POS0581 HIGHER SKIN AUTOFLUORESCENCE IN INDIVIDUALS AT RISK FOR RHEUMATOID ARTHRITIS: RESULTS FROM A LARGE POPULATION BASED COHORT

Abstract

BackgroundRheumatoid arthritis (RA) is a chronic systemic inflammatory disease which is associated with increased mortality, mostly because of a higher incidence of cardiovascular disease (CVD), which cannot be explained by traditional risk factors alone. (1,2) Also studies showed that the cardiovascular events can already occur at a higher than expected rate shortly after the first symptoms of RA. (3)This raises the question if individuals with clinical suspect arthralgia (CSA) but not yet diagnosed with RA, already have an increased risk for developing cardiovascular disease compared to healthy controls and if this is also true for ACPA positive individuals without symptoms of clinical suspect arthralgia.In our study we used skin autofluorescence (SAF), measured with the AGE reader, as an early non-invasive tool to identify subjects who are at increased risk for developing cardiovascular disease. (4) SAF measures the accumulation of AGEs in the skin and thereby offers a simple alternative to invasive measurement of AGE accumulation. (5)ObjectivesTo investigate skin autofluorescence (SAF) levels, as an early indicator for cardiovascular disease, in relation to the presence of anticitrullinated protein antibodies (ACPA), clinical suspect arthralgia (CSA) and rheumatoid arthritis (RA) in a large population-based cohort.MethodsCross-sectional data were used from 17346 participants of the Dutch Lifelines Cohort Study, of whom baseline SAF and ACPA levels were available. The presence of CSA was determined using EULAR questions from the connective tissue disease screening questionnaire (CSQ). Individuals were divided into four groups: ACPA negative controls (n=17211), ACPA positive without CSA (n=49), ACPA positive with CSA (n=31) and defined RA (n=52). Multinomial regression was used to compare SAF levels and correct for potential confounders.ResultsSAF levels were higher in the ACPA positive with CSA group (OR 2.04, p=0.034) and the defined RA group (OR 3.10, p<0.001) compared to controls, but not in the ACPA positive without CSA group (OR 1.07, p=0.875). The difference in SAF levels remained statistically significant in the defined RA group after adjusting for age (OR 2.09, p=0.011), smoking status, renal function or HbA1c. In the ACPA positive with CSA group, the effect was found to be comparable (corrected for age: OR 2.09).ConclusionOur results indicate that ACPA positive individuals with CSA have elevated SAF levels, which is regarded as an early marker for oxidative stress and a possible indicator for development of cardiovascular disease. Therefore it is important to conduct further studies to explore if, in individuals with clinical suspect arthralgia, cardiovascular risk management should be considered in future clinical practice.