scholarly journals Association of Antibodies to Citrullinated Protein Antigens with Blood Pressure in First-Degree Relatives of Rheumatoid Arthritis Patients: The Studies of the Etiology of Rheumatoid Arthritis

2017 ◽  
Vol 46 (6) ◽  
pp. 481-487 ◽  
Author(s):  
Jan M. Hughes-Austin ◽  
Ryan W. Gan ◽  
Kevin D. Deane ◽  
Michael H. Weisman ◽  
M. Kristen Demoruelle ◽  
...  

Background: Hypertension is more common in patients with rheumatoid arthritis (RA) than in the general population. It is unknown whether hypertension is due to RA-related medications or the disease itself. Therefore, we sought to investigate associations between RA-related autoantibodies, specifically antibodies to citrullinated protein antigens (ACPA) and systolic blood pressure (SBP) and diastolic blood pressure (DBP) in first-degree relatives of RA patients, who were free of RA and RA-related medications. We hypothesized that a greater number of detectable ACPA would be associated with high SBP and DBP, independent of other risk factors in these first-degree relatives. Methods: We evaluated associations between ACPA and SBP and DBP in a cross-sectional study of 72 first-degree relatives (defined as parent, child, or sibling) of RA patients. Fifteen ACPA were measured using a Bio-Plex bead-based assay; each was dichotomized as positive/negative based on pre-specified cut-points. Analysis of covariance was used to evaluate associations between ACPA positivity and SBP and DBP, adjusting for age, sex, race, body mass index (BMI), pack-years of smoking, high sensitivity C-reactive protein (hsCRP), and current use of anti-hypertensive medications. Results: Average age was 51 and 69% were women. Mean SBP was 119 ± 18 and DBP was 74 ± 9 mm Hg. Thirty-three (46%) first-degree relatives were positive for ≥1 ACPA; and were younger, had lower BMI, more pack-years of smoking, and higher hsCRP concentrations compared to ACPA negative first-degree relatives. For each additional positive ACPA, SBP was 0.98 ± 0.5 mm Hg (p = 0.05) higher, and DBP was 0.66 ± 0.3 mm Hg (p = 0.04) higher. Anti-cit-fibrinogen A (211–230) positive and anti-cit-filaggrin positive first-degree relatives had 11.5 and 13.9 mm Hg higher SBP (p = 0.02) respectively. Anti-cit-clusterin, cit-filaggrin, and cit-vimentin positive first-degree relatives had 7–8 mm Hg higher DBP (p = 0.03, 0.05, 0.05 respectively), compared to being negative for these individual ACPA. Consistent with associations between ACPA, SBP, and DBP, anti-cyclic citrullinated peptides (anti-CCP2) positive first-degree relatives had 16.4± (p = 0.03) higher SBP and 12.1± mm Hg (p = 0.01) higher DBP than anti-CCP2 negative first-degree relatives. Conclusion: In first-degree relatives without RA, ACPA positivity is associated with higher SBP and DBP. Subclinical autoimmune processes and ACPA may play a role in the vascular changes potentially leading to hypertension prior to RA onset.

2015 ◽  
Vol 21 (4) ◽  
pp. 206-211
Author(s):  
Mihailov Claudia ◽  
Tica Irina

Abstract Introduction: Autoimmune thyroiditis (AIT) associates a multitude of osteoarticular and muscular complaints but, in the same time, the association between AIT and rheumatoid arthritis (RA) remains a matter of controversy. Material, patients and method: We performed a retrospective cross-sectional study over 69 patients with RA admitted successively in the the IInd Medical Clinic of Railway Hospital between 01 Jan 2015 and 01 Aug.2015, subdivided into two groups: with and without AIT. A number of parameters were studied in each group: age, environment, parity and number of gestations, smoker status, education level, medium duration of disease, presence of rheumatoid factor (RF), of anti-cyclic citrullinated protein antibodies (ACPA), erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels, treatment for RA, VAS score, DAS 28 score. Conclusions: The percentage of patients with RA and AIT is 17.391%, higher than in general population, and so we consider that screening for AIT in patients with RA should be done. Patients with RA and AIT have a younger age of RA onset, belong to the urban environment and have a higher level of education than the ones with RA but without AIT. No correlation between the occurrence of AIT and the presence of ACPA was found.


