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Surís X, Pueyo-Sánchez MJ, Ricart A, Naranjo A, Casanova T, Gómez-Vaquero C, Duaso E, Cancio-Trujillo JM, Sánchez-Martín J, Pérez-Mitru A. [Cost-effectiveness analysis of fracture liaison services in Catalonia]. J Healthc Qual Res 2024:S2603-6479(24)00023-X. [PMID: 38614935 DOI: 10.1016/j.jhqr.2024.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 12/13/2023] [Accepted: 03/15/2024] [Indexed: 04/15/2024]
Abstract
OBJECTIVE To assess the cost-effectiveness of Fracture Liaison Service (FLS) compared to the standard of care for secondary prevention of fragility fractures form the perspective of the Catalan Health Service. METHODS Cost-utility assessment through a Markov model that simulated disease progression of a patients' cohort candidates to initiate antiosteoporotic treatment after a fragility fracture. A time horizon of 10 years and a 6-month duration per cycle was established. Clinical, economics and quality of life parameters were obtained from the literature and derived from four Catalan FLS. The Catalan Health Service perspective was adopted, considering direct health costs expressed in 2022 euros. A 3% discount rate was applied on costs and outcomes. Uncertainty was assessed through multiple sensitivity analyses. RESULTS Compared to the standard of care, FLS would promote antiosteoporotic initiation and persistence, reducing the incidence and mortality associated with subsequent fragility fractures. This incremental clinical benefit was estimated at 0.055 years and 0.112 quality-adjusted life years (QALYs) per patient. A higher cost (€1,073.79 per patient) was estimated, resulting into an incremental cost-utility ratio of €9,602.72 per QALYs gained. The sensitivity analyses performed were consistent, corroborating the robustness and conservative approach of the base-case. CONCLUSIONS The introduction of FLS for the secondary prevention of FF would represent a cost-effective strategy from the Catalan Health Service perspective.
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Affiliation(s)
- X Surís
- Departament de Salut, Pla director de les malalties reumàtiques i de l'aparell locomotor, Barcelona, España; Servicio de Reumatología, Hospital General de Granollers, Barcelona, España; Facultat de Medicina i Ciències de la Salut, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Barcelona, España; Gerència de Processos Integrats en Salut, Àrea Assistencial, Servei Català de la Salut, Barcelona, España.
| | - M J Pueyo-Sánchez
- Àrea Integral de Salut Barcelona Esquerra, Consorci Sanitari de Barcelona, Regió Sanitària Barcelona, Servei Català de la Salut, Barcelona, España
| | - A Ricart
- Gerència de Processos Integrats en Salut, Àrea Assistencial, Servei Català de la Salut, Barcelona, España
| | - A Naranjo
- Servicio de Reumatología, Hospital Universitario de Gran Canaria Dr. Negrin, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, España
| | - T Casanova
- Servicio de Medicina Interna, Complex Hospitalari Moisès Broggi, Sant Joan Despí, Barcelona, España
| | - C Gómez-Vaquero
- Servicio de Reumatología, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL)-Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España
| | - E Duaso
- Servicio de Geriatría, Atención Paliativa, Dependencia y Discapacidad, Hospital Universitari d'Igualada (Consorci Sanitari de l'Anoia), Barcelona, España
| | - J M Cancio-Trujillo
- Servicio de Geriatría y Cuidados Paliativos de Badalona Serveis Assistencials (BSA), Barcelona, España; Escuela Superior de Salud de Tecnocampus, Universidad Pompeu Fabra, Barcelona, España
| | | | - A Pérez-Mitru
- Market Access Area, Pharmalex Spain, Barcelona, España
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Gómez-Vaquero C, Hernández JL, Olmos JM, Cerdà D, Calleja CH, López JAM, Arboleya L, Del Rey FJA, Pardo SM, Vilamajó IR, Armangué XS, Grados D, Audera CB, Suero-Rosario E, Gracia IG, Chamizo AS, Martín-Esteve I, Florez H, Naranjo A, Castañeda S, Bruno SO, Carazo SG, Garcia-Vadillo A, Vives LL, Martínez-Ferrer À, Paños HB, Acín PA, Castellanos-Moreira R, Satorra P, Tebé C, Guañabens N. High incidence of clinical fragility fractures in postmenopausal women with rheumatoid arthritis. A case-control study. Bone 2023; 168:116654. [PMID: 36584785 DOI: 10.1016/j.bone.2022.116654] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 12/20/2022] [Accepted: 12/21/2022] [Indexed: 12/29/2022]
Abstract
OBJECTIVES To estimate the incidence of clinical fragility fractures in postmenopausal women with rheumatoid arthritis (RA) and analyze risk factors for fracture. METHODS Incidence of clinical fragility fractures in 330 postmenopausal women with RA was compared to that of a control population of 660 age-matched postmenopausal Spanish women. Clinical fractures during the previous five years were recorded. We analyzed associations with risk factors for fracture in both populations and with disease-related variables in RA patients. RESULTS Median age of RA patients was 64 years; median RA duration was eight years. Sixty-nine percent were in remission or on low activity. Eighty-five percent had received glucocorticoids (GCs); 85 %, methotrexate; and 40 %, ≥1 biologic DMARD. Fifty-four patients and 47 controls had ≥1 major osteoporotic fracture (MOF). Incidence of MOFs was 3.55 per 100 patient-year in patients and 0.72 in controls (HR: 2.6). Risk factors for MOFs in RA patients were age, previous fracture, parental hip fracture, years since menopause, BMD, erosions, disease activity and disability, and cumulative dose of GCs. Previous fracture in RA patients was a strong risk for MOFs (HR: 10.37). CONCLUSION Of every 100 postmenopausal Spanish women with RA, 3-4 have a MOF per year. This is more than double that of the general population. A previous fracture poses a high risk for a new fracture. Other classic risk factors for fracture, RA disease activity and disability, and the cumulative dose of GCs are associated with fracture development.
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Affiliation(s)
- Carmen Gómez-Vaquero
- Department of Rheumatology, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, University of Barcelona, Barcelona, Spain.
| | - José Luis Hernández
- Depto. de Medicina y Psiquiatría, Universidad de Cantabria, Servicio de Medicina Interna, Hospital Universitario Marqués de Valdecilla, Instituto de Investigación Valdecilla (IDIVAL), Santander, Spain
| | - José Manuel Olmos
- Depto. de Medicina y Psiquiatría, Universidad de Cantabria, Servicio de Medicina Interna, Hospital Universitario Marqués de Valdecilla, Instituto de Investigación Valdecilla (IDIVAL), Santander, Spain
| | - Dacia Cerdà
- Department of Rheumatology, Hospital Moisès Broggi, Sant Joan Despí, University of Barcelona, Barcelona, Spain
| | | | | | - Luis Arboleya
- Department of Rheumatology, University Hospital Central de Asturias, Oviedo, Spain
| | | | | | | | - Xavier Surís Armangué
- Department of Rheumatology, Hospital General de Granollers, Granollers, International University of Catalunya, Barcelona, Spain
| | - Dolors Grados
- Department of Rheumatology, Hospital d'Igualada, Igualada, Barcelona, Spain
| | | | | | | | | | | | - Helena Florez
- Department of Rheumatology, Hospital Clínic, CIBERehd, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Antonio Naranjo
- Department of Rheumatology, University Hospital de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
| | - Santos Castañeda
- Department of Rheumatology, University Hospital La Princesa IIS-, IP, Madrid, Spain
| | - Soledad Ojeda Bruno
- Department of Rheumatology, University Hospital de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
| | | | | | | | | | | | - Pilar Aguado Acín
- Department of Rheumatology, University Hospital La Paz, Madrid, Spain
| | - Raul Castellanos-Moreira
- Department of Rheumatology, Hospital Clínic, CIBERehd, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Pau Satorra
- Biostatistics Unit, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
| | - Cristian Tebé
- Biostatistics Unit, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, University of Barcelona, Barcelona, Spain
| | - Núria Guañabens
- Department of Rheumatology, Hospital Clínic, CIBERehd, IDIBAPS, University of Barcelona, Barcelona, Spain
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Morales-Ivorra I, Narváez J, Gómez-Vaquero C, Moragues C, Nolla JM, Narváez JA, Marín-López MA. A Thermographic Disease Activity Index for remote assessment of rheumatoid arthritis. RMD Open 2022; 8:rmdopen-2022-002615. [PMID: 36410775 PMCID: PMC9680322 DOI: 10.1136/rmdopen-2022-002615] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 10/20/2022] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES Remote assessment of patients with rheumatoid arthritis (RA) has increased during recent years. However, telematic consultations preclude the possibility of carrying out a physical examination and obtaining objective inflammation. In this study, we developed and validated two novel composite disease activity indexes (Thermographic Disease Activity Index (ThermoDAI) and ThermoDAI-CRP) based on thermography of hands and machine learning, in order to assess disease activity easily, rapidly and without formal joint counts. METHODS ThermoDAI was developed as the sum of Thermographic Joint Inflammation Score (ThermoJIS), a novel joint inflammation score based on the analysis of thermal images of the hands by machine learning, the Patient Global Assessment (PGA) and, for ThermoDAI-CRP, the C reactive protein (CRP). Construct validity was tested in 146 patients with RA by using Spearman's correlation with ultrasound-determined grey-scale synovial hypertrophy (GS) and power Doppler (PD) scores, CDAI, SDAI and DAS28-CRP. RESULTS Correlations of ultrasound scores with ThermoDAI (GS=0.52; PD=0.56) and ThermoDAI-CRP (GS=0.58; PD=0.61) were moderate to strong, while the correlations of ultrasound scores with PGA (GS=0.35; PD=0.39) and PGA+CRP (GS=0.44; PD=0.46) were weak to moderate. ThermoDAI and ThermoDAI-CRP also showed strong correlations with Clinical Disease Activity Index (ρ>0.83), Simplified Disease Activity Index (ρ>0.85) and Disease Activity Score with 28-Joint Counts-CRP (ρ>0.81) and high sensitivity for detecting active synovitis using remission criteria. CONCLUSIONS ThermoDAI and ThermoDAI-CRP showed stronger correlations with ultrasound-determined synovitis than PGA and PGA + CRP, thus presenting an opportunity to improve remote consultations with patients with RA.
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Affiliation(s)
| | - Javier Narváez
- Rheumatology Department, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain
| | - Carmen Gómez-Vaquero
- Rheumatology Department, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain
| | - Carmen Moragues
- Rheumatology Department, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain
| | - Joan M Nolla
- Rheumatology Department, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain
| | - José A Narváez
- Radiodiagnosis Department, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain
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Morales-Ivorra I, Narváez J, Gómez-Vaquero C, Moragues C, Nolla JM, Narváez JA, Marín-López MA. Assessment of inflammation in patients with rheumatoid arthritis using thermography and machine learning: a fast and automated technique. RMD Open 2022; 8:rmdopen-2022-002458. [PMID: 35840312 PMCID: PMC9295660 DOI: 10.1136/rmdopen-2022-002458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 06/30/2022] [Indexed: 11/28/2022] Open
Abstract
Objectives Sensitive detection of joint inflammation in rheumatoid arthritis (RA) is crucial to the success of the treat-to-target strategy. In this study, we characterise a novel machine learning-based computational method to automatically assess joint inflammation in RA using thermography of the hands, a fast and non-invasive imaging technique. Methods We recruited 595 patients with arthritis and osteoarthritis, as well as healthy subjects at two hospitals over 4 years. Machine learning was used to assess joint inflammation from the thermal images of the hands using ultrasound as the reference standard, obtaining a Thermographic Joint Inflammation Score (ThermoJIS). The machine learning model was trained and tuned using data from 449 participants with different types of arthritis, osteoarthritis or without rheumatic disease (development set). The performance of the method was evaluated based on 146 patients with RA (validation set) using Spearman’s rank correlation coefficient, area under the receiver-operating curve (AUROC), average precision, sensitivity, specificity, positive and negative predictive value and F1-score. Results ThermoJIS correlated moderately with ultrasound scores (grey-scale synovial hypertrophy=0.49, p<0.001; and power Doppler=0.51, p<0.001). The AUROC for ThermoJIS for detecting active synovitis was 0.78 (95% CI, 0.71 to 0.86; p<0.001). In patients with RA in clinical remission, ThermoJIS values were significantly higher when active synovitis was detected by ultrasound. Conclusions ThermoJIS was able to detect joint inflammation in patients with RA, even in those in clinical remission. These results open an opportunity to develop new tools for routine detection of joint inflammation.
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Affiliation(s)
| | - Javier Narváez
- Rheumatology Department, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain
| | - Carmen Gómez-Vaquero
- Rheumatology Department, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain
| | - Carmen Moragues
- Rheumatology Department, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain
| | - Joan M Nolla
- Rheumatology Department, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain
| | - José A Narváez
- Radiodiagnosis Department, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain
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Guañabens N, Olmos JM, Hernández JL, Cerdà D, Hidalgo Calleja C, Martinez López JA, Arboleya L, Aguilar Del Rey FJ, Martinez Pardo S, Ros Vilamajó I, Suris Armangué X, Grados D, Beltrán Audera C, Suero-Rosario E, Gómez Gracia I, Salmoral Chamizo A, Martín-Esteve I, Florez H, Naranjo A, Castañeda S, Ojeda Bruno S, García Carazo S, García Vadillo A, López Vives L, Martínez-Ferrer À, Borrell Paños H, Aguado Acín P, Castellanos-Moreira R, Tebé C, Gómez-Vaquero C. Vertebral fractures are increased in rheumatoid arthritis despite recent therapeutic advances: a case-control study. Osteoporos Int 2021; 32:1333-1342. [PMID: 33459805 DOI: 10.1007/s00198-021-05824-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 01/04/2021] [Indexed: 10/22/2022]
Abstract
UNLABELLED Prevalence and risk factors of vertebral fractures in postmenopausal RA women were assessed in 323 patients and compared with 660 age-matched women. Of patients, 24.15% had at least one vertebral fracture vs.16.06% of controls. Age, glucocorticoids and falls were the main fracture risks. Vertebral fractures were associated with disease severity. INTRODUCTION There is little quality data on the updated prevalence of fractures in rheumatoid arthritis (RA) that may have changed due to advances in the therapeutic strategy in recent years. This study was aimed at analysing the prevalence and risk factors of vertebral fractures in postmenopausal women with RA and comparing it with that of the general population. METHODS We included 323 postmenopausal women diagnosed with RA from 19 Spanish Rheumatology Departments, randomly selected and recruited in 2018. Lateral radiographs of the thoracic and lumbar spine were obtained to evaluate morphometric vertebral fractures and the spinal deformity index. We analysed subject characteristics, factors related to RA, and fracture risk factors. The control group consisted of 660 age-matched Spanish postmenopausal women from the population-based Camargo cohort. RESULTS Seventy-eight (24.15%) RA patients had at least one vertebral fracture. RA patients had increased fracture risk compared with controls (106 of 660, 16.06%) (p = 0.02). Logistic regression analysis showed that age (OR 2.17; 95% CI 1.27-4.00), glucocorticoids (OR 3.83; 95% CI 1.32-14.09) and falls (OR 3.57; 95% CI 1.91-6.86) were the independent predictors of vertebral fractures in RA patients. The subgroup with vertebral fractures had higher disease activity (DAS28: 3.15 vs. 2.78, p = 0.038) and disability (HAQ: 0.96 vs. 0.63, p = 0.049), as compared with those without vertebral fractures. CONCLUSION The risk of vertebral fracture in RA is still high in recent years, when compared with the general population. The key determinants of fracture risk are age, glucocorticoids and falls. Patients with vertebral fractures have a more severe RA.
