The correlation between inflammatory burden with cardiovascular diseases in patients with early rheumatoid arthritis

Objective To examine the distribution of traditional and inflammation of cardiovascular disease (CVD) in patients with early rheumatoid arthritis (ERA). Methods We compared risk factors for CVD between 80 consecutive EAR patients and 44 controls, adjusting for body mass index (BMI). We also assessed the role of inflammation on the CVD risk factor by using a BMI and high-sensitivity CRP (hsCRP)-adjusted model. The frequencies were compared using chi-squared tests for categorical variables. Student's t-tests or Mann-Whitney U-tests were used for continuous variables where appropriate. Association between the traditional and metabolic risk factors and the hs-CRP level were assessed using Spearman's correlations. Finally, we also assessed the role of inflammation on the CVD risk factor by using a BMI and hsCRP-adjusted model. Results The BMI of RA patients were significantly higher than healthy controls. After adjusted for the BMI, ERA patients had a higher prevalence of metabolism syndrome (OR=8.468, 95%CI 1.058-67.787) compared to the controls. RA patients had significantly increased systolic and diastolic blood pressures {SBP 120(107.5-132.5) mmHg vs 133(115.8-147.8) mmHg [OR=1.729, 95%CI 0.517-2.941] and DBP (72±9) mmHg vs (82±12) mmHg [OR=2.902, 95%CI 1.144-3.414]}, high density {lipoprotein 1.7(1.4-2.1) mmol/L vs 1.4 (1.2-1.6) mmol/L [OR=-1.829, 95%CI -2.550--1.011]} total cholesterol (TC)/high density lipoprotein cholesterol {HDL 1.7(1.6-1.9) mmol/L vs 3.2(2.7-4.0) mmol/L [OR=0.299, 95%CI -0.453-1.052]}, inflammatory markers [hs-CRP, white blood cell (WBC) and blood platelet (PLT)] and decreased HDL compared to controls. As expected, hs-CRP level was significantly increased in the ERA group reflecting underlying inflammation. The hs-CRP level was significantly correlated with BMI, SBP DBP, and inflammation markers WBC and PLT, as well as inversely correlated with HDL which reflected the underlying inflammation. Further adjustment for hs-CRP level rendered the differences in the prevalence of metabolic syndrome (OR=6.493, 95% CI 1.028-67.123); the TC/HDL was not significantly between the two groups, while the differences in other parameters remained statistically significant. Conclusion The data support the hypothesis that ERA may be associated with hypertension, obesity and dyslipidemia because of the shared inflammation pathway. Key words: Arthritis, rheumatoid; Inflammation; Cardiorascular diseases