1
|
Batista AA, Lazzarin T, Pereira FW, Baccaro A, Rocha OM, Narimatsu KL, Souza JT, Modesto PN, Zanati Bazan SG, Tanni SE, Okoshi MP, Polegato BF, Paiva SA, Zornoff L, Minicucci MF, Azevedo PS. Serum Vitamin D Levels, Disease Activity Score-28 for Rheumatoid Arthritis with C-Reactive Protein (DAS28-CRP), and Cardiac Remodeling Determined by Ventricular Dimensions and Left Atrium Diameter in Patients with Rheumatoid Arthritis: A Prospective Observational Study. Med Sci Monit 2023; 29:e938989. [PMID: 36609557 PMCID: PMC9832721 DOI: 10.12659/msm.938989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Rheumatoid arthritis (RA) can cause extra-articular manifestations, and the myocardium can be a target. This study aimed to describe structural and functional cardiac echocardiographic variables in RA patients and to evaluate whether vitamin D (VD) levels and inflammation markers, evaluated by Disease Activity Score-28 for Rheumatoid Arthritis with C-reactive protein (DAS28-CRP), are associated with cardiac remodeling (CR) in this population. MATERIAL AND METHODS This prospective observational study evaluated 90 patients with RA in Botucatu University Hospital wards from 2014 to 2017. Clinical data were recorded, including demographic information, comorbidities, length of disease, and treatment type. Serum VD and C-reactive protein levels were measured, and the DAS28-CRP was calculated. A transthoracic echocardiography study was performed. The outcome evaluated was CR. This parameter was assessed by left ventricular geometric patterns and left atrium diameter. RESULTS We evaluated 90 RA patients. The mean age was 52.9±10.8 years, and 17.8% were male. The length of the disease was 96 (60-180) months. Serum VD levels were 30.7±10.4 ng/mL and the DAS28 was 2.7±0.9. Regarding the CR parameters, 56.7% had altered left ventricular geometric patterns and 25.8% had enlargement of left atrium diameter. Even in multivariate analysis, the left ventricular geometric patterns were not associated with the VD levels and the inflammation marker used. However, sufficient VD levels protect from left atrium enlargement (OR: 0.905; IC 95%: 0.843-0.973; P=0.007). CONCLUSIONS Low serum vitamin D values, but not inflammation, are associated with CR in patients with RA.
Collapse
Affiliation(s)
- Andrea A.P. Batista
- Department of Internal Medicine, São Paulo State University (UNESP), Botucatu Medical School, Botucatu, SP, Brazil
| | - Taline Lazzarin
- Department of Internal Medicine, São Paulo State University (UNESP), Botucatu Medical School, Botucatu, SP, Brazil
| | - Filipe W.L. Pereira
- Department of Internal Medicine, São Paulo State University (UNESP), Botucatu Medical School, Botucatu, SP, Brazil
| | - Antonio Baccaro
- Department of Internal Medicine, São Paulo State University (UNESP), Botucatu Medical School, Botucatu, SP, Brazil
| | - Oswaldo M. Rocha
- Department of Internal Medicine, São Paulo State University (UNESP), Botucatu Medical School, Botucatu, SP, Brazil
| | - Karina L. Narimatsu
- Department of Internal Medicine, São Paulo State University (UNESP), Botucatu Medical School,, Botucatu, SP, Brazil
| | - Juli T. Souza
- Department of Internal Medicine, São Paulo State University (UNESP), Botucatu Medical School, Botucatu, SP, Brazil
| | - Pamela N. Modesto
- Department of Internal Medicine, São Paulo State University (UNESP), Botucatu Medical School,, Botucatu, SP, Brazil
| | - Silméia Garcia Zanati Bazan
- Department of Internal Medicine, São Paulo State University (UNESP), Botucatu Medical School, Botucatu, SP, Brazil
| | - Suzana E. Tanni
- Department of Internal Medicine, São Paulo State University (UNESP), Botucatu Medical School, Botucatu, SP, Brazil
| | - Marina P. Okoshi
- Department of Internal Medicine, São Paulo State University (UNESP), Botucatu Medical School, Botucatu, SP, Brazil
| | - Bertha F. Polegato
- Department of Internal Medicine, São Paulo State University (UNESP), Botucatu Medical School,, Botucatu, SP, Brazil
| | - Sergio A.R. Paiva
- Department of Internal Medicine, São Paulo State University (UNESP), Botucatu Medical School, Botucatu, SP, Brazil
| | - Leonardo Zornoff
- Department of Internal Medicine, São Paulo State University (UNESP), Botucatu Medical School, Botucatu, SP, Brazil
| | - Marcos F. Minicucci
- Department of Internal Medicine, São Paulo State University (UNESP), Botucatu Medical School, Botucatu, SP, Brazil
| | - Paula S. Azevedo
- Department of Internal Medicine, São Paulo State University (UNESP), Botucatu Medical School, Botucatu, SP, Brazil
| |
Collapse
|
2
|
Affiliation(s)
- Marina P. Okoshi
- UNESPFaculdade de Medicina de BotucatuDepartamento de Clínica MédicaBotucatuSPBrasilDepartamento de Clínica Médica - Faculdade de Medicina de Botucatu (UNESP), Botucatu, SP - Brasil.
| | - Rosana M. Cortez
- UNESPFaculdade de Medicina de BotucatuDepartamento de Clínica MédicaBotucatuSPBrasilDepartamento de Clínica Médica - Faculdade de Medicina de Botucatu (UNESP), Botucatu, SP - Brasil.
- Unimed SorocabaSão PauloSPBrasilUnimed Sorocaba, São Paulo, SP - Brasil.
| | - Luana U. Pagan
- UNESPFaculdade de Medicina de BotucatuDepartamento de Clínica MédicaBotucatuSPBrasilDepartamento de Clínica Médica - Faculdade de Medicina de Botucatu (UNESP), Botucatu, SP - Brasil.
| | - Paula F. Martinez
- Universidade Federal de Mato Grosso do SulInstituto Integrado de SaúdeCampo GrandeMSBrasilInstituto Integrado de Saúde, Universidade Federal de Mato Grosso do Sul (UFMS), Campo Grande, MS - Brasil.
| | - Filipe W. L. Pereira
- UNESPFaculdade de Medicina de BotucatuDepartamento de Clínica MédicaBotucatuSPBrasilDepartamento de Clínica Médica - Faculdade de Medicina de Botucatu (UNESP), Botucatu, SP - Brasil.
| |
Collapse
|