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Affiliation(s)
- N Guañabens
- Department of Rheumatology, Hospital Clínic, CIBERehd, IDIBAPS, University of Barcelona, Barcelona, Spain.
| | - J M Olmos
- Departament of Internal Medicine, University Hospital Marqués de Valdecilla-IDIVAL, Universidad de Cantabria, Santander, Spain
| | - J L Hernández
- Departament of Internal Medicine, University Hospital Marqués de Valdecilla-IDIVAL, Universidad de Cantabria, Santander, Spain
| | - D Cerdà
- Department of Rheumatology, Hospital Moisès Broggi, Sant Joan Despí, University of Barcelona, Barcelona, Spain
| | - C Hidalgo Calleja
- Department of Rheumatology, University Hospital de Salamanca, Salamanca, Spain
| | - J A Martinez López
- Department of Rheumatology, University Hospital Fundación Jiménez Díaz, Madrid, Spain
| | - L Arboleya
- Department of Rheumatology, University Hospital Central de Asturias, Oviedo, Spain
| | - F J Aguilar Del Rey
- Department of Rheumatology, University Hospital Virgen de la Victoria, Malaga, Spain
| | - S Martinez Pardo
- Department of Rheumatology, University Hospital Mutua Terrassa, Barcelona, Spain
| | - I Ros Vilamajó
- Department of Rheumatology, Hospital Son Llàtzer, Palma de Mallorca, Spain
| | - X Suris Armangué
- Department of Rheumatology, Hospital General de Granollers, Granollers, International University of Catalunya, Barcelona, Spain
| | - D Grados
- Department of Rheumatology, Hospital d'Igualada, Igualada, Barcelona, Spain
| | - C Beltrán Audera
- Department of Rheumatology, University Hospital Miguel Servet, Zaragoza, Spain
| | - E Suero-Rosario
- Department of Rheumatology, Hospital General Mateu Orfila, Maó, Spain
| | - I Gómez Gracia
- Department of Rheumatology, University Hospital Reina Sofía, Cordoba, Spain
| | - A Salmoral Chamizo
- Department of Rheumatology, University Hospital Reina Sofía, Cordoba, Spain
| | - I Martín-Esteve
- Department of Rheumatology, Hospital General Mateu Orfila, Maó, Spain
| | - H Florez
- Department of Rheumatology, Hospital Clínic, CIBERehd, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - A Naranjo
- Department of Rheumatology, University Hospital de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
| | - S Castañeda
- Department of Rheumatology, University Hospital La Princesa IIS-IP, Madrid, Spain
| | - S Ojeda Bruno
- Department of Rheumatology, University Hospital de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
| | - S García Carazo
- Department of Rheumatology, University Hospital La Paz, Madrid, Spain
| | - A García Vadillo
- Department of Rheumatology, University Hospital La Princesa IIS-IP, Madrid, Spain
| | - L López Vives
- Department of Rheumatology, Hospital Sant Rafael, Barcelona, Spain
| | - À Martínez-Ferrer
- Department of Rheumatology, University Hospital Doctor Peset, Valencia, Spain
| | - H Borrell Paños
- Department of Rheumatology, Hospital Sant Rafael, Barcelona, Spain
| | - P Aguado Acín
- Department of Rheumatology, University Hospital La Paz, Madrid, Spain
| | - R Castellanos-Moreira
- Department of Rheumatology, Hospital Clínic, CIBERehd, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - C Tebé
- Biostatistics Unit, Bellvitge Biomedical Research Institute (IDIBELL) L'Hospitalet de Llobregat, Barcelona, Spain
| | - C Gómez-Vaquero
- Department of Rheumatology, University Hospital de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
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Gómez-Vaquero C, Martín I, Zacarías A, Alía P, Loza E, Carmona L, Narváez J. Relation of the Serum Levels of DKK-1 and Osteoprotegerin with Bone Mass in Tightly Controlled Rheumatoid Arthritis. Curr Rheumatol Rev 2020; 17:101-108. [PMID: 33349216 DOI: 10.2174/1573397116666201221112509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 05/16/2020] [Accepted: 07/23/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To analyze the association between serum levels of osteoprotegerin (OPG) and Dickkopf-related protein 1 (DKK-1) and the annual percent change (Δ%) in bone mineral density (BMD) in patients with tightly controlled rheumatoid arthritis (RA). METHODS Observational mixed-study. RA patients followed-up with a tight-control strategy were included. Bone densitometries were performed at baseline (T0) and follow-up (T1) and serum levels of OPG and DKK-1 were measured by ELISA also in T0 and T1; additional clinical variables included disease activity measures, and treatment for RA and osteoporosis. Descriptive bivariate and multivariate analyses, stratified by gender, were performed. RESULTS We included 97 RA patients (70% female, with a mean age of 53 years, and 76% with low activity by DAS28); 95% were treated with DMARDs and 37% with anti-osteoporotic drugs. Mean time between T0 and T1 was 2.7 years. Most patients had their BMD improved. The mean Δ%BMD was +0.42% for lumbar spine, +0.15% for femoral neck and +0.91% for total femur. In men, baseline OPG was significantly associated with higher BMD loss (β coefficient -0.64) at the femoral neck. In women, DKK-1 was associated with higher BMD loss at the femoral neck (β coefficient -0.09), and total femur (β coefficient -0.11); however, DKK-1 was associated with lower BMD loss at the lumbar spine (β coefficient 0.06). CONCLUSION In tightly controlled RA patients, we have found no evidence of bone loss. The role of DKK1 and OPG seems small and might be related to sex and location.
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Affiliation(s)
- Carmen Gómez-Vaquero
- Rheumatology and Clinical Laboratory Services, Hospital Universitari de Bellvitge-IDIBELL, L'Hospitalet, Barcelona, Spain
| | - Irene Martín
- Rheumatology and Clinical Laboratory Services, Hospital Universitari de Bellvitge-IDIBELL, L'Hospitalet, Barcelona, Spain
| | - Andrea Zacarías
- Rheumatology and Clinical Laboratory Services, Hospital Universitari de Bellvitge-IDIBELL, L'Hospitalet, Barcelona, Spain
| | - Pedro Alía
- Rheumatology and Clinical Laboratory Services, Hospital Universitari de Bellvitge-IDIBELL, L'Hospitalet, Barcelona, Spain
| | | | | | - Javier Narváez
- Rheumatology and Clinical Laboratory Services, Hospital Universitari de Bellvitge-IDIBELL, L'Hospitalet, Barcelona, Spain
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7
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Soto-Subiabre M, Mayoral V, Fiter J, Valencia L, Subirana I, Gómez-Vaquero C. Vertebral fracture: clinical presentation and severity are linked to fracture risk factors. Osteoporos Int 2020; 31:1759-1768. [PMID: 32377807 DOI: 10.1007/s00198-020-05425-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 04/15/2020] [Indexed: 11/30/2022]
Affiliation(s)
- M Soto-Subiabre
- School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
- Rheumatology Service, Hospital Universitari de Bellvitge, L'Hospitalet, Barcelona, Spain.
| | - V Mayoral
- Pain Clinic, Hospital Universitari de Bellvitge, L'Hospitalet, Barcelona, Spain
| | - J Fiter
- Rheumatology Service, Hospital Universitari Son Espases, Palma de Mallorca, Spain
| | - L Valencia
- Rheumatology Service, Hospital Universitari de Bellvitge, L'Hospitalet, Barcelona, Spain
| | - I Subirana
- Rheumatology Service, Hospital Universitari de Bellvitge, L'Hospitalet, Barcelona, Spain
| | - C Gómez-Vaquero
- Rheumatology Service, Hospital Universitari de Bellvitge, L'Hospitalet, Barcelona, Spain
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Guerrero-Pérez F, Casajoana A, Gómez-Vaquero C, Virgili N, López-Urdiales R, Hernández-Montoliu L, Pujol-Gebelli J, Osorio J, Alves C, Perez-Maraver M, Pellitero S, Vidal-Alabró A, Fernández-Veledo S, Vendrell J, Vilarrasa N. Changes in Bone Mineral Density in Patients with Type 2 Diabetes After Different Bariatric Surgery Procedures and the Role of Gastrointestinal Hormones. Obes Surg 2020; 30:180-188. [PMID: 31420830 DOI: 10.1007/s11695-019-04127-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Abstract
BACKGROUND To compare changes in bone mineral density (BMD) in patients with morbid obesity and type 2 diabetes (T2D) a year after being randomized to metabolic gastric bypass (mRYGB), sleeve gastrectomy (SG), and greater curvature plication (GCP). We also analyzed the association of gastrointestinal hormones with skeletal metabolism. METHODS Forty-five patients with T2D (mean BMI 39.4 ± 1.9 kg/m2) were randomly assigned to mRYGB, SG, or GCP. Before and 12 months after surgery, anthropometric, body composition, biochemical parameters, fasting plasma glucagon, ghrelin, and PYY as well as GLP-1, GLP-2, and insulin after a standard meal were determined. RESULTS After surgery, the decrease at femoral neck (FN) was similar but at lumbar spine (LS), it was greater in the mRYGB group compared with SG and GCP - 7.29 (4.6) vs. - 0.48 (3.9) vs. - 1.2 (2.7)%, p < 0.001. Osteocalcin and alkaline phosphatase increased more after mRYGB. Bone mineral content (BMC) at the LS after surgery correlated with fasting ghrelin (r = - 0.412, p = 0.01) and AUC for GLP-1 (r = - 0.402, p = 0.017). FN BMD at 12 months correlated with post-surgical fasting glucagon (r = 0.498, p = 0.04) and insulin AUC (r = 0.384, p = 0.030) and at LS with the AUC for GLP-1 in the same time period (r = - 0.335, p = 0.049). However, in the multiple regression analysis after adjusting for age, sex, and BMI, the type of surgery (mRYGB) remained the only factor associated with BMD reduction at LS and FN. CONCLUSIONS mRYGB induces greater deleterious effects on the bone at LS compared with SG and GCP, and gastrointestinal hormones do not play a major role in bone changes.
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Affiliation(s)
- Fernando Guerrero-Pérez
- Department of Endocrinology and Nutrition, Bellvitge University Hospital-IDIBELL, c/ Feixa Llarga s/n, 08907, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Anna Casajoana
- Department of General and Gastrointestinal Surgery. Bariatric Surgery Unit, Bellvitge University Hospital-IDIBELL, c/ Feixa Llarga s/n, 08907, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Carmen Gómez-Vaquero
- Department of Rheumatology, Bellvitge University Hospital-IDIBELL, c/ Feixa Llarga s/n, 08907, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Nuria Virgili
- Department of Endocrinology and Nutrition, Bellvitge University Hospital-IDIBELL, c/ Feixa Llarga s/n, 08907, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Rafael López-Urdiales
- Department of Endocrinology and Nutrition, Bellvitge University Hospital-IDIBELL, c/ Feixa Llarga s/n, 08907, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Laura Hernández-Montoliu
- Department of Endocrinology and Nutrition, Bellvitge University Hospital-IDIBELL, c/ Feixa Llarga s/n, 08907, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Jordi Pujol-Gebelli
- Department of General and Gastrointestinal Surgery. Bariatric Surgery Unit, Bellvitge University Hospital-IDIBELL, c/ Feixa Llarga s/n, 08907, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Javier Osorio
- Department of General and Gastrointestinal Surgery. Bariatric Surgery Unit, Bellvitge University Hospital-IDIBELL, c/ Feixa Llarga s/n, 08907, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Carolina Alves
- Clinical Nutrition Unit, Bellvitge University Hospital-IDIBELL, c/ Feixa Llarga s/n, 08907, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Manuel Perez-Maraver
- Department of Endocrinology and Nutrition, Bellvitge University Hospital-IDIBELL, c/ Feixa Llarga s/n, 08907, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Silvia Pellitero
- Department of Endocrinology and Nutrition and Health Sciences Research Institute, University Hospital Germans Trias i Pujol, Badalona, Spain.,CIBERDEM-CIBER de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, Barcelona, Spain
| | - Anna Vidal-Alabró
- Instituto de Investigación Biomédica-IDIBELL,, c/ Feixa Llarga s/n, 08907, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Sonia Fernández-Veledo
- CIBERDEM-CIBER de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, Barcelona, Spain.,Diabetes and Metabolic Associated Diseases Research Group, Hospital Joan XXIII, School of Medicine, Rovira i Virgili University, Tarragona, Spain
| | - Joan Vendrell
- CIBERDEM-CIBER de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, Barcelona, Spain. .,Diabetes and Metabolic Associated Diseases Research Group, Hospital Joan XXIII, School of Medicine, Rovira i Virgili University, Tarragona, Spain.
| | - Nuria Vilarrasa
- Department of Endocrinology and Nutrition, Bellvitge University Hospital-IDIBELL, c/ Feixa Llarga s/n, 08907, L'Hospitalet de Llobregat, Barcelona, Spain. .,CIBERDEM-CIBER de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, Barcelona, Spain.
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9
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Guerrero-Pérez F, Casajoana A, Gómez-Vaquero C, Virgili N, López-Urdiales R, Hernández-Montoliu L, Pujol-Gebelli J, Osorio J, Prats A, Vidal-Alabró A, Pérez-Maraver M, Fernández-Veledo S, Vendrell J, Vilarrasa N. Long-Term Effects in Bone Mineral Density after Different Bariatric Procedures in Patients with Type 2 Diabetes: Outcomes of a Randomized Clinical Trial. J Clin Med 2020; 9:jcm9061830. [PMID: 32545353 PMCID: PMC7356739 DOI: 10.3390/jcm9061830] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 06/05/2020] [Accepted: 06/08/2020] [Indexed: 11/16/2022] Open
Abstract
There is scant evidence of the long-term effects of bariatric surgery on bone mineral density (BMD). We compared BMD changes in patients with severe obesity and type 2 diabetes (T2D) 5 years after randomization to metabolic gastric bypass (mRYGB), sleeve gastrectomy (SG) and greater curvature plication (GCP). We studied the influence of first year gastrointestinal hormone changes on final bone outcomes. Forty-five patients, averaging 49.4 (7.8) years old and body mass index (BMI) 39.4 (1.9) kg/m2, were included. BMD at lumbar spine (LS) was lower after mRYGB compared to SG and GCP: 0.89 [0.82;0.94] vs. 1.04 [0.91;1.16] vs. 0.99 [0.89;1.12], p = 0.020. A higher percentage of LS osteopenia was present after mRYGB 78.6% vs. 33.3% vs. 50.0%, respectively. BMD reduction was greater in T2D remitters vs. non-remitters. Weight at fifth year predicted BMD changes at the femoral neck (FN) (adjusted R2: 0.3218; p = 0.002), and type of surgery (mRYGB) and menopause predicted BMD changes at LS (adjusted R2: 0.2507; p < 0.015). In conclusion, mRYGB produces higher deleterious effects on bone at LS compared to SG and GCP in the long-term. Women in menopause undergoing mRYGB are at highest risk of bone deterioration. Gastrointestinal hormone changes after surgery do not play a major role in BMD outcomes.
