Umeå University's logo

umu.sePublications
Change search
Link to record
Permanent link

Direct link
Publications (10 of 27) Show all publications
Boman, A., Kokkonen, H., Berglin, E., Alenius, G.-M. & Rantapää-Dahlqvist, S. (2023). Hormonal and reproductive factors in relation to cardiovascular events in women with early rheumatoid arthritis. Journal of Clinical Medicine, 12(1), Article ID 208.
Open this publication in new window or tab >>Hormonal and reproductive factors in relation to cardiovascular events in women with early rheumatoid arthritis
Show others...
2023 (English)In: Journal of Clinical Medicine, E-ISSN 2077-0383, Vol. 12, no 1, article id 208Article in journal (Refereed) Published
Abstract [en]

Hormonal and reproductive factors affect the risk for cardiovascular events (CVE) in the general population. Although the risk of CVE is increased in rheumatoid arthritis (RA), the knowledge about the impact of hormonal factors for CVE in RA is sparse. Female postmenopausal patients ≤80 years with early RA were consecutively included in this observational study (n = 803) between 1 January 1996 until 31 December 2017. Questionnaires regarding hormonal factors were distributed from the index date. Data regarding CVE were obtained from the Swedish National Health Register and Cause of Death Register. Associations between CVE and hormonal factors were analyzed using Cox proportional hazard regression. Of the postmenopausal women, 64 women had a CVE after RA onset. The time period from menopause to RA onset was significantly longer for CVE cases with higher proportion of postmenopausal women. In Cox proportional hazard regression models, years from last childbirth and multiparity were associated with higher CVE risk. Adjustments for traditional risk factors did not affect the results except for hypertension. RA onset after menopause and a longer duration from menopause until onset increased the CVE risk. Multiparity was associated with higher CVE risk whilst oral contraceptives decreased the risk. These results can contribute to identification of high-risk patients for CVE beyond traditional risk factors.

Place, publisher, year, edition, pages
MDPI, 2023
Keywords
cardiovascular disease, cardiovascular events, early rheumatoid arthritis, hormonal factors, reproductive factors, risk factors
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-213602 (URN)10.3390/jcm12010208 (DOI)000909098800001 ()36615009 (PubMedID)2-s2.0-85145986901 (Scopus ID)
Funder
Swedish Research Council, 2018-02551Stiftelsen Konung Gustaf V:s 80-årsfondSwedish Rheumatism AssociationUmeå University
Available from: 2023-08-29 Created: 2023-08-29 Last updated: 2023-08-29Bibliographically approved
Kokkonen, H., Johansson, L., Stenlund, H. & Rantapää-Dahlqvist, S. (2022). Cardiovascular risk factors before onset of rheumatoid arthritis are associated with cardiovascular events after disease onset: a case–control study. Journal of Clinical Medicine, 11(21), Article ID 6535.
Open this publication in new window or tab >>Cardiovascular risk factors before onset of rheumatoid arthritis are associated with cardiovascular events after disease onset: a case–control study
2022 (English)In: Journal of Clinical Medicine, E-ISSN 2077-0383, Vol. 11, no 21, article id 6535Article in journal (Refereed) Published
Abstract [en]

Background: The increased comorbidity and mortality in rheumatoid arthritis (RA) patients are largely due to cardiovascular disease (CVD). Previously, we demonstrated increased frequencies of risk factors for CVD (elevated body mass index (BMI), elevated apoliprotein (Apo) B:ApoA1 ratio, and smoking) in pre-RA individuals compared with matched controls. Objectives: Assess the impact of traditional CV risk factors present before the onset of RA on the risk of CV events (CVE) after diagnosis in comparison with matched controls. Methods: A case–control study including 521 pre-symptomatic individuals and 1566 controls identified within the Health Surveys of the Medical Biobank was performed. CVD risk factors were hypertension, elevated ApoB:A1 ratio, BMI, diabetes, and smoking. Information on comorbidities was requested from the Swedish National Patient Register and Cause of Death Register. Results: Pre-RA individuals had a higher risk of future CVE compared with matched controls (HR [95% CI] 1.70 [1.31–2.21]), which remained after adjustments for risk factors for CVD (HR [95% CI] 1.73 [1.27–2.35]). Most risk factors were associated with CVE after diagnosis, and a combination resulted in a higher risk in RA compared with controls; two risk factors, HR [95% CI] 2.70 [1.19–6.13] vs. 1.26 [0.75–2.13]; and three to four risk factors, HR [95% CI] 6.32 [2.92–13.68] vs. 3.77 [2.34–6.00]. Conclusions: Risk factors for CVD present in pre-RA individuals were associated with future CVE, and even after adjustments for these risk factors and treatments after RA onset, pre-RA individuals had a higher risk of CVE compared with controls. These findings further highlight the importance of the early assessment of risk for CVD.

