| Rheumatoid arthritis(RA)is a systemic autoimmune disease characterized by invasive,progressive,chronic arthritis,synovitis,and vasculitis,which can be associated with various external manifestations of the joint.Among them,the relative risk of cardiovascular disease(CVD)was higher than normal.Given the so-called blood lipid profile paradox in patients with rheumatoid arthritis,traditional blood lipid profile profiling is not recommended for people at high risk of RA.More accurate serological markers are needed for prediction.Oxidized low density lipoprotein is produced by oxidative modification of density lipoproteins and is a key factor in atherosclerosis.Increased levels of oxidized LDL in untreated,highly active RA patients,and decreased LDL levels in combination with disease control,may be associated with the pathogenesis and progression of RA and atherosclerosis.Objective:To investigate the prognostic value of serum low density lipoprotein(ox LDL level on CVD risk in RA patients.Methods:From April 2022 to September 2022,the Affiliated Hospital of Inner Mongolia Medical University admitted 123 RA outpatient and inpatient patients.Carotid endometrial-medial thickness ≥ 0.9mm and/or carotid artery atherosclerotic plaque were used as a standard for ultrasonic diagnosis of 10-year incidence of carotid atherosclerosis based on general criteria in 10 studies.Relevant clinical information and laboratory examination findings were collected from participants and RA-disease activity scores(DAS28-ESR and DAS28-CRP)were computed.Serum ox LDL lever were measured by ELISA and CVD risk CVD risk risk assessment in patients with registered RA using Euro Score × 1.5 times as a combined CVD risk score for RA,ASCVD risk score and Framingham risk index.The cross-sectional comparison between the two groups allowed statistical analysis of the prognostic value of serum oxidized LDL for CVD risk in RA patients.Result :1.A total of 123 RA patients were enrolled,with an average age of approximately 56.22± 10.57 ages,a ratio of 1: 18.27 men to women,and an average disease duration of 4.48 ±7.03 years RA patients.Twenty(16.26%)had a history of diabetes,28(22.76%)had high blood pressure and 30(24.39%)had a history of smoking.The BMI level was 22.86±3.68,and the mean thickness of patients in the plaque group(c IMT > 0.9mm and/or plaque)was1.08±0.10 mm,The cases of unilateral,bilateral and calcified plaques were 29,26 and 1,respectively,accounting for 21.97%,19.70% and 0.76%.2.Serum levels of oxidized LDL were associated with several indicators(P<0.05).Patient ox LDL level were positively correlated with LDL-c levels CRP,DAS28-ESR 和 c IMT and carotid plaque are positive DAS28-ESR(correlation coefficients were r = 0.402,P =0.001,r = 0.198,P = 0.035,r = 0.387,P = 0.001,r = 0.719,P = 0.001,respectively).LDL-c was positively associated with Euro Score,ox LDL Level and c IMT and carotid plaque(correlation was r = 0.184,P = 0.041,r = 0.402,P = 0.001,r = 0.433,P = 0.001).3.CRP and ESR for acute inflammatory phase were significantly higher in the non-plaque group(t= 2.066,P = 0.041 and t = 3.331,P= 0.001)and DAS28-CRP and DAS28-ESR were significantly higher in the non-plaque group than in the non-plaque group(t=3.360,P=0.001,t = 2.735,P = 0.007).4.Separate risk factors for RA RA with Logistic regression analysis analysis of CVD showed that se rum ox LDL,LDL-c and DAS28-ESR score were independent risk factors,with OR values of 153.82,3.14,and 4.07,respectively.ROC curve analysis showed that serum ox LDL,DAS28-ESR,and serum LDL-c were 82.93% and 87.61%,86.42%,82.61%,70.12%,and 82.61%,respectively,of sensitivity and specificity to plaque prediction.ROC assay cutoff values were 1.086.54,3.25,subcurve area(AUC)was 0.937(95%CI: 0.895-0.980),0.855(95%CI: 0.778-0.932),0.775(95%CI: 0.688-0.863),and comprehensive prediction sensitivity and specificity were 93.51%,94.34% and 0.986(0.971-1.000)respectively.Conclusion:Previous studies have established traditional cardiovascular risk factor scoring systems that can only account for some CVD risks factors in RA patients.This study looked at associations between serum ox LDL levels,LDL levels,CRP,ESR,DAS28-CRP and DAS28-ESR,as well as c IMT thickening and plaques,confirming a strong association between these data and RA and cardiovascular risk.Important indicators for single-variable analysis of RA CVD risk factors included ox LDL,LDL-c,CRP,ESR,DAS28-ESR,DAS28-CRP,and Euro Score.However,the multivariate analysis,only ox LDL,DAS28-ESR and LDL-c were independent CVD risk in RA patients.Of these,ox LDL-C was the most valuable predictor of cardiovascular disease risk in rheumatoid arthritis patients,and the combination of LDL-c with disease activity score was highly predictive and specific. |