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Affiliation(s)
- Fernando Guerrero-Pérez
- Department of Endocrinology and Nutrition, Bellvitge University Hospital-IDIBELL, L’Hospitalet de Llobregat, 08907 Barcelona, Spain; (F.G.-P.); (N.V.); (R.L.-U.); (L.H.-M.); (M.P.-M.)
| | - Anna Casajoana
- Bariatric Surgery Unit, Bellvitge University Hospital-IDIBELL, L’Hospitalet de Llobregat, 08907 Barcelona, Spain; (A.C.); (J.P.-G.); (J.O.)
| | - Carmen Gómez-Vaquero
- Department of Rheumatology, Bellvitge University Hospital-IDIBELL, L’Hospitalet de Llobregat, 08907 Barcelona, Spain;
| | - Nuria Virgili
- Department of Endocrinology and Nutrition, Bellvitge University Hospital-IDIBELL, L’Hospitalet de Llobregat, 08907 Barcelona, Spain; (F.G.-P.); (N.V.); (R.L.-U.); (L.H.-M.); (M.P.-M.)
| | - Rafael López-Urdiales
- Department of Endocrinology and Nutrition, Bellvitge University Hospital-IDIBELL, L’Hospitalet de Llobregat, 08907 Barcelona, Spain; (F.G.-P.); (N.V.); (R.L.-U.); (L.H.-M.); (M.P.-M.)
| | - Laura Hernández-Montoliu
- Department of Endocrinology and Nutrition, Bellvitge University Hospital-IDIBELL, L’Hospitalet de Llobregat, 08907 Barcelona, Spain; (F.G.-P.); (N.V.); (R.L.-U.); (L.H.-M.); (M.P.-M.)
| | - Jordi Pujol-Gebelli
- Bariatric Surgery Unit, Bellvitge University Hospital-IDIBELL, L’Hospitalet de Llobregat, 08907 Barcelona, Spain; (A.C.); (J.P.-G.); (J.O.)
| | - Javier Osorio
- Bariatric Surgery Unit, Bellvitge University Hospital-IDIBELL, L’Hospitalet de Llobregat, 08907 Barcelona, Spain; (A.C.); (J.P.-G.); (J.O.)
| | - Anna Prats
- Clinical Nutrition Unit, Bellvitge University Hospital-IDIBELL, L’Hospitalet de Llobregat, 08907 Barcelona, Spain;
| | - Anna Vidal-Alabró
- Instituto de Investigación Biomédica-IDIBELL, L’Hospitalet de Llobregat, 08907 Barcelona, Spain;
| | - Manuel Pérez-Maraver
- Department of Endocrinology and Nutrition, Bellvitge University Hospital-IDIBELL, L’Hospitalet de Llobregat, 08907 Barcelona, Spain; (F.G.-P.); (N.V.); (R.L.-U.); (L.H.-M.); (M.P.-M.)
- Instituto de Investigación Biomédica-IDIBELL, L’Hospitalet de Llobregat, 08907 Barcelona, Spain;
- CIBERDEM-CIBER de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, 28014 Madrid, Spain; (S.F.-V.); (J.V.)
| | - Sonia Fernández-Veledo
- CIBERDEM-CIBER de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, 28014 Madrid, Spain; (S.F.-V.); (J.V.)
- Pere Virgili Research Institute (IISPV), University Hospital Joan XXIII, 43005and Rovira i Virgili University, 43003 Tarragona, Spain
| | - Joan Vendrell
- CIBERDEM-CIBER de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, 28014 Madrid, Spain; (S.F.-V.); (J.V.)
- Pere Virgili Research Institute (IISPV), University Hospital Joan XXIII, 43005and Rovira i Virgili University, 43003 Tarragona, Spain
| | - Nuria Vilarrasa
- Department of Endocrinology and Nutrition, Bellvitge University Hospital-IDIBELL, L’Hospitalet de Llobregat, 08907 Barcelona, Spain; (F.G.-P.); (N.V.); (R.L.-U.); (L.H.-M.); (M.P.-M.)
- CIBERDEM-CIBER de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, 28014 Madrid, Spain; (S.F.-V.); (J.V.)
- Correspondence: ; Tel.: +34-932-602-784
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10
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Reina D, Gómez-Vaquero C, Díaz-Torné C, Solé JMN. Assessment of nutritional status by dual X-Ray absorptiometry in women with rheumatoid arthritis: A case-control study. Medicine (Baltimore) 2019; 98:e14361. [PMID: 30732168 PMCID: PMC6380876 DOI: 10.1097/md.0000000000014361] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 01/07/2019] [Accepted: 01/10/2019] [Indexed: 12/23/2022] Open
Abstract
Rheumatoid arthritis (RA) has been related to an impairment of the nutritional status. Body mass index (BMI) has been used but questions arise about how to properly evaluate nutritional status in RA patients. Few studies have evaluated it by dual-energy X-ray absorptiometry.In women with RA, to analyze:Case-control study including 89 women with RA. The control group was composed by 100 patients affected by non-inflammatory rheumatic disorders. Study variables included age, RA duration, history, activity and disability, and in relation to nutritional status: BMI, serum albumin (ALB), whole body DXA assessment, and skeletal muscle index (SMI).Mean age of patients was 62 ± 8 years, mean duration of RA was 14 ± 9 years, mean disease activity score (DAS28) was 3.7 ± 1.4 and mean Health Assessment Questionnaire was 0.88 ± 0.77. BMI was 27.43 ± 5.16 Kg/m in patients and 27.78 ± 3.98 Kg/m in controls (P: ns). ALB was within normal range in all patients.By whole body DXA, RA patients presented a statistically significant lower lean mass in all locations and lower fat mass in limbs than controls. Patients had a redistribution of fat mass to trunk. Lean mass directly correlated with fat mass.Neither BMI nor ALB correlated with DXA parameters.BMI, appendicular lean mass and SMI correlated inversely with disease duration. Trunk lean mass correlated inversely, and fat mass directly, with RA disability parameters.RA patients fulfilled criteria of sarcopenia in 44% of cases versus 19% of controls (P <.001). In RA patients, regarding SMI, BMI showed a high specificity to detect sarcopenia (94% of the patients with low BMI had sarcopenia) but low sensitivity (47% of the patients with normal BMI or overweight had sarcopenia).RA patients have an impairment of nutritional status associated to disease duration that looks like sarcopenia and that is not predicted by BMI.
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11
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González-Serna D, Ortiz-Fernández L, Vargas S, García A, Raya E, Fernández-Gutierrez B, López-Longo FJ, Balsa A, González-Álvaro I, Narvaez J, Gómez-Vaquero C, Sabio JM, García-Portales R, González-Escribano MF, Tolosa C, Carreira P, Kiemeney L, Coenen MJH, Witte T, Schneider M, González-Gay MÁ, Martín J. Association of a rare variant of the TNFSF13B gene with susceptibility to Rheumatoid Arthritis and Systemic Lupus Erythematosus. Sci Rep 2018; 8:8195. [PMID: 29844438 PMCID: PMC5974315 DOI: 10.1038/s41598-018-26573-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 05/14/2018] [Indexed: 12/29/2022] Open
Abstract
A rare variant (BAFF-var) of the tumor necrosis factor superfamily 13b (TNFSF13B) gene has been recently associated with multiple sclerosis (MS) and systemic lupus erythematosus (SLE). The aim of this study was to investigate the association between TNFSF13B BAFF-var and susceptibility to rheumatoid arthritis (RA) and replicate that association in SLE. 6,218 RA patients, 2,575 SLE patients and 4,403 healthy controls from three different countries were included in the study. TNFSF13B BAFF-var was genotyped using TaqMan allelic discrimination assay. PLINK software was used for statistical analyses. TNFSF13B BAFF-var was significantly associated with RA (p = 0.015, OR = 1.21, 95% CI = 1.03-1.41) in the Spanish cohort. A trend of association was observed in the Dutch (p = 0.115) and German (p = 0.228) RA cohorts. A meta-analysis of the three RA cohorts included in this study revealed a statistically significant association (p = 0.002, OR = 1.24, 95% CI = 1.10-1.38). In addition, TNFSF13B BAFF-var was significantly associated with SLE in the Spanish (p = 0.001, OR = 1.41, 95% CI = 1.14-1.74) and the German cohorts (p = 0.030, OR = 1.86, 95% CI = 1.05-3.28), with a statistically significant p-value obtained in the meta-analysis (p = 0.0002, OR = 1.46, 95% CI = 1.09-2.32). The results obtained confirm the known association of TNFSF13B BAFF-var with SLE and, for the first time, demonstrate that this variant contributes to susceptibility to RA.
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Affiliation(s)
| | | | - Sofía Vargas
- Institute of Parasitology and Biomedicine López-Neyra, CSIC, Granada, Spain
| | - Antonio García
- Rheumatology Department, Hospital Virgen de las Nieves, Granada, Spain
| | - Enrique Raya
- Systemic Autoimmune Diseases Unit, Hospital Campus de la Salud, Granada, Spain
| | | | | | - Alejandro Balsa
- Rheumatology Department, Instituto de Investigación Hospital Universitario La Paz (IDIPAZ), Madrid, Spain
| | - Isidoro González-Álvaro
- Rheumatology Department, Instituto de Investigación del Hospital de La Princesa (IIS-IP), Madrid, Spain
| | - Javier Narvaez
- Rheumatology Service, Hospital Universitario de Bellvitge, Barcelona, Spain
| | | | - José Mario Sabio
- Systemic Autoimmune Diseases Unit, Department of Internal Medicine, Hospital Virgen de las Nieves, Granada, Spain
| | | | | | - Carles Tolosa
- Department of Internal Medicine, Hospital Parc Taulí, Sabadell, Spain
| | - Patricia Carreira
- Rheumatology Service, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Lambertus Kiemeney
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud university medical center, Nijmegen, The Netherlands
| | - Marieke J H Coenen
- Department of Human Genetics, Radboud Institute for Health Sciences, Radboud university medical center, Nijmegen, The Netherlands
| | - Torsten Witte
- Department for Clinical Immunology and Rheumatology, Hannover Medical School, Hannover, Germany
| | - Matthias Schneider
- Policlinic and Hiller Research Unit for Rheumatology, UKD, Heinrich-Heine-University Dusseldorf, Dusseldorf, Germany
| | - Miguel Ángel González-Gay
- Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases IDIVAL, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Javier Martín
- Institute of Parasitology and Biomedicine López-Neyra, CSIC, Granada, Spain.
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12
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Peris P, Filella X, Monegal A, Guañabens N, Foj L, Bonet M, Boquet D, Casado E, Cerdá D, Erra A, Gómez-Vaquero C, Martínez S, Montalá N, Pittarch C, Kanterewicz E, Sala M, Suris X, Carrasco JL. Concordance between direct and indirect measurements of free 25-OH vitamin D. Clin Chim Acta 2017; 475:169-171. [PMID: 29056531 DOI: 10.1016/j.cca.2017.10.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 10/17/2017] [Accepted: 10/18/2017] [Indexed: 10/18/2022]
Abstract
At present, data comparing the quantification methods for measurement of free vitamin D (direct assay [direct 25-OHDF] and estimated by calculation [calculated 25-OHDF]), are scarce. The aim of this study was to analyse the concordance between these two methods of 25-OHDF analysis (direct vs. calculated). METHODS Serum values of total 25-OHD (25-OHDT), vitamin D binding protein (DBP) (by R&D Systems ELISA), calculated 25-OHDF (by DBP, albumin and 25-OHDT) and direct 25-OHDF (by DIAsource ELISA) were analysed in 173 healthy women (aged 35-45years). Assessment of concordance was evaluated by the Bland-Altman plot and the total deviation index (TDI). RESULTS The mean values of calculated and direct 25-OHDF in these subjects were 5.27±2.5 and 3.83±1.01pg/mL, respectively. We found significantly lower values of 25-OHDF on comparing subjects with and without vitamin D deficiency, independently of the method used. The total deviation index evaluated by the Bland-Altman plot showed low concordance for both measurements. Only low 25-OHDF levels were concordant. CONCLUSIONS This study shows that the concordance between these two methods of 25-OHDF analysis is low and has a concentration dependent bias. Further studies are necessary to clarify the reference values and the indications for 25-OHDF measurement.
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Affiliation(s)
- Pilar Peris
- Hospital Clínic de Barcelona, IDIBAPS, CIBERehd, Spain.
| | | | - Ana Monegal
- Hospital Clínic de Barcelona, IDIBAPS, CIBERehd, Spain.
| | | | - Laura Foj
- Servicio de Bioquímica Clínica, Hospital Clinic, Spain.
| | | | | | | | | | - Alba Erra
- Hospital Universitari de Bellvitge, Spain.
| | | | | | | | | | | | | | | | - Josep L Carrasco
- Departament de Fonaments Clínics, Universitat de Barcelona, Spain.
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13
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Peris P, Filella X, Monegal A, Guañabens N, Foj L, Bonet M, Boquet D, Casado E, Cerdá D, Erra A, Gómez-Vaquero C, Martínez S, Montalá N, Pittarch C, Kanterewicz E, Sala M, Suris X, Carrasco JL. Comparison of total, free and bioavailable 25-OH vitamin D determinations to evaluate its biological activity in healthy adults: the LabOscat study. Osteoporos Int 2017; 28:2457-2464. [PMID: 28466136 DOI: 10.1007/s00198-017-4062-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 04/17/2017] [Indexed: 01/07/2023]
Abstract
UNLABELLED Determination of different forms of 25-OHD (total, free and bioavailable) in healthy young women does not offer additional advantages over standard 25-OHDT for evaluating vitamin D deficiency. In these subjects 25-OHDT values <15 ng/ml would be more appropriate for defining this deficiency. INTRODUCTION Determination of 25-OH vitamin D serum levels (25-OHD) constitutes the method of choice for evaluating vitamin D deficiency. However, vitamin D-binding protein (DBP) may modulate its bioavailability thereby affecting correct evaluation of 25-OHD status. We analysed the impact of the determination of 25-OHD (total, free and bioavailable) on the evaluation its biologic activity (estimated by serum PTH determination) in healthy young women. METHODS 173 premenopausal women (aged 35-45 yrs.) were included. We analysed serum values of total 25-OHD (25-OHDT), DBP, albumin, PTH and bone formation (PINP,OC) and resorption (NTx,CTx) markers. Free(25-OHDF) and bioavailable (25-OHDB) serum 25-OHD levels were estimated by DBP and albumin determinations and also directly by ELISA (25-OHDF-2). We analysed threshold PTH values for the different forms of 25-OHD and the correlations and differences according to 25-OHDT levels <20 ng/ml. RESULTS 62% of subjects had 25-OHD values <20 ng/ml and also had significantly lower 25-OHDF and 25-OHDB values, with no significant differences in bone markers and PTH values. The PTH threshold value was similar for all forms of 25-OHD (∼70 pg/ml). Women with PTH values >70 had lower 25-OHDT (15.4 ± 1.4 vs. 18.3 ± 2.7, p < 0.05) and 25OHDB values (1.7 ± 0.2 vs. 2.2 ± 0.09, p < 0.05). The different forms of 25OHD were significantly intercorrelated, with marginal correlations between PTH and 25-OHDT (r = -0.136, p = 0.082). CONCLUSIONS Determination of different forms of 25-OHD in healthy young women does not offer additional advantages over standard 25-OHDT for evaluating vitamin D deficiency. In these subjects 25-OHDT values <15 ng/ml would be more appropriate for defining this deficiency.