2017 ◽  
Vol 9 (9) ◽  
pp. 213-229 ◽  
Author(s):  
Arduino A. Mangoni ◽  
Leena R. Baghdadi ◽  
E. Michael Shanahan ◽  
Michael D. Wiese ◽  
Sara Tommasi ◽  
...  

Background: Methotrexate (MTX) treatment in rheumatoid arthritis (RA) has been associated with lower cardiovascular risk compared to other disease-modifying antirheumatic drugs (DMARDs). We sought to identify whether the MTX-associated cardioprotection involves changes in blood pressure (BP) and/or arterial function. Methods: Clinic and 24-hour peripheral and central systolic and diastolic BP (SBP and DBP), augmentation index (AIx), pulse wave velocity (PWV) and plasma asymmetric dimethylarginine (ADMA) were assessed in RA patients on stable treatment with either MTX ± other DMARDs (MTX group, n = 56, age 61 ± 13 years, 70% females) or other DMARDs (non-MTX group, n = 30, age 63 ± 12 years, 76% females). Measurements were performed at baseline and after 8 months. Results: After adjusting for visit, age, gender, body mass index, folic acid use and 28-joint disease activity score, the MTX group had significantly lower clinic peripheral SBP (−7.7 mmHg, 95% CI −13.2 to −2.3, p = 0.006) and DBP (−6.1 mmHg, 95% CI −9.8 to −2.4, p = 0.001) and clinic central SBP (−7.8 mmHg, 95% CI −13.1 to −2.6, p = 0.003) and DBP (−5.4 mmHg, 95% CI −9.1 to −1.6, p = 0.005) versus the non-MTX group. Furthermore, the MTX group had significantly lower 24-hour peripheral and central SBP and DBP and PWV versus the non-MTX group ( p < 0.01 for all comparisons). By contrast, there were no significant between-group differences in AIx and ADMA. Conclusions: RA patients on MTX treatment had significantly lower clinic and 24-hour peripheral and central BP compared to those who did not take MTX. The lower BP with MTX may be related to differences in PWV, but not in AIx or ADMA concentrations. Further longitudinal studies including randomized controlled trials are warranted to confirm these findings, to identify other possible mechanisms responsible for the effects of MTX on BP and PWV, and to establish whether these effects might account for the reduced cardiovascular risk with MTX.


2021 ◽  
Vol 48 (1) ◽  
Author(s):  
Eman A. Baraka ◽  
Mona G. Balata ◽  
Shereen H. Ahmed ◽  
Afaf F. Khamis ◽  
Enas A. Elattar

Abstract Background This study aimed to measure the serum and synovial interleukin (IL)-37 levels in rheumatoid arthritis (RA) patients compared to patients with primary knee osteoarthritis (PKOA) and healthy controls and to detect its relation to RA disease activity. Results This cross-sectional study included 50 RA patients with a mean age of 40.24 ± 8.62 years, 50 patients with PKOA with a mean age of 56.69 ± 4.21, and 40 healthy controls with a mean age of 41.75 ± 7.38 years. The mean serum IL-37 level in the RA patients (382.6 ± 73.97 pg/ml) was statistically significantly (P < 0.001) the highest among the studied groups; however, it showed a non-significant difference between the PKOA patients (70.38 ± 27.49 pg/ml) and the healthy controls (69.97 ± 25.12 pg/ml) (P > 0.94). Both serum and synovial IL-37 levels were significantly positively correlated with disease activity scores (r = 0.92, P< 0.001 and r = 0.85, P < 0.001), tender joint counts (r = 0.83, P < 0.001 and r = 0.82, P < 0.001 ), swollen joint counts (r = 0.72, P < 0.001 and r = 0.60, P < 0.001), visual analog scale (r = 0.82, P < 0.001 and r = 0.82, P < 0.001), erythrocyte sedimentation rate (r = 0.75, P < 0.001 and r = 0.65, P < 0.001), and C-reactive protein (r = 0.93, P < 0.001 and r = 0.79, P < 0.001), respectively. Conclusion Serum and synovial IL-37 were significantly elevated in the RA patients, and they were closely correlated. Being less invasive, the serum IL-37 could be a marker of disease activity and could reflect the effective disease control by drugs. Having an anti-inflammatory effect could not suggest IL-37 as the key player to control inflammation alone, but its combination with other anti-proinflammatory cytokines could be investigated.


