Abstract
IntroductionCardiovascular (CV) morbidity and mortality are increased in patients with rheumatoid arthritis (RA). Inflammation is thought to be an important factor in accelerated atherosclerosis in RA, whereas insulin resistance is a known risk factor for atherosclerosis in RA. We hypothesised that adipokines could be a link between inflammation, insulin resistance, and atherosclerosis in RA.MethodsThe common carotid artery (CCA) intima-media thickness (IMT), CCA resistive index (RI), and carotid plaques were measured by ultrasonography in 192 patients with RA. Insulin resistance was assessed by the homeostasis model assessment for insulin resistance (HOMA-IR). Serum adiponectin, leptin, resistin, tumor necrosis factor-α, and interleukin (IL)-6 concentrations were determined.ResultsThe CCA RI was associated with CCA IMT and the estimated total plaque volume after adjustment for conventional CV risk factors. Among adipokines, resistin and IL-6 were correlated with inflammatory parameters. Leptin and leptin:adiponectin (L:A) ratio were correlated with metabolic risk factors, including HOMA-IR. And L:A ratio was related to the CCA RI after adjustment for conventional and nonconventional CV risk factors, including HOMA-IR, erythrocyte sedimentation rate and C-reactive protein.ConclusionL:A ratio was associated with HOMA-IR and carotid RI. L:A ratio might be an independent factor for predicting cardiovascular risk in patients with RA.
Highlights
Cardiovascular (CV) morbidity and mortality are increased in patients with rheumatoid arthritis (RA)
The common carotid artery (CCA) resistive index (RI), the CCA intima-media thickness (IMT) and concentrations of adipokines did not differ between patients who received biologics and those who did not
CCA RI was associated with CCA IMT, the estimated total plaque volume independent of
Summary
Cardiovascular (CV) morbidity and mortality are increased in patients with rheumatoid arthritis (RA). Inflammation is thought to be an important factor in accelerated atherosclerosis in RA, whereas insulin resistance is a known risk factor for atherosclerosis in RA. We hypothesised that adipokines could be a link between inflammation, insulin resistance, and atherosclerosis in RA. Inflammation is an important nonconventional factor in the increased CV risk observed in RA [5,6]. Insulin resistance, which is important in the development and progression of atherosclerotic CV disease [7], has been suggested as a risk factor for atherosclerosis in RA [8,9]. The common carotid artery (CCA) intima-media thickness (IMT) had been established as a valid marker of early atherosclerosis [12]. The IMT is a morphological parameter and represents the histologically verified intima-media segment of the vascular wall. Whereas the carotid IMT has been reported in patients with RA in many studies [14], the RI in these patients has not yet been studied
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