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Affiliation(s)
- P Peris
- Hospital Clínic de Barcelona, IDIBAPS. CIBERehd, Barcelona, Spain.
| | - X Filella
- Servicio de Bioquímica Clínica, Hospital Clinic, Barcelona, Spain
| | - A Monegal
- Hospital Clínic de Barcelona, IDIBAPS. CIBERehd, Barcelona, Spain
| | - N Guañabens
- Hospital Clínic de Barcelona, IDIBAPS. CIBERehd, Barcelona, Spain
| | - L Foj
- Servicio de Bioquímica Clínica, Hospital Clinic, Barcelona, Spain
| | - M Bonet
- Hospital de l'Alt Penedés, Barcelona, Spain
| | - D Boquet
- Hospital Arnau de Vilanova, Lleida, Spain
| | - E Casado
- Instituto Universitario Parc Taulí, Barcelona, Spain
| | - D Cerdá
- Hospital Moisés Broggi, Barcelona, Spain
| | - A Erra
- Hospital Universitari de Bellvitge, Barcelona, Spain.
| | | | - S Martínez
- Hospital Mútua de Terrassa, Madrid, Spain
| | - N Montalá
- Hospital Sta María, Barcelona, Spain
| | | | | | - M Sala
- Hospital de Figueres, Barcelona, Spain
| | - X Suris
- Hospital de Ganollers, Catalonia, Spain
| | - J L Carrasco
- Departament de Fonaments Clínics, Universitat de Barcelona, Barcelona, Spain
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14
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Gómez-Vaquero C, Bianchi M, Santo P, Roig-Vilaseca D, Narváez J, Nolla JM. Erratum to "The activity of a Spanish bone densitometry unit revisited under the point of view of FRAX" <[Reumatol Clin 8 (2012) 179-183]>. Reumatol Clin 2017; 13:248. [PMID: 28668196 DOI: 10.1016/j.reuma.2017.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Accepted: 06/01/2017] [Indexed: 06/07/2023]
Affiliation(s)
- Carmen Gómez-Vaquero
- Rheumatology Service, IDIBELL-Hospital Universitari de Bellvitge, L'Hospitalet, Barcelona, España.
| | - María Bianchi
- Rheumatology Service, IDIBELL-Hospital Universitari de Bellvitge, L'Hospitalet, Barcelona, España
| | - Pilar Santo
- Rheumatology Service, IDIBELL-Hospital Universitari de Bellvitge, L'Hospitalet, Barcelona, España
| | | | - Javier Narváez
- Rheumatology Service, IDIBELL-Hospital Universitari de Bellvitge, L'Hospitalet, Barcelona, España
| | - Joan M Nolla
- Rheumatology Service, IDIBELL-Hospital Universitari de Bellvitge, L'Hospitalet, Barcelona, España
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López-Mejías R, Corrales A, Vicente E, Robustillo-Villarino M, González-Juanatey C, Llorca J, Genre F, Remuzgo-Martínez S, Dierssen-Sotos T, Miranda-Filloy JA, Huaranga MAR, Pina T, Blanco R, Alegre-Sancho JJ, Raya E, Mijares V, Ubilla B, Ferraz-Amaro I, Gómez-Vaquero C, Balsa A, López-Longo FJ, Carreira P, González-Álvaro I, Ocejo-Vinyals JG, Rodríguez-Rodríguez L, Fernández-Gutiérrez B, Castañeda S, Martín J, González-Gay MA. Influence of coronary artery disease and subclinical atherosclerosis related polymorphisms on the risk of atherosclerosis in rheumatoid arthritis. Sci Rep 2017; 7:40303. [PMID: 28059143 PMCID: PMC5216400 DOI: 10.1038/srep40303] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Accepted: 12/05/2016] [Indexed: 11/09/2022] Open
Abstract
A genetic component influences the development of atherosclerosis in the general population and also in rheumatoid arthritis (RA). However, genetic polymorphisms associated with atherosclerosis in the general population are not always involved in the development of cardiovascular disease (CVD) in RA. Accordingly, a study in North-American RA patients did not show the association reported in the general population of coronary artery disease with a series of relevant polymorphisms (TCF21, LPA, HHIPL1, RASD1-PEMT, MRPS6, CYP17A1-CNNM2-NT5C2, SMG6-SRR, PHACTR1, WDR12 and COL4A1-COL4A2). In the present study, we assessed the potential association of these polymorphisms with CVD in Southern European RA patients. We also assessed if polymorphisms implicated in the increased risk of subclinical atherosclerosis in non-rheumatic Caucasians (ZHX2, PINX1, SLC17A4, LRIG1 and LDLR) may influence the risk for CVD in RA. 2,609 Spanish patients were genotyped by TaqMan assays. Subclinical atherosclerosis was determined in 1,258 of them by carotid ultrasonography (assessment of carotid intima media thickness and presence/absence of carotid plaques). No statistically significant differences were found when each polymorphism was assessed according to the presence/absence of cardiovascular events and subclinical atherosclerosis, after adjustment for potential confounder factors. Our results do not show an association between these 15 polymorphisms and atherosclerosis in RA.
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Affiliation(s)
- Raquel López-Mejías
- Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Department, IDIVAL, Santander, Spain
| | - Alfonso Corrales
- Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Department, IDIVAL, Santander, Spain
| | - Esther Vicente
- Rheumatology Department, Hospital Universitario la Princesa, IIS-IP, Madrid, Spain
| | | | | | - Javier Llorca
- Department of Epidemiology and Computational Biology, School of Medicine, University of Cantabria, and CIBER Epidemiología y Salud Pública (CIBERESP), IDIVAL, Santander, Spain
| | - Fernanda Genre
- Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Department, IDIVAL, Santander, Spain
| | - Sara Remuzgo-Martínez
- Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Department, IDIVAL, Santander, Spain
| | - Trinidad Dierssen-Sotos
- Department of Epidemiology and Computational Biology, School of Medicine, University of Cantabria, and CIBER Epidemiología y Salud Pública (CIBERESP), IDIVAL, Santander, Spain
| | | | | | - Trinitario Pina
- Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Department, IDIVAL, Santander, Spain
| | - Ricardo Blanco
- Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Department, IDIVAL, Santander, Spain
| | | | - Enrique Raya
- Rheumatology Department, Hospital Clínico San Cecilio, Granada, Spain
| | - Verónica Mijares
- Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Department, IDIVAL, Santander, Spain
| | - Begoña Ubilla
- Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Department, IDIVAL, Santander, Spain
| | - Iván Ferraz-Amaro
- Rheumatology Division, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain
| | | | - Alejandro Balsa
- Department of Rheumatology, Hospital Universitario La Paz, Madrid, Spain
| | | | - Patricia Carreira
- Department of Rheumatology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | | | | | | | | | - Santos Castañeda
- Rheumatology Department, Hospital Universitario la Princesa, IIS-IP, Madrid, Spain
| | - Javier Martín
- Instituto de Parasitología y Biomedicina 'López-Neyra', CSIC, PTS Granada, Granada, Spain
| | - Miguel A González-Gay
- Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Department, IDIVAL, Santander, Spain.,School of Medicine, University of Cantabria, Santander, Spain.,Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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16
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Carmona FD, Vaglio A, Mackie SL, Hernández-Rodríguez J, Monach PA, Castañeda S, Solans R, Morado IC, Narváez J, Ramentol-Sintas M, Pease CT, Dasgupta B, Watts R, Khalidi N, Langford CA, Ytterberg S, Boiardi L, Beretta L, Govoni M, Emmi G, Bonatti F, Cimmino MA, Witte T, Neumann T, Holle J, Schönau V, Sailler L, Papo T, Haroche J, Mahr A, Mouthon L, Molberg Ø, Diamantopoulos AP, Voskuyl A, Brouwer E, Daikeler T, Berger CT, Molloy ES, O’Neill L, Blockmans D, Lie BA, Mclaren P, Vyse TJ, Wijmenga C, Allanore Y, Koeleman BP, Barrett JH, Cid MC, Salvarani C, Merkel PA, Morgan AW, González-Gay MA, Martín J, Callejas JL, Caminal-Montero L, Corbera-Bellalta M, de Miguel E, López JBD, García-Villanueva MJ, Gómez-Vaquero C, Guijarro-Rojas M, Hidalgo-Conde A, Marí-Alfonso B, Berriochoa AM, Zapico AM, Martínez-Taboada VM, Miranda-Filloy JA, Monfort J, Ortego-Centeno N, Pérez-Conesa M, Prieto-González S, Raya E, Fernández RR, Sánchez-Martín J, Sopeña B, Tío L, Unzurrunzaga A, Gough A, Isaacs JD, Green M, McHugh N, Hordon L, Kamath S, Nisar M, Patel Y, Yee CS, Stevens R, Nandi P, Nandagudi A, Jarrett S, Li C, Levy S, Mollan S, Salih A, Wordsworth O, Sanders E, Roads E, Gill A, Carr L, Routledge C, Culfear K, Nugaliyadde A, James L, Spimpolo J, Kempa A, Mackenzie F, Fong R, Peters G, Rowbotham B, Masqood Z, Hollywood J, Gondo P, Wood R, Martin S, Rashid LH, Robinson JI, Morgan M, Sorensen L, Taylor J, Carette S, Chung S, Cuthbertson D, Forbess LJ, Gewurz-Singer O, Hoffman GS, Koening CL, Maksimowicz-McKinnon KM, McAlear CA, Moreland LW, Pagnoux C, Seo P, Specks U, Spiera RF, Sreih A, Warrington KJ, Weisman M. A Genome-wide Association Study Identifies Risk Alleles in Plasminogen and P4HA2 Associated with Giant Cell Arteritis. Am J Hum Genet 2017; 100:64-74. [PMID: 28041642 DOI: 10.1016/j.ajhg.2016.11.013] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Accepted: 11/18/2016] [Indexed: 02/07/2023] Open
Abstract
Giant cell arteritis (GCA) is the most common form of vasculitis in individuals older than 50 years in Western countries. To shed light onto the genetic background influencing susceptibility for GCA, we performed a genome-wide association screening in a well-powered study cohort. After imputation, 1,844,133 genetic variants were analyzed in 2,134 case subjects and 9,125 unaffected individuals from ten independent populations of European ancestry. Our data confirmed HLA class II as the strongest associated region (independent signals: rs9268905, p = 1.94 × 10-54, per-allele OR = 1.79; and rs9275592, p = 1.14 × 10-40, OR = 2.08). Additionally, PLG and P4HA2 were identified as GCA risk genes at the genome-wide level of significance (rs4252134, p = 1.23 × 10-10, OR = 1.28; and rs128738, p = 4.60 × 10-9, OR = 1.32, respectively). Interestingly, we observed that the association peaks overlapped with different regulatory elements related to cell types and tissues involved in the pathophysiology of GCA. PLG and P4HA2 are involved in vascular remodelling and angiogenesis, suggesting a high relevance of these processes for the pathogenic mechanisms underlying this type of vasculitis.
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17
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López-Mejías R, Genre F, Remuzgo-Martínez S, González-Juanatey C, Robustillo-Villarino M, Llorca J, Corrales A, Vicente E, Miranda-Filloy JA, Magro C, Tejera-Segura B, Ramírez Huaranga MA, Pina T, Blanco R, Alegre-Sancho JJ, Raya E, Mijares V, Ubilla B, Mínguez Sánchez MD, Gómez-Vaquero C, Balsa A, Pascual-Salcedo D, López-Longo FJ, Carreira P, González-Álvaro I, Rodríguez-Rodríguez L, Fernández-Gutiérrez B, Ferraz-Amaro I, Castañeda S, Martín J, González-Gay MA. Influence of elevated-CRP level-related polymorphisms in non-rheumatic Caucasians on the risk of subclinical atherosclerosis and cardiovascular disease in rheumatoid arthritis. Sci Rep 2016; 6:31979. [PMID: 27534721 PMCID: PMC4989194 DOI: 10.1038/srep31979] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Accepted: 08/01/2016] [Indexed: 12/30/2022] Open
Abstract
Association between elevated C-reactive protein (CRP) serum levels and subclinical atherosclerosis and cardiovascular (CV) events was described in rheumatoid arthritis (RA). CRP, HNF1A, LEPR, GCKR, NLRP3, IL1F10, PPP1R3B, ASCL1, HNF4A and SALL1 exert an influence on elevated CRP serum levels in non-rheumatic Caucasians. Consequently, we evaluated the potential role of these genes in the development of CV events and subclinical atherosclerosis in RA patients. Three tag CRP polymorphisms and HNF1A, LEPR, GCKR, NLRP3, IL1F10, PPP1R3B, ASCL1, HNF4A and SALL1 were genotyped in 2,313 Spanish patients by TaqMan. Subclinical atherosclerosis was determined in 1,298 of them by carotid ultrasonography (by assessment of carotid intima-media thickness-cIMT-and presence/absence of carotid plaques). CRP serum levels at diagnosis and at the time of carotid ultrasonography were measured in 1,662 and 1,193 patients, respectively, by immunoturbidimetry. Interestingly, a relationship between CRP and CRP serum levels at diagnosis and at the time of the carotid ultrasonography was disclosed. However, no statistically significant differences were found when CRP, HNF1A, LEPR, GCKR, NLRP3, IL1F10, PPP1R3B, ASCL1, HNF4A and SALL1 were evaluated according to the presence/absence of CV events, carotid plaques and cIMT after adjustment. Our results do not confirm an association between these genes and CV disease in RA.
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Affiliation(s)
- Raquel López-Mejías
- Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Division of Rheumatology, IDIVAL, Santander, Spain
| | - Fernanda Genre
- Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Division of Rheumatology, IDIVAL, Santander, Spain
| | - Sara Remuzgo-Martínez
- Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Division of Rheumatology, IDIVAL, Santander, Spain
| | | | | | - Javier Llorca
- Department of Epidemiology and Computational Biology, School of Medicine, University of Cantabria, and CIBER Epidemiología y Salud Pública (CIBERESP), IDIVAL, Santander, Spain
| | - Alfonso Corrales
- Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Division of Rheumatology, IDIVAL, Santander, Spain
| | - Esther Vicente
- Division of Rheumatology, Hospital Universitario la Princesa, IIS-IPrincesa, Madrid, Spain
| | | | - César Magro
- Division of Rheumatology, Hospital Clínico San Cecilio, Granada, Spain
| | - Beatriz Tejera-Segura
- Rheumatology Division, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain
| | | | - Trinitario Pina
- Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Division of Rheumatology, IDIVAL, Santander, Spain
| | - Ricardo Blanco
- Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Division of Rheumatology, IDIVAL, Santander, Spain
| | | | - Enrique Raya
- Division of Rheumatology, Hospital Clínico San Cecilio, Granada, Spain
| | - Verónica Mijares
- Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Division of Rheumatology, IDIVAL, Santander, Spain
| | - Begoña Ubilla
- Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Division of Rheumatology, IDIVAL, Santander, Spain
| | | | | | - Alejandro Balsa
- Department of Rheumatology, Hospital Universitario La Paz, Madrid, Spain
| | | | | | - Patricia Carreira
- Department of Rheumatology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | | | | | | | - Iván Ferraz-Amaro
- Rheumatology Division, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain
| | - Santos Castañeda
- Division of Rheumatology, Hospital Universitario la Princesa, IIS-IPrincesa, Madrid, Spain
| | - Javier Martín
- Institute of Parasitology and Biomedicine López-Neyra, IPBLN-CSIC, Granada, Spain
| | - Miguel A González-Gay
- Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Division of Rheumatology, IDIVAL, Santander, Spain.,School of Medicine, University of Cantabria, Santander, Spain.,Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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18
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Guañabens N, Filella X, Monegal A, Gómez-Vaquero C, Bonet M, Buquet D, Casado E, Cerdá D, Erra A, Martinez S, Montalá N, Pitarch C, Kanterewicz E, Sala M, Surís X, Torres F, on behalf of the LabOscat Study Gro. Reference intervals for bone turnover markers in Spanish premenopausal women. ACTA ACUST UNITED AC 2016; 54:293-303. [DOI: 10.1515/cclm-2015-0162] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Accepted: 05/18/2015] [Indexed: 11/15/2022]
Abstract
AbstractThe aims of this study were to establish robust reference intervals and to investigate the factors influencing bone turnover markers (BTMs) in healthy premenopausal Spanish women.A total of 184 women (35–45 years) from 13 centers in Catalonia were analyzed. Blood and second void urine samples were collected between 8 a.m. and 10 a.m. after an overnight fast. Serum procollagen type I amino-terminal propeptide (PINP) and serum cross-linked C-terminal telopeptide of type I collagen (CTX-I) were measured by two automated assays (Roche and IDS), bone alkaline phosphatase (bone ALP) by ELISA, osteocalcin (OC) by IRMA and urinary NTX-I by ELISA. PTH and 25-hydroxyvitamin D (25OHD) levels were measured. All participants completed a questionnaire on lifestyle factors.Reference intervals were: PINP: 22.7–63.1 and 21.8–65.5 μg/L, bone ALP: 6.0–13.6 μg/L, OC: 8.0–23.0 μg/L, CTX-I: 137–484 and 109–544 ng/L and NTX-I: 19.6–68.9 nM/mM. Oral contraceptive pills (OCPs) influenced PINP (p=0.007), and low body mass index (BMI) was associated with higher BTMs except for bone ALP. Women under 40 had higher median values of most BTMs. CTX-I was influenced by calcium intake (p=0.010) and PTH (p=0.007). 25OHD levels did not influence BTMs. Concordance between the two automated assays for PINP and particularly CTX-I was poor.Robust reference intervals for BTMs in a Southern European country are provided. The effects of OCPs and BMI on their levels are significant, whilst serum 25OHD levels did not influence BTMs. Age, calcium intake, BMI and PTH influenced CTX-I. The two automated assays for measuring PINP and CTX-I are not interchangeable.