Place, publisher, year, edition, pages
MDPI, 2022
Keywords
cardiovascular disease, rheumatoid arthritis, risk factors
National Category
Cardiac and Cardiovascular Systems Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-201228 (URN)10.3390/jcm11216535 (DOI)000883465600001 ()36362763 (PubMedID)2-s2.0-85141656161 (Scopus ID)
Funder
Swedish Research Council, 2018-02551Stiftelsen Konung Gustaf V:s 80-årsfondSwedish Rheumatism AssociationUmeå UniversityRegion Västerbotten
Available from: 2022-12-01 Created: 2022-12-01 Last updated: 2022-12-01Bibliographically approved
Kissel, T., Van Wesemael, T. J., Lundquist, A., Kokkonen, H., Kawakami, A., Tamai, M., . . . Toes, R. E. .. (2021). Genetic predisposition (HLA-SE) is associated with ACPA-IgG variable domain glycosylation in the predisease phase of RA. Annals of the Rheumatic Diseases, 16, 1-3
Open this publication in new window or tab >>Genetic predisposition (HLA-SE) is associated with ACPA-IgG variable domain glycosylation in the predisease phase of RA
Show others...
2021 (English)In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 16, p. 1-3Article in journal (Refereed) Published
Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2021
Keywords
anti-citrullinated protein antibodies, arthritis, autoimmune diseases, rheumatoid
National Category
Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:umu:diva-187005 (URN)10.1136/annrheumdis-2021-220841 (DOI)000723320800001 ()2-s2.0-85113169902 (Scopus ID)
Funder
Swedish Research Council, 2018–02551
Available from: 2021-08-31 Created: 2021-08-31 Last updated: 2023-09-05Bibliographically approved
Kissel, T., van Schie, K. A., Hafkenscheid, L., Lundquist, A., Kokkonen, H., Wuhrer, M., . . . Rantapää-Dahlqvist, S. (2019). On the presence of HLA-SE alleles and ACPA-IgG variable domain glycosylation in the phase preceding the development of rheumatoid arthritis. Annals of the Rheumatic Diseases, 78(12), 1616-1620
Open this publication in new window or tab >>On the presence of HLA-SE alleles and ACPA-IgG variable domain glycosylation in the phase preceding the development of rheumatoid arthritis
Show others...
2019 (English)In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 78, no 12, p. 1616-1620Article in journal (Refereed) Published
Abstract [en]

Objective: Anti-citrullinated protein antibodies (ACPA) in rheumatoid arthritis (RA) patients display a unique feature defined by the abundant presence of N-linked glycans within the variable domains (V-domains). Recently, we showed that N-glycosylation sites, which are required for the incorporation of V-domain glycans, are introduced following somatic hypermutation. However, it is currently unclear when V-domain glycosylation occurs. Further, it is unknown which factors might trigger the generation of V-domain glycans and whether such glycans are relevant for the transition towards RA. Here, we determined the presence of ACPA-IgG V-domain glycans in paired samples of pre-symptomatic individuals and RA patients.

Methods: ACPA-IgG V-domain glycosylation was analysed using ultra-high performance liquid chromatography (UHPLC) in paired samples of pre-symptomatic individuals (median interquartile range (IQR) pre-dating time: 5.8 (5.9) years; n=201; 139 ACPA-positive and 62 ACPA-negative) and RA patients (n=99; 94 ACPA-positive and 5 ACPA-negative).

Results: V-domain glycans on ACPA-IgG were already present up to 15 years before disease in pre-symptomatic individuals and their abundance increased closer to symptom onset. Noteworthy, human leucocyte antigen class II shared epitope (HLA-SE) alleles associated with the presence of V-domain glycans on ACPA-IgG.

