Raquel López-Mejias1, Begoña Ubilla1, Fernanda Genre1, Alfonso Corrales1, José L Hernández1, Ivan Ferraz-Amaro1, Linda Tsang1, Javier Llorca1, Ricardo Blanco1, Carlos González-Juanatey1, Miguel A Gonzalez-Gay1, Patrick H Dessein1. 1. From the Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, Department of Internal Medicine, Hospital Universitario Marques de Valdecilla, and the Department of Epidemiology and Computational Biology, School of Medicine, University of Cantabria, and Fundación Instituto de Investigación Marqués de Valdecilla, and Red Temática de Investigación Cooperativa en Envejecimiento y Fragilidad (RETICEF), and CIBER Epidemiología y Salud Pública (CIBERESP), Santander; the Rheumatology Division, Hospital Universitario de Canarias, Tenerife; the Cardiology Division, Hospital Lucus Augusti, Lugo, Spain; the Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.P.H. Dessein and M.A. Gonzalez-Gay share senior authorship.R. López-Mejias, PhD; B. Ubilla, BSc; F. Genre, PhD; A. Corrales, MD, PhD; R. Blanco, MD, PhD, Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, Hospital Universitario Marques de Valdecilla, IFIMAV; J.L. Hernández, MD, PhD, Department of Internal Medicine, Hospital Universitario Marques de Valdecilla, University of Cantabria, RETICEF, IFIMAV; I. Ferraz-Amaro, MD, Rheumatology Division, Hospital Universitario de Canarias; L. Tsang; P.H. Dessein, MD, FCP(SA), FRCP(UK), PhD, Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand; J. Llorca, MD, PhD, Department of Epidemiology and Computational Biology, School of Medicine, University of Cantabria, and CIBERESP, IFIMAV; C. Gonzalez-Juanatey, MD, PhD, Cardiology Division, Hospital Lucus Augusti; M.A. Gonzalez-Gay, MD, PhD, Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, Hospital Universitario Marques de Valdecilla, IFIMAV
Abstract
OBJECTIVE: We determined whether osteoprotegerin (OPG) concentrations are associated with established cardiovascular disease (CVD) among patients with rheumatoid arthritis (RA). METHODS: OPG concentrations were measured by ELISA in 151 patients with RA (54 with CVD) and 62 age-matched control subjects without CVD. Established CVD was composed of documented ischemic heart disease, cerebrovascular disease, and peripheral artery disease. RESULTS: In patients with RA, age, body mass index (BMI), rheumatoid factor (RF) positivity, anticyclic citrullinated peptide (anti-CCP) antibody positivity, and joint erosion status were associated with OPG concentrations [partial R (p) = 0.175 (0.03), -0.277 (0.0009), 0.323 (< 0.0001), 0.217 (0.008), and 0.159 (0.05), respectively]. Median (interquartile range) OPG concentrations increased from 6.38 (3.46-9.31) to 7.07 (5.04-10.65) and 8.64 (6.00-11.52) ng/ml in controls and patients with RA who had CVD and those who did not, respectively (p = 0.0002). Upon adjustment for age, sex, traditional risk factors, and BMI in mixed regression models, OPG concentrations remained lower in controls compared to patients with RA without CVD (p = 0.05) and in the latter compared to those with CVD (p = 0.03); the association of OPG concentrations with CVD among patients with RA also persisted after additional adjustment for RF and anti-CCP antibody positivity, and erosion status (p = 0.04). CONCLUSION: OPG concentrations are associated with disease severity and CVD prevalence in patients with RA. Whether consideration of OPG concentrations can improve CVD risk stratification in RA merits future longitudinal investigation.
OBJECTIVE: We determined whether osteoprotegerin (OPG) concentrations are associated with established cardiovascular disease (CVD) among patients with rheumatoid arthritis (RA). METHODS:OPG concentrations were measured by ELISA in 151 patients with RA (54 with CVD) and 62 age-matched control subjects without CVD. Established CVD was composed of documented ischemic heart disease, cerebrovascular disease, and peripheral artery disease. RESULTS: In patients with RA, age, body mass index (BMI), rheumatoid factor (RF) positivity, anticyclic citrullinated peptide (anti-CCP) antibody positivity, and joint erosion status were associated with OPG concentrations [partial R (p) = 0.175 (0.03), -0.277 (0.0009), 0.323 (< 0.0001), 0.217 (0.008), and 0.159 (0.05), respectively]. Median (interquartile range) OPG concentrations increased from 6.38 (3.46-9.31) to 7.07 (5.04-10.65) and 8.64 (6.00-11.52) ng/ml in controls and patients with RA who had CVD and those who did not, respectively (p = 0.0002). Upon adjustment for age, sex, traditional risk factors, and BMI in mixed regression models, OPG concentrations remained lower in controls compared to patients with RA without CVD (p = 0.05) and in the latter compared to those with CVD (p = 0.03); the association of OPG concentrations with CVD among patients with RA also persisted after additional adjustment for RF and anti-CCP antibody positivity, and erosion status (p = 0.04). CONCLUSION:OPG concentrations are associated with disease severity and CVD prevalence in patients with RA. Whether consideration of OPG concentrations can improve CVD risk stratification in RA merits future longitudinal investigation.
Authors: Cecilia P Chung; Joseph F Solus; Annette Oeser; Chun Li; Paolo Raggi; Jeffrey R Smith; C Michael Stein Journal: Int J Mol Sci Date: 2015-02-11 Impact factor: 5.923
Authors: Michelle J Ormseth; Cecilia P Chung; Annette M Oeser; Margery A Connelly; Tuulikki Sokka; Paolo Raggi; Joseph F Solus; James D Otvos; C Michael Stein Journal: Arthritis Res Ther Date: 2015-05-09 Impact factor: 5.156