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Cruzado JM, Moreno P, Torregrosa JV, Taco O, Mast R, Gómez-Vaquero C, Polo C, Revuelta I, Francos J, Torras J, García-Barrasa A, Bestard O, Grinyó JM. A Randomized Study Comparing Parathyroidectomy with Cinacalcet for Treating Hypercalcemia in Kidney Allograft Recipients with Hyperparathyroidism. J Am Soc Nephrol 2015; 27:2487-94. [PMID: 26647424 DOI: 10.1681/asn.2015060622] [Citation(s) in RCA: 98] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2015] [Accepted: 11/01/2015] [Indexed: 12/16/2022] Open
Abstract
Tertiary hyperparathyroidism is a common cause of hypercalcemia after kidney transplant. We designed this 12-month, prospective, multicenter, open-label, randomized study to evaluate whether subtotal parathyroidectomy is more effective than cinacalcet for controlling hypercalcemia caused by persistent hyperparathyroidism after kidney transplant. Kidney allograft recipients with hypercalcemia and elevated intact parathyroid hormone (iPTH) concentration were eligible if they had received a transplant ≥6 months before the study and had an eGFR>30 ml/min per 1.73 m(2) The primary end point was the proportion of patients with normocalcemia at 12 months. Secondary end points were serum iPTH concentration, serum phosphate concentration, bone mineral density, vascular calcification, renal function, patient and graft survival, and economic cost. In total, 30 patients were randomized to receive cinacalcet (n=15) or subtotal parathyroidectomy (n=15). At 12 months, ten of 15 patients in the cinacalcet group and 15 of 15 patients in the parathyroidectomy group (P=0.04) achieved normocalcemia. Normalization of serum phosphate concentration occurred in almost all patients. Subtotal parathyroidectomy induced greater reduction of iPTH and associated with a significant increase in femoral neck bone mineral density; vascular calcification remained unchanged in both groups. The most frequent adverse events were digestive intolerance in the cinacalcet group and hypocalcemia in the parathyroidectomy group. Surgery would be more cost effective than cinacalcet if cinacalcet duration reached 14 months. All patients were alive with a functioning graft at the end of follow-up. In conclusion, subtotal parathyroidectomy was superior to cinacalcet in controlling hypercalcemia in these patients with kidney transplants and persistent hyperparathyroidism.
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Affiliation(s)
- Josep M Cruzado
- Nephrology Department, Hospital Universitari de Bellvitge, University of Barcelona, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain;
| | | | - José V Torregrosa
- Nephrology and Renal Transplant Service, Hospital Clínic, Barcelona, Spain
| | - Omar Taco
- Nephrology Department, Hospital Universitari de Bellvitge, University of Barcelona, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
| | | | - Carmen Gómez-Vaquero
- Rheumatology, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain; and
| | - Carolina Polo
- Nephrology Department, Hospital Universitari de Bellvitge, University of Barcelona, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
| | - Ignacio Revuelta
- Nephrology and Renal Transplant Service, Hospital Clínic, Barcelona, Spain
| | | | - Joan Torras
- Nephrology Department, Hospital Universitari de Bellvitge, University of Barcelona, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
| | | | - Oriol Bestard
- Nephrology Department, Hospital Universitari de Bellvitge, University of Barcelona, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
| | - Josep M Grinyó
- Nephrology Department, Hospital Universitari de Bellvitge, University of Barcelona, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
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20
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Narváez J, Estrada P, López-Vives L, Ricse M, Zacarías A, Heredia S, Gómez-Vaquero C, Nolla JM. Prevalence of ischemic complications in patients with giant cell arteritis presenting with apparently isolated polymyalgia rheumatica. Semin Arthritis Rheum 2015; 45:328-33. [DOI: 10.1016/j.semarthrit.2015.06.009] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Revised: 04/18/2015] [Accepted: 06/12/2015] [Indexed: 10/23/2022]
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21
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Cruzado JM, Taco O, Vicens T, Mast R, Polo C, Bestard O, Melilli E, Francos J, Torras J, Gómez-Vaquero C, Arantxa GB, Grinyó JM, Moreno P. SaO029A RANDOMIZED STUDY COMPARING PARATHYROIDECTOMY VERSUS CINACALCET TO TREAT HYPERCALCEMIA IN KIDNEY ALLOGRAFT RECIPIENTS WITH PERSISTENT HYPERPARATHYROIDISM. Nephrol Dial Transplant 2015. [DOI: 10.1093/ndt/gfv151.01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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22
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Narváez J, Narváez JA, Serrallonga M, de Lama E, Hernández-Gañan J, Gómez-Vaquero C, Nolla JM. Subaxial cervical spine involvement in symptomatic rheumatoid arthritis patients: Comparison with cervical spondylosis. Semin Arthritis Rheum 2015; 45:9-17. [PMID: 25841801 DOI: 10.1016/j.semarthrit.2015.02.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Revised: 02/27/2015] [Accepted: 02/27/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To investigate the frequency, location, characteristics, and clinical significance of subaxial involvement (below C1-C2) in a series of patients with rheumatoid arthritis (RA) and symptomatic involvement of the cervical spine. METHODS A total of 41 patients with RA were examined via cervical spine magnetic resonance imaging (MRI). A comparative analysis of the incidence of the different types of subaxial lesions was performed between these patients and 41 age- and sex-matched patients with symptomatic cervical spondylosis. RESULTS Stenosis of the spinal canal was found at the subaxial level in 85% of RA patients, and at the atlantoaxial level in 44%. Comparative analysis between these patients and the cervical spondylosis patients revealed significant differences in the types and frequencies of subaxial lesions. For both conditions, signs of discopathy and end-plate osteophytosis were the most common abnormalities observed on magnetic resonance imaging (MRI). However, in the RA patients these abnormalities coincided with subchondral bone and ligamentous acute inflammatory changes and with secondary destruction (vertebral instability) or repair (vertebral ankyloses). Only evidence of subaxial myelopathy was significantly associated with an increased risk of neurological dysfunction among the RA patients [Ranawat class II or III; P = 0.01; odds ratio (OR) = 11.43], although subaxial cord compression tended toward a significant association with the risk of neurological dysfunction (P = 0.06; OR = 3.95). CONCLUSION Subaxial stenosis seems to be the consequence of both the inflammatory process and mechanical-degenerative changes. Despite its frequency, it was not usually related to the occurrence of myelopathy symptoms, not even in cases with MRI evidence of spinal cord compression.
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Affiliation(s)
- Javier Narváez
- Department of Rheumatology (Planta 10-2), Hospital Universitario de Bellvitge-IDIBELL, Feixa Llarga s/n, Hospitalet de Llobregat, Barcelona 08907, Spain.
| | - José Antonio Narváez
- Department of Radiology, Hospital Universitario de Bellvitge-IDIBELL, Barcelona, Spain
| | - Marta Serrallonga
- Institut de Diagnostic per la Imatge (IDI), Centre Bellvitge, Barcelona, Spain
| | - Eugenia de Lama
- Department of Radiology, Hospital Universitario de Bellvitge-IDIBELL, Barcelona, Spain
| | | | - Carmen Gómez-Vaquero
- Department of Rheumatology (Planta 10-2), Hospital Universitario de Bellvitge-IDIBELL, Feixa Llarga s/n, Hospitalet de Llobregat, Barcelona 08907, Spain
| | - Joan M Nolla
- Department of Rheumatology (Planta 10-2), Hospital Universitario de Bellvitge-IDIBELL, Feixa Llarga s/n, Hospitalet de Llobregat, Barcelona 08907, Spain
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Carmona F, Mackie S, Martín JE, Taylor J, Vaglio A, Eyre S, Bossini-Castillo L, Castañeda S, Cid M, Hernández-Rodríguez J, Prieto-González S, Solans R, Ramentol-Sintas M, González-Escribano M, Ortiz-Fernández L, Morado I, Narváez J, Miranda-Filloy J, Beretta L, Lunardi C, Cimmino MA, Gianfreda D, Santilli D, Ramirez GA, Soriano A, Muratore F, Pazzola G, Addimanda O, Wijmenga C, Witte T, Schirmer JH, Moosig F, Schönau V, Franke A, Palm Ø, Molberg Ø, Diamantopoulos AP, Carette S, Cuthbertson D, Forbess LJ, Hoffman GS, Khalidi NA, Koening CL, Langford CA, McAlear CA, Moreland L, Monach PA, Pagnoux C, Seo P, Spiera R, Sreih AG, Warrington KJ, Ytterberg SR, Gregersen PK, Pease CT, Gough A, Green M, Hordon L, Jarrett S, Watts R, Levy S, Patel Y, Kamath S, Dasgupta B, Worthington J, Koeleman BP, de Bakker PI, Barrett JH, Salvarani C, Merkel PA, González-Gay MA, Morgan AW, Martín J, Martínez-Berriochoa A, Unzurrunzaga A, Hidalgo-Conde A, Madroñero-Vuelta A, Fernández-Nebro A, Ordóñez-Cañizares M, Escalante B, Marí-Alfonso B, Sopeña B, Magro C, Raya E, Grau E, Román J, de Miguel E, López-Longo F, Martínez L, Gómez-Vaquero C, Fernández-Gutiérrez B, Rodríguez-Rodríguez L, Díaz-López J, Caminal-Montero L, Martínez-Zapico A, Monfort J, Tío L, Sánchez-Martín J, Alegre-Sancho J, Sáez-Comet L, Pérez-Conesa M, Corbera-Bellalta M, García-Villanueva M, Fernández-Contreras M, Sanchez-Pernaute O, Blanco R, Ortego-Centeno N, Ríos-Fernández R, Callejas J, Fanlo-Mateo P, Martínez-Taboada V. A large-scale genetic analysis reveals a strong contribution of the HLA class II region to giant cell arteritis susceptibility. Am J Hum Genet 2015; 96:565-80. [PMID: 25817017 DOI: 10.1016/j.ajhg.2015.02.009] [Citation(s) in RCA: 114] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Accepted: 02/12/2015] [Indexed: 02/08/2023] Open
Abstract
We conducted a large-scale genetic analysis on giant cell arteritis (GCA), a polygenic immune-mediated vasculitis. A case-control cohort, comprising 1,651 case subjects with GCA and 15,306 unrelated control subjects from six different countries of European ancestry, was genotyped by the Immunochip array. We also imputed HLA data with a previously validated imputation method to perform a more comprehensive analysis of this genomic region. The strongest association signals were observed in the HLA region, with rs477515 representing the highest peak (p = 4.05 × 10(-40), OR = 1.73). A multivariate model including class II amino acids of HLA-DRβ1 and HLA-DQα1 and one class I amino acid of HLA-B explained most of the HLA association with GCA, consistent with previously reported associations of classical HLA alleles like HLA-DRB1(∗)04. An omnibus test on polymorphic amino acid positions highlighted DRβ1 13 (p = 4.08 × 10(-43)) and HLA-DQα1 47 (p = 4.02 × 10(-46)), 56, and 76 (both p = 1.84 × 10(-45)) as relevant positions for disease susceptibility. Outside the HLA region, the most significant loci included PTPN22 (rs2476601, p = 1.73 × 10(-6), OR = 1.38), LRRC32 (rs10160518, p = 4.39 × 10(-6), OR = 1.20), and REL (rs115674477, p = 1.10 × 10(-5), OR = 1.63). Our study provides evidence of a strong contribution of HLA class I and II molecules to susceptibility to GCA. In the non-HLA region, we confirmed a key role for the functional PTPN22 rs2476601 variant and proposed other putative risk loci for GCA involved in Th1, Th17, and Treg cell function.
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García-Bermúdez M, López-Mejías R, Genre F, Castañeda S, Corrales A, Llorca J, González-Juanatey C, Ubilla B, Miranda-Filloy JA, Pina T, Gómez-Vaquero C, Rodríguez-Rodríguez L, Fernández-Gutiérrez B, Balsa A, Pascual-Salcedo D, López-Longo FJ, Carreira P, Blanco R, Martín J, González-Gay MA. Lack of association between JAK3 gene polymorphisms and cardiovascular disease in Spanish patients with rheumatoid arthritis. Biomed Res Int 2015; 2015:318364. [PMID: 25815310 PMCID: PMC4359874 DOI: 10.1155/2015/318364] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/08/2014] [Revised: 09/03/2014] [Accepted: 09/03/2014] [Indexed: 01/18/2023]
Abstract
Rheumatoid arthritis (RA) is a polygenic disease associated with accelerated atherosclerosis and increased cardiovascular (CV) mortality. JAK/STAT signalling pathway is involved in autoimmune diseases and in the atherosclerotic process. JAK3 is a highly promising target for immunomodulatory drugs and polymorphisms in JAK3 gene have been associated with CV events in incident dialysis patients. Therefore, the aim of this study was to assess the potential role of JAK3 polymorphisms in the development of CV disease in patients with RA. 2136 Spanish RA patients were genotyped for the rs3212780 and rs3212752 JAK3 gene polymorphisms by TaqMan assays. Subclinical atherosclerosis was evaluated in 539 of these patients by carotid ultrasonography (US). No statistically significant differences were found when each polymorphism was assessed according to carotid intima-media thickness values and presence/absence of carotid plaques in RA, after adjusting the results for potential confounders. Moreover, no significant differences were obtained when RA patients were stratified according to the presence/absence of CV events after adjusting for potential confounders. In conclusion, our results do not confirm association between JAK3 polymorphisms and CV disease in RA.