Conclusion: Our observations indicate that somatic hypermutation of ACPA, which results in the incorporation of N-linked glycosylation sites and consequently V-domain glycans, occurs already years before symptom onset in individuals that will develop RA later in life. Moreover, our findings provide first evidence that HLA-SE alleles associate with ACPA-IgG V-domain glycosylation in the pre-disease phase and thereby further refine the connection between HLA-SE and the development of ACPA-positive RA.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2019
National Category
Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:umu:diva-167073 (URN)10.1136/annrheumdis-2019-215698 (DOI)000500726200016 ()31471298 (PubMedID)2-s2.0-85071766205 (Scopus ID)
Available from: 2020-01-13 Created: 2020-01-13 Last updated: 2023-03-23Bibliographically approved
Kissel, T., van Schie, K., Hafkenscheid, L., Lundquist, A., Scherer, H. U., Kokkonen, H., . . . Rantapää-Dahlqvist, S. (2019). Rising ACPA igg variable domain glycosylation pre-disease associates with an increase in autoantibody levels and the development of rheumatoid arthritis. Paper presented at Annual European Congress of Rheumatology (EULAR), Madrid, Spain, June 12-15, 2019. Annals of the Rheumatic Diseases, 78, 249-250
Open this publication in new window or tab >>Rising ACPA igg variable domain glycosylation pre-disease associates with an increase in autoantibody levels and the development of rheumatoid arthritis
Show others...
2019 (English)In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 78, p. 249-250Article in journal, Meeting abstract (Other academic) Published
Abstract [en]

Background: Anti-citrullinated protein antibodies (ACPA) are present in the majority of rheumatoid arthritis (RA) patients (60-70%) and play a pivotal role in disease development1. ACPA IgGs are unique in a way that they are abundantly N-glycosylated within their variable regions2. These variable domain (V-domain) glycans are found on over 90% of ACPAs present in sera from RA-patients3. To undergo N-linked glycosylation, a consensus sequence in the protein backbone is required (N-X-S/T, where X ≠ P)4. Recently, it was shown that the N-linked glycosylation sites in ACPA-IgG V-domains are introduced during somatic hypermutation and that the introduction of such sites likely conveys a selective advantage to ACPA expressing B-cells5. However, it is currently unknown, whether ACPA-expressing B-cells already introduced glycosylation-sites into their V-domains before disease onset or when ACPA-V-domain glycosylation occurs.

Objectives: Investigate the appearance of ACPA V-domain glycosylation in pre-symptomatic individuals and RA patients.

Methods In a case-control study, individuals (n=201) from the Medical Biobank, who were sampled before onset of symptoms (mean±SEM predating time; 5.8±0.3 years) (140 aCCP+ and 61 aCCP-), and after diagnosis of RA (n=99, 94 aCCP+ and 5 aCCP-) and randomly selected control samples (n=43, 3 aCCP+ and 40 aCCP-) were analyzed for their ACPA IgG V-domain glycosylation levels. ACPA IgGs were affinity purified, N-linked glycans released, and 2-AA labeled for further analysis using UHPLC6. Data calibration and integration was performed and a cut-off defined. Samples below the cut-off were determined as non-detectable and excluded from the analysis. The percentage V-domain glycosylation was calculated as described previously3. Statistical calculations were performed using SPSS.

Results: Our data indicated that ACPA IgG V-domain glycans are already present years before symptom onset, in pre-symptomatic individuals who subsequently will develop RA. Analysis of matched pairs showed a significant increase of ACPA V-domain glycosylation in RA patients compared to individuals pre-disease (p<0.001). The results showed that ACPA N-glycosylation was correlated with anti-CCP concentrations pre-disease (rs =0.504, p<0.001), while no such association can be found after RA onset. Further, V-domain glycosylation levels increase closer to symptom onset.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2019
National Category
Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:umu:diva-161721 (URN)10.1136/annrheumdis-2019-eular.5341 (DOI)000472207100546 ()
Conference
Annual European Congress of Rheumatology (EULAR), Madrid, Spain, June 12-15, 2019
Note

