Antioxidants and other novel cardiovascular risk factors in subjects with rheumatoid arthritis in a large population sample

Authors

  • Paola De Pablo,

    Corresponding author
    1. Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
    2. Tufts-New England Medical Center, Tufts University School of Medicine, Boston, Massachusetts
    • Division of Rheumatology, Tufts-New England Medical Center, 750 Washington Street, Box 406, Boston, MA 02111
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  • Thomas Dietrich,

    1. School of Dental Medicine, Boston University, Boston, Massachusetts
    2. Charité Hospital, Humboldt University, Berlin, Germany
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  • Elizabeth W. Karlson

    1. Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
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Abstract

Objective

To compare antioxidants and other novel and traditional cardiovascular disease (CVD) risk factors in participants with rheumatoid arthritis (RA) and non-RA controls in a large population sample.

Methods

The Third National Health and Nutrition Examination Survey (NHANES-III) was a cross-sectional population survey in which subjects ages ≥60 underwent a musculoskeletal examination. RA subjects were defined as those who met ≥3 of 6 available 1987 American College of Rheumatology (ACR) criteria. Non-RA subjects were defined as those who met no ACR criteria. We performed univariate and multivariate analyses of the association between RA and each novel and traditional CVD risk factor in RA versus non-RA subjects.

Results

The sample included 5,302 subjects ages ≥60, with 131 (2.5%) RA and 4,444 (84%) non-RA participants. A total of 727 subjects were excluded. Plasma levels of antioxidants α-carotene, β-cryptoxanthin, lutein/zeaxanthin, and lycopene were significantly lower in RA subjects compared with non-RA subjects in multivariate analysis adjusting for potential confounders. Compared with non-RA participants, RA subjects were more likely to have increased C-reactive protein (CRP) levels in multivariate analysis adjusting for potential confounders. RA and non-RA participants had similar prevalence of traditional CVD risk factors and previous CVD.

Conclusion

In this large population study, RA subjects had similar prevalence of previous CVD and traditional CVD risk factors as controls. Among novel CVD risk factors, plasma carotenoid levels were significantly lower and CRP level was significantly higher in RA compared with non-RA subjects after adjustment for potential confounders. Further research should evaluate whether these differences account for the observed increased incidence of CVD in individuals with RA.

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