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Affiliation(s)
| | - Raquel López-Mejías
- Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Disease, Rheumatology Division, Hospital Universitario Marqués de Valdecilla, IDIVAL, Avenida de Valdecilla s/n, 39008 Santander, Spain
| | - Fernanda Genre
- Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Disease, Rheumatology Division, Hospital Universitario Marqués de Valdecilla, IDIVAL, Avenida de Valdecilla s/n, 39008 Santander, Spain
| | - Santos Castañeda
- Rheumatology Department, Hospital Universitario La Princesa, IIS-Princesa, 28006 Madrid, Spain
| | - Alfonso Corrales
- Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Disease, Rheumatology Division, Hospital Universitario Marqués de Valdecilla, IDIVAL, Avenida de Valdecilla s/n, 39008 Santander, Spain
| | - Javier Llorca
- Department of Epidemiology and Computational Biology, School of Medicine, University of Cantabria, and CIBER Epidemiology and Public Health (CIBERESP), IDIVAL, 39011 Santander, Spain
| | | | - Begoña Ubilla
- Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Disease, Rheumatology Division, Hospital Universitario Marqués de Valdecilla, IDIVAL, Avenida de Valdecilla s/n, 39008 Santander, Spain
| | | | - Trinitario Pina
- Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Disease, Rheumatology Division, Hospital Universitario Marqués de Valdecilla, IDIVAL, Avenida de Valdecilla s/n, 39008 Santander, Spain
| | - Carmen Gómez-Vaquero
- Department of Rheumatology, Hospital Universitario Bellvitge, 08907 Barcelona, Spain
| | | | | | - Alejandro Balsa
- Department of Rheumatology, Hospital Universitario La Paz, 28046 Madrid, Spain
| | | | - Francisco J. López-Longo
- Department of Rheumatology, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain
| | - Patricia Carreira
- Department of Rheumatology, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain
| | - Ricardo Blanco
- Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Disease, Rheumatology Division, Hospital Universitario Marqués de Valdecilla, IDIVAL, Avenida de Valdecilla s/n, 39008 Santander, Spain
| | - Javier Martín
- Institute of Parasitología and Biomedicina López-Neyra, IPBLN-CSIC, 18016 Granada, Spain
| | - Miguel A. González-Gay
- Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Disease, Rheumatology Division, Hospital Universitario Marqués de Valdecilla, IDIVAL, Avenida de Valdecilla s/n, 39008 Santander, Spain
- Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2000, South Africa
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de la Rica L, García-Gómez A, Comet NR, Rodríguez-Ubreva J, Ciudad L, Vento-Tormo R, Company C, Álvarez-Errico D, García M, Gómez-Vaquero C, Ballestar E. NF-κB-direct activation of microRNAs with repressive effects on monocyte-specific genes is critical for osteoclast differentiation. Genome Biol 2015; 16:2. [PMID: 25601191 PMCID: PMC4290566 DOI: 10.1186/s13059-014-0561-5] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Accepted: 12/04/2014] [Indexed: 12/12/2022] Open
Abstract
Background Monocyte-to-osteoclast conversion is a unique terminal differentiation process that is exacerbated in rheumatoid arthritis and bone metastasis. The mechanisms implicated in upregulating osteoclast-specific genes involve transcription factors, epigenetic regulators and microRNAs (miRNAs). It is less well known how downregulation of osteoclast-inappropriate genes is achieved. Results In this study, analysis of miRNA expression changes in osteoclast differentiation from human primary monocytes revealed the rapid upregulation of two miRNA clusters, miR-212/132 and miR-99b/let-7e/125a. We demonstrate that they negatively target monocyte-specific and immunomodulatory genes like TNFAIP3, IGF1R and IL15. Depletion of these miRNAs inhibits osteoclast differentiation and upregulates their targets. These miRNAs are also upregulated in other inflammatory monocytic differentiation processes. Most importantly, we demonstrate for the first time the direct involvement of Nuclear Factor kappa B (NF-κB) in the regulation of these miRNAs, as well as with their targets, whereby NF-κB p65 binds the promoters of these two miRNA clusters and NF-κB inhibition or depletion results in impaired upregulation of their expression. Conclusions Our results reveal the direct involvement of NF-κB in shutting down certain monocyte-specific genes, including some anti-inflammatory activities, through a miRNA-dependent mechanism for proper osteoclast differentiation. Electronic supplementary material The online version of this article (doi:10.1186/s13059-014-0561-5) contains supplementary material, which is available to authorized users.
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Genre F, López-Mejías R, García-Bermúdez M, Castañeda S, González-Juanatey C, Llorca J, Corrales A, Ubilla B, Miranda-Filloy JA, Pina T, Gómez-Vaquero C, Rodríguez-Rodríguez L, Fernández-Gutiérrez B, Balsa A, Pascual-Salcedo D, López-Longo FJ, Carreira P, Blanco R, González-Álvaro I, Martín J, González-Gay MA. Osteoprotegerin CGA haplotype protection against cerebrovascular complications in anti-CCP negative patients with rheumatoid arthritis. PLoS One 2014; 9:e106823. [PMID: 25184828 PMCID: PMC4153690 DOI: 10.1371/journal.pone.0106823] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2014] [Accepted: 08/01/2014] [Indexed: 12/03/2022] Open
Abstract
Introduction Rheumatoid arthritis is an inflammatory disease with high incidence of cardiovascular disease due to accelerated atherosclerosis. Osteoprotegerin (OPG) has been associated with increased risk of atherosclerotic disease in the general population. Several polymorphisms in the OPG gene with functional effects on cardiovascular disease in non-rheumatic individuals have been described. Therefore, we aimed to analyze the effect of three of these functional OPG polymorphisms on the risk of cardiovascular disease in a large and well-characterized cohort of Spanish patients with rheumatoid arthritis. Methods Three OPG gene variants (rs3134063, rs2073618 and rs3134069) were genotyped by TaqMan assays in 2027 Spanish patients with rheumatoid arthritis. Anti-cyclic citrullinated peptide (anti-CCP) antibody testing was positive in 997 of 1714 tested. Also, 18.3% of the whole series had experienced cardiovascular events, including 5.4% with cerebrovascular accidents. The relationship between OPG variants and cardiovascular events was assessed using Cox regression. Results No association between OPG gene variants and cardiovascular disease was observed in the whole group of rheumatoid arthritis patients or in anti-CCP positive patients. Nevertheless, a protective effect of CGA haplotype on the risk of cardiovascular disease in general, and specifically in the risk of cerebrovascular complications after adjusting for sex, age at disease diagnosis and traditional cardiovascular risk factors was disclosed in anti-CCP negative patients (HR = 0.54; 95%CI: 0.31–0.95; p = 0.032 and HR = 0.17; 95%CI: 0.04–0.78; p = 0.022, respectively). Conclusion Our results indicate a protective effect of the OPG CGA haplotype on cardiovascular risk, mainly due to a protective effect against cerebrovascular events in anti-CCP negative rheumatoid arthritis patients.
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Affiliation(s)
- Fernanda Genre
- Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, IDIVAL, Santander, Spain
| | - Raquel López-Mejías
- Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, IDIVAL, Santander, Spain
| | | | - Santos Castañeda
- Department of Rheumatology, Hospital Universitario la Princesa, IIS-Princesa, Madrid, Spain
| | | | - Javier Llorca
- Department of Epidemiology and Computational Biology, School of Medicine, University of Cantabria, and CIBER Epidemiología y Salud Pública (CIBERESP), IDIVAL, Santander, Spain
| | - Alfonso Corrales
- Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, IDIVAL, Santander, Spain
| | - Begoña Ubilla
- Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, IDIVAL, Santander, Spain
| | | | - Trinitario Pina
- Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, IDIVAL, Santander, Spain
| | | | | | | | - Alejandro Balsa
- Department of Rheumatology, Hospital Universitario La Paz, Madrid, Spain
| | | | | | - Patricia Carreira
- Department of Rheumatology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Ricardo Blanco
- Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, IDIVAL, Santander, Spain
| | | | - Javier Martín
- Instituto de Parasitología y Biomedicina López-Neyra, IPBLN-CSIC, Granada, Spain
| | - Miguel A González-Gay
- Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, IDIVAL, Santander, Spain
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López-Mejías R, Genre F, García-Bermúdez M, Castañeda S, González-Juanatey C, Llorca J, Corrales A, Miranda-Filloy JA, Rueda-Gotor J, Gómez-Vaquero C, Rodríguez-Rodríguez L, Fernández-Gutiérrez B, Balsa A, Pascual-Salcedo D, López-Longo FJ, Carreira P, Blanco R, González-Álvaro I, Martín J, González-Gay MA. The 11q23.3 genomic region-rs964184-is associated with cardiovascular disease in patients with rheumatoid arthritis. ACTA ACUST UNITED AC 2014; 82:344-7. [PMID: 24131021 DOI: 10.1111/tan.12217] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2013] [Revised: 08/28/2013] [Accepted: 09/11/2013] [Indexed: 11/29/2022]
Abstract
Rheumatoid arthritis (RA) is an inflammatory disease associated with high risk of cardiovascular (CV) events. Recently, the rs964184 polymorphism has been associated with coronary artery disease in nonrheumatic Caucasian individuals. 2160 Spanish RA patients were genotyped for the rs964184 polymorphism. Sex, age at diagnosis and traditional CV risk factors (diabetes mellitus, dyslipidemia and smoking habit) were associated with increased risk of CV events. Interestingly, RA patients carrying the rs964184 GG genotype had significantly higher risk of CV events than those with CC genotype [hazard ratio (HR) = 2.91, 95% confidence interval (CI): 1.36-6.26, P = 0.006] after adjusting the results for sex, age at diagnosis and traditional CV risk factors. Our results indicate that rs964184 polymorphism is associated with CV disease in RA.
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Affiliation(s)
- R López-Mejías
- Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, Hospital Universitario Marqués de Valdecilla, IFIMAV, Santander, Spain
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Márquez A, Hernández-Rodríguez J, Cid MC, Solans R, Castañeda S, Fernández-Contreras ME, Ramentol M, Morado IC, Narváez J, Gómez-Vaquero C, Martínez-Taboada VM, Ortego-Centeno N, Sopeña B, Monfort J, García-Villanueva MJ, Caminal-Montero L, de Miguel E, Blanco R, Palm O, Molberg O, Latus J, Braun N, Moosig F, Witte T, Beretta L, Santaniello A, Pazzola G, Boiardi L, Salvarani C, González-Gay MA, Martín J. Influence of theIL17A locusin giant cell arteritis susceptibility. Ann Rheum Dis 2014; 73:1742-5. [DOI: 10.1136/annrheumdis-2014-205261] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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29
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Márquez A, Solans R, Hernández-Rodríguez J, Cid MC, Castañeda S, Ramentol M, Morado IC, Rodriguez-Rodriguez L, Narváez J, Gómez-Vaquero C, Miranda-Filloy JA, Martínez-Taboada VM, Ríos R, Sopeña B, Monfort J, García-Villanueva MJ, Martínez-Zapico A, Marí-Alfonso B, Sánchez-Martín J, Unzurrunzaga A, Raya E, de Miguel E, Hidalgo-Conde A, Blanco R, González-Gay MÁ, Martín J. Analysis of two autoimmunity genes, IRAK1 and MECP2, in giant cell arteritis. Clin Exp Rheumatol 2014; 32:S30-S33. [PMID: 24709033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Accepted: 12/05/2013] [Indexed: 06/03/2023]
Abstract
OBJECTIVES The Xq28 region, containing IRAK and MECP2, represent a common susceptibility locus for a high number of autoimmune diseases. Our aim in the present study was to evaluate the influence of the IRAK1 and MECP2 autoimmunity-associated genetic variants in the giant cell arteritis (GCA) susceptibility and its clinical subphenotypes. METHODS We analysed a total of 627 female biopsy-proven GCA patients and 1,520 female healthy controls of Spanish Caucasian origin. Two polymorphisms, rs1059702 and rs17345, located at IRAK1 and MECP2, respectively, were genotyped using TaqMan® allelic discrimination assays. RESULTS No association with any of the analysed polymorphisms was evident when genotype and allele frequencies were compared between GCA patients and controls (rs1059702: allelic p-value=0.699, OR=0.96, CI 95% 0.80-1.17; rs17435: allelic p-value=0.994, OR=1.00, CI 95% 0.84-1.19). Likewise, the subphenotype analysis yield similar negative results. CONCLUSIONS We have assessed for the first time the possible role of IRAK1 and MECP2 autoimmune disease-associated polymorphisms in GCA. Our data suggest that IRAK1 rs1059702 and MECP2 rs17435 genetic variants do not play a significant role in GCA susceptibility or severity.
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Affiliation(s)
- Ana Márquez
- Instituto de Parasitología y Biomedicina López-Neyra, CSIC, Granada, Spain.
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Bossini-Castillo L, de Kovel C, Kallberg H, van ‘t Slot R, Italiaander A, Coenen M, Tak PP, Posthumus MD, Wijmenga C, Huizinga T, van der Helm-van Mil AHM, Stoeken-Rijsbergen G, Rodriguez-Rodriguez L, Balsa A, González-Álvaro I, González-Gay MÁ, Gómez-Vaquero C, Franke B, Vermeulen S, van der Horst-Bruinsma IE, Dijkmans BAC, Wolbink GJ, Ophoff RA, Maehlen MT, van Riel P, Merriman M, Klareskog L, Lie BA, Merriman T, Crusius JBA, Brouwer E, Martin J, de Vries N, Toes R, Padyukov L, Koeleman BPC. A genome-wide association study of rheumatoid arthritis without antibodies against citrullinated peptides. Ann Rheum Dis 2014; 74:e15. [DOI: 10.1136/annrheumdis-2013-204591] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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López-López J, Castellanos-Cosano L, Estrugo-Devesa A, Gómez-Vaquero C, Velasco-Ortega E, Segura-Egea JJ. Radiolucent periapical lesions and bone mineral density in post-menopausal women. Gerodontology 2013; 32:195-201. [PMID: 24164489 DOI: 10.1111/ger.12076] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/03/2013] [Indexed: 11/30/2022]
Abstract
PURPOSE To investigate the relationship between radiolucent periapical lesions and bone mineral density in post-menopausal women. MATERIAL AND METHODS Seventy-five post-menopausal women were recruited for the study. Bone mineral density was measured using dual-energy X-ray absorptiometry. Three groups were established: healthy bone group, osteopenic group and osteoporotic group. Periapical radiolucencies were diagnosed on the basis of examination of digital panoramic radiographs. Statistical analysis was carried out using anova and chi-squared tests, and logistic regression analysis. RESULTS In both the osteopenic and osteoporotic groups, 25% of women showed at least one periapical radiolucency, whereas this was only 7.4% in the healthy bone group (odds ratio = 4.2; p = 0.061). After multivariate logistic regression analysis adjusting for covariates (age, number of teeth, number of root-filled teeth and number of teeth with coronal restorations), a marginally significant association was evident between bone mineral density and the presence of periapical radiolucencies (odds ratio = 1.9; CI 95% = 1.0-3.8; p = 0.050). CONCLUSIONS After adjusting for covariates, low bone mineral density is marginally associated with a higher frequency of radiolucent periapical lesions.
