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001-es BibID:	BIBFORM002148
Első szerző:	Kerekes György (belgyógyász, kardiológus, angiológus)
Cím:	Endothelial dysfunction and atherosclerosis in rheumatoid arthritis : a multiparametric analysis using imaging techniques and laboratory markers of inflammation and autoimmunity / Kerekes György, Szekanecz Zoltán, Dér Henrietta, Sándor Zsuzsa, Lakos Gabriella, Muszbek László, Csípő István, Sipka Sándor, Seres Ildikó, Paragh György, Kappelmayer János, Szomják Edit, Veres Katalin, Szegedi Gyula, Shoenfeld Yehuda, Soltész Pál
Dátum:	2008
Megjegyzések:	Cardiovascular disease is a leading cause of mortality in rheumatoid arthritis (RA). Endothelial dysfunction often precedes manifest atherosclerosis. We assessed endothelial dysfunction and atherosclerosis in RA in context with laboratory markers. METHODS: Fifty-two patients with RA and 40 matched healthy controls were studied. We assessed common carotid intima-media thickness (ccIMT) and flow- (FMD) and nitroglycerine-mediated vasodilation (NMD). We also assayed numerous immunological and metabolic laboratory markers. RESULTS: FMD was significantly lower in RA (5.32% +/- 4.66%) compared to controls (8.30% +/- 3.96%) (p = 0.001). NMD was preserved in RA. ccIMT was significantly greater in patients with RA (0.63 +/- 0.14 mm) versus controls (0.54 +/- 0.15 mm) (p = 0.012). In patients with RA, ccIMT correlated with FMD% (R = -0.318, p = 0.022), age (R = 0.831, p < 0.001), and anti-dsDNA levels (R = 0.463, p = 0.006). FMD% correlated with serum interferon-gamma (IFN-gamma) levels (R = 0.516, p = 0.014). NMD% correlated inversely with the percentage of Th0 lymphocytes (R = -0.636, p = 0.006), serum immune complex (R = -0.692, p < 0.001), and IgM levels (R = -0.606, p = 0.003). Patients with RA were divided as "low" (< 0.65 mm) versus "high" (> 0.65 mm) ccIMT groups, and into "normal" (> 5%) versus "impaired" (< 5%) FMD% subsets. Low and high ccIMT groups differed significantly in age and serum interleukin 1 (IL-1) and anti-dsDNA levels. RA patients with normal versus impaired FMD% differed significantly in age, disease duration, and serum IFN-gamma levels. Lipoprotein(a) [Lp(a)] also correlated with rheumatoid factor (RF) and C-reactive protein (CRP); homocysteine (HCy) correlated with CRP and correlated inversely with folate and vitamin B12 production. Paraoxonase-1 (PON-1) activity correlated with serum tumor necrosis factor-alpha(TNF-alpha) and IL-6 levels. CONCLUSION: This was a well characterized RA population, where FMD and ccIMT were impaired, indicating early endothelial dysfunction and accelerated atherosclerosis, respectively. RA-related autoimmune-inflammatory mechanisms and metabolic factors including anti-CCP, RF, CRP, circulating immune complexes, IgM, TNF-alpha, IL-6, Th0/Th1 ratio, HCy, folate, vitamin B12, and PON-1 may all be involved in the development of vascular disease in RA. Although ccIMT and FMD, as well as some laboratory factors, have been assessed by other investigators in RA-associated atherosclerosis, our results regarding the possible involvement of anti-CCP, anti-dsDNA, Lp(a), some cytokines, and PON-1 activity are novel. Early determination of FMD% and ccIMT may be useful to assess RA patients with high cardiovascular risk.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:	The Journal of Rheumatology. - 35 : 3 (2008), p. 398-406. -
További szerzők:	Szekanecz Zoltán (1964-) (reumatológus, belgyógyász, immunológus) Dér Henrietta (1977-) (orvos) Sándor Zsuzsa (1980-) (pathológus) Lakos Gabriella (1963-) (laboratóriumi szakorvos, transzfúziológus, immunológus) Muszbek László (1942-) (haematológus, kutató orvos) Csípő István (1953-) (vegyész) Sipka Sándor (1945-) (laboratóriumi szakorvos) Seres Ildikó (1954-) (biokémikus) Paragh György (1953-) (belgyógyász) Kappelmayer János (1960-) (laboratóriumi szakorvos) Szomják Edit (1961-) (belgyógyász) Veres Katalin (1971-) (orvos) Szegedi Gyula (1936-2013) (belgyógyász, immunológus) Shoenfeld, Yehuda Soltész Pál (1961-) (belgyógyász, kardiológus)
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