Serum levels of anticyclic citrullinated peptide antibodies, interleukin-6, tumor necrosis factor-α, and C-reactive protein are associated with increased carotid intima-media thickness: a cross-sectional analysis of a cohort of rheumatoid arthritis patients without cardiovascular risk factors

Mónica Vázquez-Del Mercado, Lourdes Nuñez-Atahualpa, Mauricio Figueroa-Sánchez, Eduardo Gómez-Bañuelos, Alberto Daniel Rocha-Muñoz, Beatriz Teresita Martín-Márquez, Esther Guadalupe Corona-Sanchez, Erika Aurora Martínez-García, Héctor Macias-Reyes, Laura Gonzalez-Lopez, Jorge Ivan Gamez-Nava, Rosa Elena Navarro-Hernandez, María Alejandra Nuñez-Atahualpa, Javier Andrade-Garduño, Mónica Vázquez-Del Mercado, Lourdes Nuñez-Atahualpa, Mauricio Figueroa-Sánchez, Eduardo Gómez-Bañuelos, Alberto Daniel Rocha-Muñoz, Beatriz Teresita Martín-Márquez, Esther Guadalupe Corona-Sanchez, Erika Aurora Martínez-García, Héctor Macias-Reyes, Laura Gonzalez-Lopez, Jorge Ivan Gamez-Nava, Rosa Elena Navarro-Hernandez, María Alejandra Nuñez-Atahualpa, Javier Andrade-Garduño

Abstract

The main cause of death in rheumatoid arthritis (RA) is cardiovascular events. We evaluated the relationship of anticyclic citrullinated peptide (anti-CCP) antibody levels with increased carotid intima-media thickness (cIMT) in RA patients.

Methods: Forty-five anti-CCP positive and 37 anti-CCP negative RA patients, and 62 healthy controls (HC) were studied. All groups were assessed for atherogenic index of plasma (AIP) and cIMT. Anti-CCP, C-reactive protein (CRP), and levels of tumor necrosis factor alpha (TNFα) and interleukin-6 (IL-6) were measured by enzyme-linked immunosorbent assay (ELISA).

Results: The anti-CCP positive RA patients showed increased cIMT compared to HC and anti-CCP negative (P < 0.001). Anti-CCP positive versus anti-CCP negative RA patients, had increased AIP, TNFα and IL-6 (P < 0.01), and lower levels of high density lipoprotein cholesterol (HDL-c) (P = 0.02). The cIMT correlated with levels of anti-CCP (r = 0.513, P = 0.001), CRP (r = 0.799, P < 0.001), TNFα (r = 0.642, P = 0.001), and IL-6 (r = 0.751, P < 0.001). In multiple regression analysis, cIMT was associated with CRP (P < 0.001) and anti-CCP levels (P = 0.03).

Conclusions: Levels of anti-CCP and CRP are associated with increased cIMT and cardiovascular risk supporting a clinical role of the measurement of cIMT in RA in predicting and preventing cardiovascular events.

Figures

Figure 1
Figure 1
Carotid intima-media thickness (cIMT) in patients with rheumatoid arthritis (RA) classified by anti-CCP antibodies, compared with healthy controls (HC). Horizontal bars indicate the median. ANOVA P values indicate the significance of the overall trend while comparisons between groups are compared by Scheffé's post hoc test.

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