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Affiliation(s)
- José López-López
- Department of Odontostomatology, School of Dentistry, University of Barcelona, Barcelona, Spain
| | | | - Albert Estrugo-Devesa
- Department of Odontostomatology, School of Dentistry, University of Barcelona, Barcelona, Spain
| | | | | | - Juan José Segura-Egea
- Department of Stomatology, School of Dentistry, University of Sevilla, Sevilla, Spain
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García-Bermúdez M, López-Mejías R, Genre F, Castañeda S, González-Juanatey C, Llorca J, Corrales A, Miranda-Filloy JA, Rueda-Gotor J, Gómez-Vaquero C, Rodríguez-Rodríguez L, Fernández-Gutiérrez B, Pascual-Salcedo D, Balsa A, López-Longo FJ, Carreira P, Blanco R, González-Álvaro I, Martín J, González-Gay MA. SMAD3 rs17228212 gene polymorphism is associated with reduced risk to cerebrovascular accidents and subclinical atherosclerosis in anti-CCP negative Spanish rheumatoid arthritis patients. PLoS One 2013; 8:e77695. [PMID: 24204921 PMCID: PMC3804609 DOI: 10.1371/journal.pone.0077695] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2013] [Accepted: 09/03/2013] [Indexed: 12/14/2022] Open
Abstract
Rheumatoid arthritis (RA) is a complex polygenic inflammatory disease associated with accelerated atherosclerosis and increased risk of cardiovascular (CV) disease. Previous genome-wide association studies have described SMAD3 rs17228212 polymorphism as an important signal associated with CV events. The aim of the present study was to evaluate for the first time the relationship between this gene polymorphism and the susceptibility to CV manifestations and its potential association with the presence of subclinical atherosclerosis assessed by the evaluation of carotid intima-media thickness (cIMT) in patients with RA.
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Affiliation(s)
| | - Raquel López-Mejías
- Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, Hospital Universitario Marqués de Valdecilla, IFIMAV, Santander, Spain
| | - Fernanda Genre
- Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, Hospital Universitario Marqués de Valdecilla, IFIMAV, Santander, Spain
| | - Santos Castañeda
- Department of Rheumatology, Hospital Universitario la Princesa, IIS-Princesa, Madrid, Spain
| | | | - Javier Llorca
- Department of Epidemiology and Computational Biology, School of Medicine, University of Cantabria, and CIBER Epidemiología y Salud Pública (CIBERESP), IFIMAV, Santander, Spain
| | - Alfonso Corrales
- Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, Hospital Universitario Marqués de Valdecilla, IFIMAV, Santander, Spain
| | | | - Javier Rueda-Gotor
- Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, Hospital Universitario Marqués de Valdecilla, IFIMAV, Santander, Spain
| | | | | | | | | | - Alejandro Balsa
- Department of Rheumatology, Hospital Universitario la Paz, Madrid, Spain
| | | | | | - Ricardo Blanco
- Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, Hospital Universitario Marqués de Valdecilla, IFIMAV, Santander, Spain
| | | | - Javier Martín
- Instituto de Parasitología y Biomedicina López-Neyra, IPBLN-CSIC, Granada, Spain
| | - Miguel A. González-Gay
- Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, Hospital Universitario Marqués de Valdecilla, IFIMAV, Santander, Spain
- * E-mail:
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García-Bermúdez M, López-Mejías R, Genre F, Castañeda S, González-Juanatey C, Llorca J, Corrales A, Miranda-Filloy JA, Pina T, Gómez-Vaquero C, Rodríguez-Rodríguez L, Fernández-Gutiérrez B, Pascual-Salcedo D, Balsa A, López-Longo FJ, Carreira P, Blanco R, González-Álvaro I, Martín J, González-Gay MA. Single-nucleotide polymorphisms at the 9p21.3 genomic region not associated with the risk of cardiovascular disease in patients with rheumatoid arthritis. ACTA ACUST UNITED AC 2013; 82:405-9. [DOI: 10.1111/tan.12227] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2013] [Revised: 09/13/2013] [Accepted: 09/22/2013] [Indexed: 02/02/2023]
Affiliation(s)
- M. García-Bermúdez
- Instituto de Parasitología y Biomedicina López-Neyra, IPBLN-CSIC; 18016 Granada Spain
| | - R. López-Mejías
- Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division; Hospital Universitario Marqués de Valdecilla, IFIMAV; 39008 Santander Spain
| | - F. Genre
- Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division; Hospital Universitario Marqués de Valdecilla, IFIMAV; 39008 Santander Spain
| | - S. Castañeda
- Rheumatology Department; Hospital Universitario la Princesa, IIS-Princesa; 28006 Madrid Spain
| | | | - J. Llorca
- Department of Epidemiology and Computational Biology, School of Medicine; University of Cantabria, and CIBER Epidemiología y Salud Pública (CIBERESP), IFIMAV; 39011 Santander Spain
| | - A. Corrales
- Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division; Hospital Universitario Marqués de Valdecilla, IFIMAV; 39008 Santander Spain
| | | | - T. Pina
- Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division; Hospital Universitario Marqués de Valdecilla, IFIMAV; 39008 Santander Spain
| | - C. Gómez-Vaquero
- Department of Rheumatology; Hospital Universitario Bellvitge; 08908 Barcelona Spain
| | | | | | - D. Pascual-Salcedo
- Rheumatology Department; Hospital Universitario La Paz; 28046 Madrid Spain
| | - A. Balsa
- Rheumatology Department; Hospital Universitario La Paz; 28046 Madrid Spain
| | - F. J. López-Longo
- Rheumatology Department; Hospital General Universitario Gregorio Marañón; 28007 Madrid Spain
| | - P. Carreira
- Rheumatology Department; Hospital Universitario 12 de Octubre; 28041 Madrid Spain
| | - R. Blanco
- Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division; Hospital Universitario Marqués de Valdecilla, IFIMAV; 39008 Santander Spain
| | - I. González-Álvaro
- Rheumatology Department; Hospital Universitario la Princesa, IIS-Princesa; 28006 Madrid Spain
| | - J. Martín
- Instituto de Parasitología y Biomedicina López-Neyra, IPBLN-CSIC; 18016 Granada Spain
| | - M. A. González-Gay
- Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division; Hospital Universitario Marqués de Valdecilla, IFIMAV; 39008 Santander Spain
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Gómez-Vaquero C, Corrales A, Zacarías A, Rueda-Gotor J, Blanco R, González-Juanatey C, Llorca J, González-Gay MA. SCORE and REGICOR function charts underestimate the cardiovascular risk in Spanish patients with rheumatoid arthritis. Arthritis Res Ther 2013; 15:R91. [PMID: 23965231 PMCID: PMC3979098 DOI: 10.1186/ar4271] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2013] [Accepted: 08/21/2013] [Indexed: 11/10/2022] Open
Abstract
Introduction Our objective was to determine which one of the two function charts available in Spain to calculate cardiovascular (CV) risk, Systematic COronary Risk Evaluation (SCORE) or Framingham-REgistre GIroní del COR (REGICOR), should be used in patients with rheumatoid arthritis (RA). Methods A series of RA patients seen over a one-year period without history of CV events were assessed. SCORE, REGICOR, modified (m)SCORE and mREGICOR according to the European League Against Rheumatism (EULAR) recommendations were applied. Carotid ultrasonography (US) was performed. Carotid intima-media thickness (cIMT) > 0.90 mm and/or carotid plaques were used as the gold standard test for severe subclinical atherosclerosis and high CV risk (US+). The area under the receiver operating curves (AUC) for the predicted risk for mSCORE and mREGICOR were calculated according to the presence of severe carotid US findings (US+). Results We included 370 patients (80% women; mean age 58.9 ± 13.7 years); 36% had disease duration of 10 years or more; rheumatoid factor (RF) and/or anticyclic citrullinated peptide (anti-CCP) were positive in 68%; and 17% had extra-articular manifestations. The EULAR multiplier factor was used in 122 (33%) of the patients. The mSCORE was 2.16 ± 2.49% and the mREGICOR 4.36 ± 3.46%. Regarding US results, 196 (53%) patients were US+. The AUC mSCORE was 0.798 (CI 95%: 0.752 to 0.844) and AUC mREGICOR 0.741 (95% CI; 0.691 to 0.792). However, mSCORE and mREGICOR failed to identify 88% and 91% of US+ patients. More than 50% of patients with mSCORE ≥1% or mREGICOR >1% were US+. Conclusions Neither of these two function charts was useful in estimating CV risk in Spanish RA patients.
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Teruel M, McKinney C, Balsa A, Pascual-Salcedo D, Rodriguez-Rodriguez L, Ortiz AM, Gómez-Vaquero C, González-Gay MA, Smith M, Witte T, Merriman T, Lie BA, Martin J. Association of CD247 polymorphisms with rheumatoid arthritis: a replication study and a meta-analysis. PLoS One 2013; 8:e68295. [PMID: 23861880 PMCID: PMC3702579 DOI: 10.1371/journal.pone.0068295] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2013] [Accepted: 05/28/2013] [Indexed: 11/18/2022] Open
Abstract
Given the role of CD247 in the response of the T cells, its entailment in autoimmune diseases and in order to better clarify the role of this gene in RA susceptibility, we aimed to analyze CD247 gene variants previously associated with other autoimmune diseases (rs1052237, rs2056626 and rs864537) in a large independent European Caucasian population. However, no evidence of association was found for the analyzed CD247 single-nucleotide polymorphisms (SNPs) with RA and with the presence/absence of anti-cyclic citrullinated polypeptide. We performed a meta-analysis including previously published GWAS data from the rs864537 variant, revealing an overall genome-wide significant association between this CD247 SNP and RA with anti-CCP (OR = 0.90, CI 95% = 0.87-0.93, Poverall = 2.1×10(-10)). Our results show for first time a GWAS-level association between this CD247 polymorphism and RA risk.
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Affiliation(s)
- María Teruel
- Instituto de Parasitología y Biomedicina López-Neyra, Granada, Spain.
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Gómez-Vaquero C, Roig-Vilaseca D, Narváez J, Nolla JM. Respuesta. Med Clin (Barc) 2013; 141:45. [DOI: 10.1016/j.medcli.2013.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2012] [Revised: 12/23/2012] [Accepted: 01/10/2013] [Indexed: 11/26/2022]
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Teruel M, McKinney C, Balsa A, Pascual-Salcedo D, Rodriguez-Rodriguez L, Ortiz AM, Gómez-Vaquero C, González-Gay MA, Smith M, Witte T, Merriman TR, Lie BA, Martin J. AB0093 Association of cd247 polymorphisms with rheumatoid arthritis: a replication study and a meta-analysis. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.2416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Heredia S, Nolla JM, Baliellas C, Llado L, Gómez-Vaquero C. AB0623 Assessment of bone mineral density and fracture risk in patients awaiting liver transplantation. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.2945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Gómez-Vaquero C, Roig-Vilaseca D, Bianchi M, Santo P, Narváez J, Nolla JM. Evaluación de una propuesta de criterios de indicación de densitometría ósea en mujeres posmenopáusicas españolas basados en la herramienta FRAX®. Med Clin (Barc) 2013; 140:439-43. [DOI: 10.1016/j.medcli.2012.03.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2011] [Revised: 02/26/2012] [Accepted: 03/01/2012] [Indexed: 10/28/2022]
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Narváez J, Narváez JA, Gómez-Vaquero C, Nolla JM. Lack of response to teriparatide therapy for bisphosphonate-associated osteonecrosis of the jaw. Osteoporos Int 2013; 24:731-3. [PMID: 22398853 DOI: 10.1007/s00198-012-1918-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2011] [Accepted: 01/23/2012] [Indexed: 10/28/2022]
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de la Rica L, Rodríguez-Ubreva J, García M, Islam ABMMK, Urquiza JM, Hernando H, Christensen J, Helin K, Gómez-Vaquero C, Ballestar E. PU.1 target genes undergo Tet2-coupled demethylation and DNMT3b-mediated methylation in monocyte-to-osteoclast differentiation. Genome Biol 2013; 14:R99. [PMID: 24028770 PMCID: PMC4054781 DOI: 10.1186/gb-2013-14-9-r99] [Citation(s) in RCA: 155] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2013] [Accepted: 09/09/2013] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND DNA methylation is a key epigenetic mechanism for driving and stabilizing cell-fate decisions. Local deposition and removal of DNA methylation are tightly coupled with transcription factor binding, although the relationship varies with the specific differentiation process. Conversion of monocytes to osteoclasts is a unique terminal differentiation process within the hematopoietic system. This differentiation model is relevant to autoimmune disease and cancer, and there is abundant knowledge on the sets of transcription factors involved. RESULTS Here we focused on DNA methylation changes during osteoclastogenesis. Hypermethylation and hypomethylation changes took place in several thousand genes, including all relevant osteoclast differentiation and function categories. Hypomethylation occurred in association with changes in 5-hydroxymethylcytosine, a proposed intermediate toward demethylation. Transcription factor binding motif analysis revealed an over-representation of PU.1, NF-κB, and AP-1 (Jun/Fos) binding motifs in genes undergoing DNA methylation changes. Among these, only PU.1 motifs were significantly enriched in both hypermethylated and hypomethylated genes; ChIP-seq data analysis confirmed its association to both gene sets. Moreover, PU.1 interacts with both DNMT3b and TET2, suggesting its participation in driving hypermethylation and hydroxymethylation-mediated hypomethylation. Consistent with this, siRNA-mediated PU.1 knockdown in primary monocytes impaired the acquisition of DNA methylation and expression changes, and reduced the association of TET2 and DNMT3b at PU.1 targets during osteoclast differentiation. CONCLUSIONS The work described here identifies key changes in DNA methylation during monocyte-to-osteoclast differentiation and reveals novel roles for PU.1 in this process.
