA kit. RESULTS We found that RA patients had significantly higher levels of serum hs-CRP (p<0.001), IL-6 (p<0.001), TNF-α (p<0.001), and IL-10 (p<0.01) as compared to healthy controls. hs-CRP, IL-6 and TNF-α correlated positively (p<0.001) and IL-10 correlated negatively (p<0.01) with DAS28. CONCLUSIONS These results demonstrate that RA patients have high levels of inflammatory markers, and these levels are correlated with the DAS28. These findings suggest a possible role of these markers in the pathogenesis of RA. Moreover, these biomarkers can be used as markers of disease activity in the diagnosis and treatment of RA.
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Affiliation(s)
- A K Shrivastava
- Department of Biochemistry, Sudha Rustagi College of Dental Sciences & Research, Faridabad 121001, India.
| | - H V Singh
- Biochemist, Department of Pathology, Hindu Rao Hospital, Delhi 110007, India
| | - A Raizada
- Department of Pathology and Laboratory Medicine, Medanta-The Medicity, Gurgaon 122001, India
| | - S K Singh
- Department of Biochemistry, G. R. Medical College, Gwalior 474009, India
| | - A Pandey
- Department of Biochemistry, Narsinhbhai Patel Dental College and Hospital, Visnagar 384315, India
| | - N Singh
- Department of Biochemistry, G. R. Medical College, Gwalior 474009, India
| | - D S Yadav
- Department of Pathology and Laboratory Medicine, Medanta-The Medicity, Gurgaon 122001, India
| | - H Sharma
- Department of Rheumatology, Hindu Rao Hospital, Delhi 110007, India
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