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Vascular Age, Metabolic Panel, Cardiovascular Risk and Inflammaging in Patients With Rheumatoid Arthritis Compared
Gabriel-Santiago Rodríguez-Vargas1,2, Pedro Santos-Moreno2, Jaime-Andrés Rubio-Rubio1
1Research Institute, Fundación Universitaria de Ciencias de la Salud-FUCS, Bogotá, Colombia.
Insights
Rheumatoid arthritis patients treated to target showed no difference in vascular age compared to osteoarthritis patients. However, methotrexate use in RA patients was associated with lower vascular age, suggesting a potential impact on cardiovascular disease risk.
Area of Science:
- Rheumatology
- Cardiology
- Aging Research
Background:
- Rheumatoid arthritis (RA) significantly increases cardiovascular disease (CVD) risk (1.5-2x general population).
- Aging is a primary CVD risk factor, involving arterial changes.
- Inflammaging and metabolic factors may influence vascular health in RA.
Purpose of the Study:
- Compare vascular age (VA) in RA patients under strict treat-to-target (T2T) strategy versus osteoarthritis (OA) patients.
- Assess the impact of inflammaging and metabolic markers on VA in these groups.
Main Methods:
- Analytical cross-sectional study comparing RA (T2T) and OA patients.
- Exclusion criteria: uncontrolled hypertension, CVD, current smoking.
- Measurements included BMI, waist-hip ratio, DAS-28, inflammatory markers, lipid profile, glycaemia, and pulse wave velocity (PWV) for VA calculation.
- Eleven inflammaging components (interleukins, MMPs, TIMPs) were analyzed.
Main Results:
- No significant differences in VA, inflammaging, or PWV between RA and OA groups.
- VA showed a weak positive correlation with age and LDL cholesterol.
- RA patients not receiving methotrexate had higher VA (p=0.013).
- LDL levels correlated with MMP1, TIMP1, and TIMP2.
Conclusions:
- Despite strict T2T in RA, no VA difference was observed compared to OA patients.
- Methotrexate treatment in RA patients appears to influence VA.
- Therapeutic strategies may impact both joint inflammation and CVD risk.
Introduction:
The risk of cardiovascular disease (CVD) in patients with rheumatoid arthritis (RA) is 1.5-2 times higher than the general population. The fundamental risk factor for CVD is age, related to alterations at the arterial level. The aim of the study was to compare vascular age (VA) in RA patients under a strict treat-to-target (T2T) strategy with Osteoarthritis (OA) patients without strict follow up and to assess the influence of inflammaging (chronic, sterile, low-grade inflammation related to aging) and metabolic markers on VA.
Materials And Methods:
This was an analytical cross-sectional study. Patients with RA (under a strict a T2T strategy) and OA patients without strict clinical follow-up were included. Patients with a history of uncontrolled hypertension, CVD, and/or current smoking were excluded. Sociodemographic, physical activity, and toxic exposure data were obtained. Waist-hip ratio and body mass index (BMI) were measured. DAS-28 (RA) and inflammatory markers, lipid profile, and glycaemia were analyzed. Pulse wave velocity (PWV) was measured (oscillometric method, Arteriograph-TensioMed®). VA was calculated based on PWV. Eleven components of inflammaging [six interleukins, three metalloproteinases (MMP), and two tissue inhibitors of metalloproteinases (TIMP)] were evaluated (Luminex® system). Univariate and bivariate analyzes (Mann Whitney U and chi-square) and correlations (Spearmans Rho) were done to compare the two groups.
Results:
A total of 106 patients (74% women) were included, 52/RA and 54/OA. The mean age was 57 (Interquartile range - IQR 9 years). The BMI, waist circumference, and weight were higher in patients with OA (p < 0.001). RA patients had low disease activity (DAS-28-CRP). There were no differences in VA, inflammaging nor in PWV between the two groups. VA had a positive, but weak correlation, with age and LDL. In group of RA, VA was higher in those who did not receive methotrexate (p = 0.013). LDL levels correlated with MMP1, TIMP1, and TIMP2.
Conclusions:
When comparing RA patients with low levels of disease activity with OA patients with poor metabolic control, there are no differences in VA. Furthermore, methotrexate also influences VA in RA patients. This shows that implemented therapies may have an impact on not only the inflammatory state of the joint but also CVD risk.
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