 Supplement: 2

Meeting Abstract: OP0333

Available from: 2019-07-26 Created: 2019-07-26 Last updated: 2020-01-23Bibliographically approved
Kindstedt, E., Johansson, L., Palmqvist, P., Koskinen Holm, C., Kokkonen, H., Johansson, I., . . . Lundberg, P. (2018). Association between marginal jawbone loss and the onset of rheumatoid arhtritis and relationship to plasma levels of RANKL. Arthritis & Rheumatology, 70(4), 508-515
Open this publication in new window or tab >>Association between marginal jawbone loss and the onset of rheumatoid arhtritis and relationship to plasma levels of RANKL
Show others...
2018 (English)In: Arthritis & Rheumatology, ISSN 2326-5191, E-ISSN 2326-5205, Vol. 70, no 4, p. 508-515Article in journal (Refereed) Published
Abstract [en]

Objective: To investigate whether periodontitis, characterized by marginal jawbone loss, precedes the onset of symptoms of rheumatoid arthritis (RA), and to analyze plasma levels of RANKL (a cytokine that is crucial for bone resorption) and anti–citrullinated peptide antibodies (ACPAs) in presymptomatic individuals compared with matched referent controls.

Methods: Marginal jawbone loss was measured on dental radiographs of the premolar/molar regions in the jaws in 176 subjects, 93 of whom subsequently developed RA. Among these participating subjects, 46 had documented radiographs predating symptom onset, and 45 cases could be matched to controls, according to sex, age, and smoking status. Plasma RANKL concentrations were analyzed using enzyme‐linked immunosorbent assay. A receiver operating characteristic curve was used to define the cutoff value for RANKL positivity.

Results: Bone loss was significantly greater in presymptomatic subjects classified as never smokers compared with that in controls, and increasing levels of bone loss were associated with a higher risk of the subsequent development of RA (hazard ratio 1.03, 95% confidence interval 1.01–1.05). No association between jawbone loss and RA was observed in smokers. A significantly greater extent of marginal jawbone loss was detected in RANKL‐positive presymptomatic subjects, and even more pronounced jawbone loss was observed in those who were positive for both RANKL and ACPA.

Conclusion: Marginal jawbone loss preceded the clinical onset of RA symptoms, but this was observed only in nonsmokers. Moreover, marginal jawbone loss was significantly greater in RANKL‐positive presymptomatic subjects compared with RANKL‐negative presymptomatic subjects and was highest in presymptomatic subjects positive for both ACPA and RANKL.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2018
National Category
Rheumatology and Autoimmunity
Research subject
rheumatology; Odontology
Identifiers
urn:nbn:se:umu:diva-146131 (URN)10.1002/art.40394 (DOI)000428697300005 ()29195021 (PubMedID)2-s2.0-85043335100 (Scopus ID)
Available from: 2018-04-03 Created: 2018-04-03 Last updated: 2023-03-24Bibliographically approved
Kindstedt, E., Johansson, L., Palmqvist, P., Koskinen Holm, C. & Kokkonen, H. (2018). Association between marginal jawbone loss and the onset of rheumatoid arhtritis and relationship to plasma levels of RANKL. Rheumatology, 70(4), 508-515
Open this publication in new window or tab >>Association between marginal jawbone loss and the onset of rheumatoid arhtritis and relationship to plasma levels of RANKL
Show others...
2018 (English)In: Rheumatology, ISSN 1462-0324, E-ISSN 1462-0332, Vol. 70, no 4, p. 508-515Article in journal (Refereed) Published
Abstract [en]

Objective: To investigate whether periodontitis, characterized by marginal jawbone loss, precedes the onset of symptoms of rheumatoid arthritis (RA), and to analyze plasma levels of RANKL (a cytokine that is crucial for bone resorption) and anti–citrullinated peptide antibodies (ACPAs) in presymptomatic individuals compared with matched referent controls.

Methods: Marginal jawbone loss was measured on dental radiographs of the premolar/molar regions in the jaws in 176 subjects, 93 of whom subsequently developed RA. Among these participating subjects, 46 had documented radiographs predating symptom onset, and 45 cases could be matched to controls, according to sex, age, and smoking status. Plasma RANKL concentrations were analyzed using enzyme‐linked immunosorbent assay. A receiver operating characteristic curve was used to define the cutoff value for RANKL positivity.

Results: Bone loss was significantly greater in presymptomatic subjects classified as never smokers compared with that in controls, and increasing levels of bone loss were associated with a higher risk of the subsequent development of RA (hazard ratio 1.03, 95% confidence interval 1.01–1.05). No association between jawbone loss and RA was observed in smokers. A significantly greater extent of marginal jawbone loss was detected in RANKL‐positive presymptomatic subjects, and even more pronounced jawbone loss was observed in those who were positive for both RANKL and ACPA.