2021 ◽  
pp. 71-73
Author(s):  
Amit Kumar Tiwari ◽  
Umesh Chandra Jha ◽  
Debarshi Jana

INTRODUCTION:Cerebrovascular accident (commonly called stroke) is dened as an abrupt onset of a neurologic decit that is attributable to a focal vascular cause. Thus, the diagnosis of stroke is clinical and laboratory studies including brain imaging are used to support the diagnosis AIMS AND OBJECTIVES: To evaluate the serum levels of high sensitivity C-reactive protein (hsCRP) in different types of cerebrovascular accidents on admission. MATERIALS AND METHODS: This study was an institution based cross-sectional study designed to investigate the association of hs-CRP levels with stroke and its types in Indian patients. The study was done in the Department of Medicine, Darbhanga Medical College and Hospital, Laheriasarai, Bihar from march 2019 to March 2020. 50 patients of either sex above 12 years of age admitted in Medicine Department of DMCH, Laheriasarai, Bihar with clinically or radiologically diagnosed stroke. RESULT: The mean level of hsCRP (mean ± s.d.) of the cases in our study was 7.65±7.01 with range 1.4 – 26 and the median was 3.7 and 58% of the cases were having level of hsCRP≥3 (p=0.023).Mean level of hsCRPof cases was signicantly higher than that of control (t98=7.25;p=0.001). CONCLUSION:We concluded that hs-CRPlevel is increased in cases of cerebrovascular accident- ischemic as well as haemorrhagic, suggesting an inammatory response in acute cerebrovascular accident. hs-CRP level is increased in patients with ischemic cerebrovascular accident dramatically but not in haemorrhagic cerebrovascular accident which might be considered as useful adjunct method for determining type of stroke in patients with cerebrovascular problems.


Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Mana Kogure ◽  
Tomohiro Nakamura ◽  
Naho Tsuchiya ◽  
Takumi Hirata ◽  
Akira Narita ◽  
...  