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Affiliation(s)
- Lorenzo de la Rica
- Chromatin and Disease Group, Cancer Epigenetics and Biology Programme (PEBC), Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, Barcelona 08908, Spain
| | - Javier Rodríguez-Ubreva
- Chromatin and Disease Group, Cancer Epigenetics and Biology Programme (PEBC), Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, Barcelona 08908, Spain
| | - Mireia García
- Rheumatology Service, Bellvitge University Hospital (HUB), L’Hospitalet de Llobregat, Barcelona 08908, Spain
| | - Abul BMMK Islam
- Department of Experimental and Health Sciences, Barcelona Biomedical Research Park, Universitat Pompeu Fabra (UPF), Barcelona 08003, Spain
- Department of Genetic Engineering and Biotechnology, University of Dhaka, Dhaka 1000, Bangladesh
| | - José M Urquiza
- Chromatin and Disease Group, Cancer Epigenetics and Biology Programme (PEBC), Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, Barcelona 08908, Spain
| | - Henar Hernando
- Chromatin and Disease Group, Cancer Epigenetics and Biology Programme (PEBC), Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, Barcelona 08908, Spain
| | - Jesper Christensen
- Biotech Research and Innovation Center (BRIC), Center for Epigenetics University of Copenhagen, Ole Maaløes Vej 5, Copenhagen 2200, Denmark
| | - Kristian Helin
- Biotech Research and Innovation Center (BRIC), Center for Epigenetics University of Copenhagen, Ole Maaløes Vej 5, Copenhagen 2200, Denmark
| | - Carmen Gómez-Vaquero
- Rheumatology Service, Bellvitge University Hospital (HUB), L’Hospitalet de Llobregat, Barcelona 08908, Spain
| | - Esteban Ballestar
- Chromatin and Disease Group, Cancer Epigenetics and Biology Programme (PEBC), Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, Barcelona 08908, Spain
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Narváez J, Narváez JA, de Albert M, Gómez-Vaquero C, Nolla JM. Can Magnetic Resonance Imaging of the Hand and Wrist Differentiate Between Rheumatoid Arthritis and Psoriatic Arthritis in the Early Stages of the Disease? Semin Arthritis Rheum 2012; 42:234-45. [DOI: 10.1016/j.semarthrit.2012.03.016] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2011] [Revised: 03/23/2012] [Accepted: 03/29/2012] [Indexed: 01/25/2023]
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García-Bermúdez M, López-Mejías R, González-Juanatey C, Corrales A, Castañeda S, Ortiz AM, Miranda-Filloy JA, Gómez-Vaquero C, Fernández-Gutiérrez B, Balsa A, Pascual-Salcedo D, Blanco R, Llorca J, Martín J, González-Gay MA. CARD8 rs2043211 (p.C10X) polymorphism is not associated with disease susceptibility or cardiovascular events in Spanish rheumatoid arthritis patients. DNA Cell Biol 2012; 32:28-33. [PMID: 23088220 DOI: 10.1089/dna.2012.1836] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Rheumatoid arthritis (RA) is a complex polygenic inflammatory disease associated with accelerated atherosclerosis, which is the main cause of increased cardiovascular (CV) morbidity and mortality in RA patients. CARD8 is a constituent of inflammasome, which regulates interleukin 1-beta production, and has been associated with a worse disease course in early RA. One thousand six hundred twenty-one patients fulfilling the 1987 ACR classification criteria for RA and 1300 matched controls, were genotyped for the CARD8 rs2043211 (30T>A, p.C10X) single-nucleotide polymorphism (SNP) using predesigned TaqMan SNP genotyping assay. The genotyping success rate in our study was greater than 94%. We assessed CARD8 rs2043211 gene polymorphism results in 1530 Spanish RA patients in whom information on CV disease and CV risk factors was available at the time of the study. Also, a subgroup of patients with no history of CV events (n=276) was assessed for the potential influence of the rs2043211 variant in the development of subclinical atherosclerosis, by measurement of carotid intima-media thickness (IMT) and presence of carotid plaques. No statistically significant differences in allele or genotype frequencies for the rs2043211 CARD8 gene variant between patients with RA and controls were seen. Similarly, CARD8 rs2043211 (30T>A, p.C10X) SNP did not influence the development of CV events or the risk of CV events throughout the time. Likewise, no significant association between this gene variant and carotid IMT or the presence of plaques was found. In summary, our results do not support a role of the CARD8 rs2043211 gene variant in susceptibility to RA or in the development of CV disease in patients with RA.
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García-Bermúdez M, López-Mejías R, González-Juanatey C, Corrales A, Robledo G, Castañeda S, Miranda-Filloy JA, Blanco R, Fernández-Gutiérrez B, Balsa A, González-Alvaro I, Gómez-Vaquero C, Llorca J, Martín J, González-Gay MA. Analysis of the interferon gamma (rs2430561, +874T/A) functional gene variant in relation to the presence of cardiovascular events in rheumatoid arthritis. PLoS One 2012; 7:e47166. [PMID: 23077565 PMCID: PMC3471910 DOI: 10.1371/journal.pone.0047166] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2012] [Accepted: 09/10/2012] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Rheumatoid arthritis (RA) is a chronic inflammatory disease associated with increased cardiovascular (CV) morbidity and mortality. Since interferon-gamma (IFN-γ) has a direct effect on inflammation, in this study we assessed the potential association of the IFNG functional gene variant rs2430561 with CV disease in patients with RA. METHODS One thousand six hundred and thirty-five patients fulfilling the 1987 American College of Rheumatology classification criteria for RA were genotyped for the IFNG (rs2430561, +874T/A) gene polymorphism using TaqMan genotyping assay. Patients were stratified according to the presence of CV events or not. Logistic regression models to explain the presence of CV disease according to the IFNG rs2430561 allele distribution were performed. The potential influence of this variant in the development of subclinical atherosclerosis was also analyzed in a subgroup of patients with no history of CV events to determine carotid artery intima-media thickness (IMT) (n = 286) and presence of carotid plaques. Levels of the cytokine were determined in a subgroup of patients by ELISA. RESULTS Adjusted logistic regression model disclosed that presence of the minor allele A was not associated with increased risk of suffering CV events in RA patients. Besides, differences did not achieve statistical significance regarding carotid IMT and presence of carotid plaques in RA patients carrying IFNG rs2430561 variant allele. Levels of IFN-γ were higher in patients who had suffered CV events compared to patients who did not. CONCLUSION Our results do not support a role of IFNG rs2430561 (+874T/A) functional gene variant in the development of CV disease in RA patients.
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Affiliation(s)
- Mercedes García-Bermúdez
- Instituto de Parasitología y Biomedicina López-Neyra, Consejo Superior de Investigaciones Científicas, IPBLN-C.S.I.C., Granada, Spain
| | - Raquel López-Mejías
- Department of Rheumatology, Hospital Universitario Marqués de Valdecilla, IFIMAV, Santander, Spain
| | | | - Alfonso Corrales
- Department of Rheumatology, Hospital Universitario Marqués de Valdecilla, IFIMAV, Santander, Spain
| | - Gema Robledo
- Instituto de Parasitología y Biomedicina López-Neyra, Consejo Superior de Investigaciones Científicas, IPBLN-C.S.I.C., Granada, Spain
| | - Santos Castañeda
- Department of Rheumatology, Hospital Universitario La Princesa, IIS-Princesa, Madrid, Spain
| | | | - Ricardo Blanco
- Department of Rheumatology, Hospital Universitario Marqués de Valdecilla, IFIMAV, Santander, Spain
| | | | - Alejandro Balsa
- Department of Rheumatology, Hospital Universitario La Paz, Madrid, Spain
| | | | - Carmen Gómez-Vaquero
- Department of Rheumatology, Hospital Universitario de Bellvitge, IDIBELL, ĹHospitalet del Llobregat, Barcelona, Spain
| | - Javier Llorca
- Department of Epidemiology and Computational Biology, School of Medicine, University of Cantabria, and CIBER Epidemiología y Salud Pública (CIBERESP), IFIMAV, Santander, Spain
| | - Javier Martín
- Instituto de Parasitología y Biomedicina López-Neyra, Consejo Superior de Investigaciones Científicas, IPBLN-C.S.I.C., Granada, Spain
| | - Miguel A. González-Gay
- Department of Rheumatology, Hospital Universitario Marqués de Valdecilla, IFIMAV, Santander, Spain
- * E-mail:
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García-Bermúdez M, López-Mejías R, González-Juanatey C, Corrales A, Castañeda S, Miranda-Filloy JA, Gómez-Vaquero C, Fernández-Gutiérrez B, Balsa A, Pascual-Salcedo D, Blanco R, González-Álvaro I, Llorca J, Martín J, González-Gay MA. Association Study of MIA3 rs17465637 Polymorphism with Cardiovascular Disease in Rheumatoid Arthritis Patients. DNA Cell Biol 2012; 31:1412-7. [DOI: 10.1089/dna.2012.1672] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Affiliation(s)
| | - Raquel López-Mejías
- Department of Rheumatology, Hospital Universitario Marqués de Valdecilla, IFIMAV, Santander, Spain
| | | | - Alfonso Corrales
- Department of Rheumatology, Hospital Universitario Marqués de Valdecilla, IFIMAV, Santander, Spain
| | - Santos Castañeda
- Rheumatology Department, Hospital Universitario la Princesa, IIS-Princesa, Madrid, Spain
| | | | | | | | - Alejandro Balsa
- Department of Rheumatology, Hospital Universitario La Paz, Madrid, Spain
| | | | - Ricardo Blanco
- Department of Rheumatology, Hospital Universitario Marqués de Valdecilla, IFIMAV, Santander, Spain
| | | | - Javier Llorca
- Department of Epidemiology and Computational Biology, School of Medicine, University of Cantabria, and CIBER Epidemiología y Salud Pública (CIBERESP), IFIMAV, Santander, Spain
| | - Javier Martín
- Instituto de Parasitología y Biomedicina López-Neyra, IPBLN-CSIC, Granada, Spain
| | - Miguel A. González-Gay
- Department of Rheumatology, Hospital Universitario Marqués de Valdecilla, IFIMAV, Santander, Spain
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López-Mejías R, García-Bermúdez M, González-Juanatey C, Castañeda S, Miranda-Filloy JA, Gómez-Vaquero C, Fernández-Gutiérrez B, Balsa A, Pascual-Salcedo D, Blanco R, González-Álvaro I, Llorca J, Martín J, González-Gay MA. NFKB1-94ATTG ins/del polymorphism (rs28362491) is associated with cardiovascular disease in patients with rheumatoid arthritis. Atherosclerosis 2012; 224:426-9. [PMID: 22742859 DOI: 10.1016/j.atherosclerosis.2012.06.008] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2012] [Revised: 05/22/2012] [Accepted: 06/04/2012] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Rheumatoid arthritis (RA) is an inflammatory disease associated with increased cardiovascular (CV) mortality. A recent study has disclosed association between NFKB1-94ATTG ins/del polymorphism and higher risk of coronary heart disease in healthy Caucasians. Because of that, we assessed the influence of this polymorphism in the risk of CV disease in RA patients. MATERIAL AND METHODS 1437 Spanish patients with RA were genotyped for the NFKB1-94ATTG ins/del polymorphism. Two hundred and seventy-one of them (18.8%) had experienced CV events. RESULTS After adjusting for sex, age at RA diagnosis and traditional CV risk factors RA patients carrying the NFKB1 del/del genotype had higher risk of CV events than those with ins/ins genotype (Hazard ratio [HR] = 1.76, 95% CI: 1.05-2.97, p = 0.03), while heterozygous patients had an intermediate (but non-significant) risk (HR = 1.31, 95% CI: 0.90-1.92, p = 0.16). CONCLUSION Our results suggest that NFKB1-94ATTG ins/del polymorphism is associated with CV disease in patients with RA.
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Affiliation(s)
- Raquel López-Mejías
- Department of Rheumatology, Hospital Universitario Marqués de Valdecilla, IFIMAV, s/n 39008 Santander, Spain
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García-Bermúdez M, López-Mejías R, González-Juanatey C, Castañeda S, Miranda-Filloy JA, Blanco R, Fernández-Gutiérrez B, Balsa A, González-Álvaro I, Gómez-Vaquero C, Llorca J, Martín J, González-Gay MA. Association of the methionine sulfoxide reductase A rs10903323 gene polymorphism with cardiovascular disease in patients with rheumatoid arthritis. Scand J Rheumatol 2012; 41:350-3. [DOI: 10.3109/03009742.2012.677063] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Gómez-Vaquero C, Bianchi M, Santo P, Roig-Vilaseca D, Narváez J, Nolla JM. The activity of a Spanish bone densitometry unit revisited under the point of view of FRAX. ACTA ACUST UNITED AC 2012; 8:179-83. [PMID: 22608955 DOI: 10.1016/j.reuma.2012.02.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2011] [Revised: 01/31/2012] [Accepted: 02/01/2012] [Indexed: 11/16/2022]
Abstract
UNLABELLED In March 2008, FRAX, developed by Kanis and collaborators in the University of Sheffield and supported by the World Health Organization, became available online to calculate absolute risk of osteoporotic fracture in the next 10 years. OBJECTIVE To analyze the risk of fracture calculated by FRAX and its determinants in the patients sent to a densitometry unit for bone mineral density (BMD) testing. METHODS All the patients submitted by Primary Care to the Densitometry Unit for BMD testing underwent a self administered questionnaire to assess the clinical risk factors included in FRAX and a bone densitometry of lumbar spine and proximal femur with a DXA densitometer Hologic QDR 4500. They were classified as having a normal BMD, osteopenia or osteoporosis along with the recommendations of the International Society for Clinical Densitometry. As the reference population to calculate the T and Z scores, we used the one from the NHANES III study for femoral neck and total hip and the one from the Study of the Spanish Population for total spine. With the data of the questionnaire, we calculated, by FRAX, the absolute risk in the next ten years of having a major fracture (MFR) or a hip fracture (HFR). Both risks were calculated with or without the inclusion in the algorithm of BMD: MFR+, MFR-, HFR+ and HFR-. The results were recorded in an Access 2003 database and analyzed with the statistical package SPSS 15.0 for Windows. RESULTS We analyzed the data from 853 women with a mean age of 61.9 (8.9) years and a mean body mass index of 27.0 (4.2)kg/m(2). Mean BMD at lumbar spine was 0.873 (0.127)g/cm(2); at femoral neck, 0.704 (0.105)g/cm(2); and at total hip, 0.817 (0.107)g/cm(2). Twenty percent of the patients had a normal BMD, 55% had osteopenia and 25%, osteoporosis. Yet excluding age and body mass index, the number of fracture risk factors seems low: 31% of the patients had no risk of fracture; 40%, had one; 22%, two; 6%, three; 1%, four; and one patient had five. Mean MFR+ was 5.4 (4.8)%; mean MFR-, 6.3 (5.5)%; mean HFR+, 1.5 (2.9)%; and HFR-, 2.1 (3.3)%. When BMD was included in the algorithm for the calculation of the risk of fracture, the risk was statistically lower (p<0.001), especially in patients with better BMD. CONCLUSIONS The risk of fracture calculated by FRAX in the patients sent to a densitometry unit for bone BMD testing seems low and, probably, a better selection of the patients would detect a higher risk of fracture population. When the fracture risk is calculated with the introduction of BMD in the algorithm, it is lower than without including BMD.
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Affiliation(s)
- Carmen Gómez-Vaquero
- Rheumatology Service, IDIBELL-Hospital Universitari de Bellvitge, L'Hospitalet, Barcelona, Spain.
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Robledo G, González-Gay MA, Fernández-Gutiérrez B, Lamas JR, Balsa A, Pascual-Salcedo D, Castañeda S, Blanco R, González-Alvaro I, García A, Raya E, Gómez-Vaquero C, Delgado M, Martín J. NPSR1 gene is associated with reduced risk of rheumatoid arthritis. J Rheumatol 2012; 39:1166-70. [PMID: 22548958 DOI: 10.3899/jrheum.111205] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
OBJECTIVE Neuropeptide S receptor 1 (NPSR1) is a G protein-coupled receptor involved in immune response and is associated with several inflammatory diseases. We investigated the possible contribution of several polymorphisms in the intronic region of NPSR1 to rheumatoid arthritis (RA). METHODS Genotyping of 7 single-nucleotide polymorphisms (SNP) was performed in a total of 1232 patients with RA and 983 healthy controls of Spanish white origin by real-time polymerase chain reaction technology, using the TaqMan 5'-allele discrimination assay. RESULTS One out of the 7 SNP analyzed (rs740347) was associated with RA [p after Bonferroni correction (p(BNF)) = 1.2 × 10(-3), OR 0.73]. An association was also observed with rheumatoid factor-positive and shared epitope-positive RA (p(BNF) = 0.011, OR 0.73; p(BNF) = 0.037, OR 0.75, respectively). CONCLUSION Our results show that variations in the NPSR1 intronic region are associated with low risk in patients with RA, supporting other evidence that this locus represents a common genetic factor in inflammatory diseases.
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Affiliation(s)
- Gema Robledo
- Instituto de Parasitología y Biomedicina López-Neyra, CSIC, Granada, Spain
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Narváez J, Domingo-Domenech E, Gómez-Vaquero C, López-Vives L, Estrada P, Aparicio M, Martín-Esteve I, Nolla JM. Biological Agents in the Management of Felty's Syndrome: A Systematic Review. Semin Arthritis Rheum 2012; 41:658-68. [DOI: 10.1016/j.semarthrit.2011.08.008] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2011] [Revised: 08/29/2011] [Accepted: 08/31/2011] [Indexed: 11/27/2022]
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