Conclusion: Marginal jawbone loss preceded the clinical onset of RA symptoms, but this was observed only in nonsmokers. Moreover, marginal jawbone loss was significantly greater in RANKL‐positive presymptomatic subjects compared with RANKL‐negative presymptomatic subjects and was highest in presymptomatic subjects positive for both ACPA and RANKL.

Place, publisher, year, edition, pages
Oxford University Press, 2018
National Category
Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:umu:diva-143006 (URN)10.1002/art.40394 (DOI)000428697300005 ()29195021 (PubMedID)2-s2.0-85043335100 (Scopus ID)
Available from: 2017-12-14 Created: 2017-12-14 Last updated: 2023-03-24Bibliographically approved
Johansson, L., Kindstedt, E., Palmqvist, P., Holm, C. K., Kokkonen, H., Johansson, I., . . . Rantapää-Dahlqvist, S. (2018). Marginal jawbone loss is associated with onset of rheumatoid arthritis and is related to plasma level of receptor activator of nuclear factor kappa-B ligand. Scandinavian Journal of Rheumatology, 47, 22-22
Open this publication in new window or tab >>Marginal jawbone loss is associated with onset of rheumatoid arthritis and is related to plasma level of receptor activator of nuclear factor kappa-B ligand
Show others...
2018 (English)In: Scandinavian Journal of Rheumatology, ISSN 0300-9742, E-ISSN 1502-7732, Vol. 47, p. 22-22Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
Taylor & Francis, 2018
National Category
Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:umu:diva-151577 (URN)000442295400034 ()
Note

Supplement: 129

Meeting Abstract: PP17

Available from: 2018-09-07 Created: 2018-09-07 Last updated: 2018-09-07Bibliographically approved
Johansson, L., Ärlestig, L., Kokkonen, H., Brink, M. & Rantapää-Dahlqvist, S. (2017). An increased concentration of receptor activator of nuclear factor kappa-B ligand pre-dates the onset of rheumatoid arthritis. Rheumatology, 56(12), 2190-2196
Open this publication in new window or tab >>An increased concentration of receptor activator of nuclear factor kappa-B ligand pre-dates the onset of rheumatoid arthritis
Show others...
2017 (English)In: Rheumatology, ISSN 1462-0324, E-ISSN 1462-0332, Vol. 56, no 12, p. 2190-2196Article in journal (Refereed) Published
Abstract [en]

Objectives: RANK ligand (RANKL) is involved in destruction and osteoporosis in RA. In this study, the relationships between RANKL and ACPA, anti-carbamylated protein antibodies (anti-CarP), cytokines and chemokines were analysed in individuals before the onset of RA symptoms, and their associations with radiological findings at disease onset were assessed.

Methods: This was a case-control study performed within the Medical Biobank of Northern Sweden that included 470 pre-symptomatic individuals [334 women and 136 men; mean (S.D.) age 52.3 (9.4) years] using blood samples donated before symptom onset (pre-dating time; 5.0 years) and 96 controls (60 women and 36 men). Plasma was analysed for RANKL (BioVendor, Karasek, Brno, Czech Republic), anti-CCP2 antibodies (Eurodiagnostics, Malmo, Sweden), anti-CarP antibodies (in-house ELISA), ACPA specificities (ISAC-platform, Phadia AB, Uppsala, Sweden) and cytokines/chemokines (Meso Scale Discovery methods, Rockville, MD, USA). Radiographs of hands and feet were graded using the Larsen score.

Results: The concentration of RANKL was higher in the pre-symptomatic individuals compared with controls; mean (S.E.M.): 0.50 (0.03) vs 0.22 (0.02) nmol/l (P < 0.001). The concentration increased gradually over time until symptom onset but appeared later than ACPA/RF/anti-CarP antibodies. Positivity for these antibodies yielded higher levels of RANKL compared with seronegativity (P < 0.001). RANKL concentrations were significantly associated with IL-6 and IL-10 concentrations. The combination of positivity for RANKL and anti-CarP antibodies resulted in a higher Larsen score at diagnosis beta = 6.18 (95% CI: 0.93, 11.43; P = 0.022).