Introduction: Recently, the balance between sodium and potassium intake, i.e. sodium-to-potassium (Na/K) ratio, has received significant attention for prevention of hypertension. Previous studies reported the positive association between urinary Na/K (uNa/K) ratio and hypertension. However, even the same uNa/K ratio value, there might be high Na/ high K ratio or low Na/ low K ratio. Hypothesis: We assessed the hypothesis that blood pressure (BP) is higher in high Na/ high K group than that in low Na/ low K group even at the same uNa/K ratio in general population in cross-sectional study. Methods: The subjects were 20 to 74 years old who participated in The Tohoku Medical Megabank Project Community-based Cohort Study. Of these participants, we targeted 54,011 subjects (men: 20,505 women: 33,506 mean age: 59.9 years) who had information of BP, urinary Na and K. We estimated 24-h urinary excretion of Na and K using Tanaka formula. Urinary Na and K were each classified into quartiles (Na; Q1~Q4, K; Q1~Q4), and set all 16 groups of uNa/K ratio by combining Na and K respectively. To assess the relationship between casual uNa/K ratio and BP, we performed an analysis of covariance to calculate the adjusted mean systolic BP (SBP). We included covariate factors as age, sex, BMI and alcohol intake. We also assessed the relationship between uNa/K ratio and SBP using multiple regression analyses adjusted for covariate factors. We stratified the participants into two groups: ‘under treatment for hypertension’ (n=17,091) and ‘without treatment for hypertension (n=36,920)’. Results: The mean of uNa/K ratio for each group of Na (Q1)/K(Q1), Na (Q2)/K(Q2), Na (Q3)/K(Q3) and Na (Q4)/K(Q4) was all 4.0. As previous report showed, higher uNa/K ratio group showed higher SBP and lower uNa/K group showed lower BP. When we compared adjusted mean SBP of Na (Q1)/K(Q1) and Na (Q4)/K(Q4) the value were comparable, but the value were significantly higher in Na (Q4)/K(Q4) group (The adjusted mean SBP of Na (Q1)/K(Q1), Na (Q2)/K(Q2), Na (Q3)/K(Q3) and Na (Q4)/K(Q4) was 123.6, 124.9, 124.7 and 125.5 mmHg, respectively). The uNa/K was significantly positively associated with SBP independently of age, sex, BMI, and alcohol intake. The finding was unchanged the results in under treatment group. Conclusions: BP was significantly higher in high Na/ high K group than in low Na/ low K group even at the same uNa/K ratio. We suggested that not only increasing K intake but also reducing salt is important for preventing hypertension.


2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Sonhee Park ◽  
Hong Wang ◽  
Bruce Daggy ◽  
Jamie McManus ◽  
Paul Jacques

Abstract Objectives The aim of the present study is to compare cardiometabolic biomarker levels (MARKERS) from a cohort using multiple (2+) dietary supplements (MDS) manufactured by Shaklee Corporation for 3–5 yr (SHAKLEE) to those from the age-matched MDS users from NHANES 2007–10 (NHANES). Methods Each subject from SHAKLEE [n = 58; mean age: 48 yr (22–79 yr)], using MDS manufactured by Shaklee Corp for 3–5 yr, voluntarily signed the IRB approved informed consent form before the study participation. Body mass index (BMI), systolic and diastolic blood pressures (SBP and DSP) were measured, and approximately 30 mL of 12-h fasting blood sample was collected. Pregnant women and people with a history of cancer were excluded. MARKERS from SHAKLEE were compared to those from NHANES [n = 1952; mean age: 51 yr (22–79 yr)]. MARKERS included total cholesterol (TC), HDL-c, TC/HDL-c ratio, LDL-c, triglycerides (TG), high sensitivity C-Reactive Protein (CRP), glucose, hemoglobin A1c (HbA1c), and Insulin levels in the blood as well as BMI, SBP, and DBP. Statistical analyses were performed using independent samples t-tests, and P < 0.05 was considered significantly different between groups. Results SHAKLEE had significantly lower TC (189 vs. 201 mg/dL), TC/HDL-c ratio (3.1 vs. 4.0), LDL-c (103 vs. 118 mg/dL), TG (81 vs. 131 mg/dL), glucose (93 vs. 107 mg/dL), HbA1c (5.1 vs. 5.7%), insulin (8.3 vs. 13.4 mIU/L), BMI (26.7 vs. 29.0), and SBP (110 vs. 122 mmHg), and higher HDL-c (69 vs. 55 mg/dL) but had higher DBP (76 vs. 71 mmHg) than NHANES. There was no significant difference in CRP although CRP was slightly lower in SHAKLEE than NHANES (2.9 vs. 3.8 mg/L). Conclusions The present study showed that 3–5 yr MDS users from the Shaklee cohort had healthier pattern in cardiometabolic biomarkers than the age-matched MDS users from NHANES 2007–2010. Funding Sources Shaklee Corporation, 4747 Willow Road, Pleasanton, CA 94,588, USA.


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