Conclusion: RANKL concentrations were increased several years before symptom onset for RA, particularly in ACPA/RF/anti-CarP-positive individuals, all detectable earlier than RANKL. Positivity for RANKL and anti-CarP antibodies yielded the highest Larsen score at disease onset.

Place, publisher, year, edition, pages
Oxford University Press, 2017
Keywords
RANK ligand, ACPA, anti-CarP IgG, RA, pre-symptomatic individuals
National Category
Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:umu:diva-163051 (URN)10.1093/rheumatology/kex339 (DOI)000416628500027 ()29029341 (PubMedID)2-s2.0-85038129437 (Scopus ID)
Available from: 2019-09-11 Created: 2019-09-11 Last updated: 2023-03-24Bibliographically approved
Kokkonen, H., Stenlund, H. & Rantapää-Dahlqvist, S. (2017). Cardiovascular risk factors predate the onset of symptoms of rheumatoid arthritis: a nested case-control study. Arthritis Research & Therapy, 19, Article ID 148.
Open this publication in new window or tab >>Cardiovascular risk factors predate the onset of symptoms of rheumatoid arthritis: a nested case-control study
2017 (English)In: Arthritis Research & Therapy, ISSN 1478-6354, E-ISSN 1478-6362, Vol. 19, article id 148Article in journal (Refereed) Published
Abstract [en]

Background: Patients with rheumatoid arthritis (RA) are at increased risk of developing cardiovascular disease (CVD). Our aim was to evaluate the impact of factors related to CVD, such as smoking, lipid levels, hypertension, body mass index (BMI) and diabetes, in individuals prior to the onset of symptoms of RA. Methods: A nested case-control study was performed including data from 547 pre-symptomatic individuals (i.e. individuals who had participated in population surveys in northern Sweden prior to onset of symptoms of RA, median time to symptom onset 5.0 (interquartile range 2.0-9.0) years) and 1641 matched controls. Within the survey, health examinations prior to symptom onset were performed, blood samples were analysed for plasma glucose and lipids, and data on lifestyle factors had been collected with a questionnaire. CVD risk factors were extracted and further analysed with conditional logistic regression models for association with subsequent RA development, including hypertension, apolipoprotein (Apo) B/ApoA1 ratio, BMI, diabetes and smoking habits. Results: Smoking and BMI >= 25 (odds ratio (OR) (95% confidence interval (CI)) = 1.86 (1.48-2.35) and OR = 1.28 (1.01-1.62), respectively) were associated with increased risk for future RA development. In women, elevated ApoB/ApoA1 ratio (OR = 1.36 (1.03-1.80)) and smoking (OR = 1.82 (1.37-2.41)) were significantly associated with being pre-symptomatic for RA, whilst in men smoking (OR = 1.92 (1.26-2.92)) and diabetes (OR = 3.62 (95% CI 1.13-11.64)) were significant. In older (> 50.19 years) individuals, only smoking (OR = 1.74 (1.24-2.45)) was significantly associated with increased risk of future RA, whereas in younger individuals the significant factors were elevated ApoB/ApoA1 ratio (OR = 1.39 (1.00-1.93)), BMI >= 25.0 (OR = 1.45 (1.04-2.02)) and smoking (OR = 2.11 (1.51-2.95)). Pre-symptomatic individuals had a higher frequency of risk factors: 41.5% had >= 3 compared with 30.4% among matched controls (OR = 2.81 (1.78-4.44)). Conclusions: Several risk factors for CVD were present in pre-symptomatic individuals and significantly associated with increased risk for future RA. These factors differed in women and men. The CVD risk factors had a greater impact in younger individuals. These results urge an early analysis of cardiovascular risk factors for proposed prevention in patients with early RA.

Place, publisher, year, edition, pages
BioMed Central, 2017
Keywords
Rheumatoid arthritis, Cardiovascular disease, Body mass index, Apolipoproteins, Diabetes mellitus, Smoking
National Category
Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:umu:diva-138558 (URN)10.1186/s13075-017-1351-8 (DOI)000404797300003 ()28666478 (PubMedID)2-s2.0-85021725421 (Scopus ID)
Available from: 2017-09-13 Created: 2017-09-13 Last updated: 2023-03-24Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-9600-5364

Search in DiVA

Show all publications