| Objective:Rheumatoid arthritis (RA) is a chronic and systemicinflammatory autoimmune disease, characterized with symmetric polyarthritis.Recently, many researchers have observed that cardiocerebrovascular disease(CCVD) had high incidence in RA patients. It serious influenced daily life,and its mechanism was not very clear. The impairment of endothelial functionand platelet activation of RA patients had become a research hotspot in recentyears. The aim of this study was to investigate the impairment of endothelialfunction and platelet activation of RA patients through measuring the levels ofendothelin-1(ET-1), soluble thrombomodulin(sTM) and alpha-granular memb-rane protein-140(GMP-140), and analyzing the correlationship between theseparameters and the clinical parameters such as ESR, CRP, DAS28and so on,to discuss the risk of CCVD in RA patients and provide certain reference fortreatment of RA.Methods:32RA patients and20normal controls aged over30years werechosen. The diagnosis of RA was consistent with the major classificationcriteria revised by American College of Rheumatoligy (ACR) and EuropeanLeague Against Rheumatism (EULAR). All the subjects were excluded anyother rheumatic diseases, endocrine diseases,blood diseases, CCVD except forhypertension, liver and kidney disease. All the RA patients had not beentreated by biological antirheumatic drug. The levels of serum ET-1, sTM, andGMP-140were determined by avidin biotin peroxidase complexenzyme-linked immunosorbent assay (ABC-ELISA), and compared withnormal controls. RA patients were divided into simple RA group (21patients)and RA with hypertension group (11patients) according to their bloodpressure, and statistical analysis was performed. The clinical data of RA patients were collected such as age, sex, disease duration, erythrocyte sedime-ntation rate (ESR), c-reactive protein(CRP), platelet(PLT), rheumatoidfactor(RF), DAS28and total cholesterol(TC), etc. The correlation betweenabove parameters were analyzed.All the data were analyzed by SPSS13.0for Windows statistical software.All the measurement data which met normal distribution were expressed asmean number±standard deviation (x±s). The t or t' test was adopted forcomparison between two groups. Analysis of variance was adopted forcomparison between multiple groups. Chi-square test was used for thecomparison of the enumeration data.Linear correlation analysis was performedfor correlationship. The measurement data which did not met normaldistribution were expressed as median and quartile range (M,QR), rank-sumtest was adopted for comparison, and rank correlation analysis was performedfor correlationship. P value<0.05was considered significant.Results:1The demographic details in RA: The RA group comprised32patients (26women and6men) The mean disease duration was (9.25±5.62) yr (range6months to20years). The mean age was (56.13±10.48) yr (range33years to77years).There were11cases in RA combined with hypertension group (10women and1man), and the mean disease duration was (9.86±6.54) years,with a mean age of (60.27±9.25) yr. There were21cases in simple RAgroup(16women and5men) and the mean disease duration at presentationwas(8.93±5.22)yr, with a mean age of (53.95±10.62)yr. The normal controlcomprised20subjects(13women and7men), with a mean age of(52.50±11.04)yr(range30years to67years). There was no significantdifference between the RA group and control group in age and gender(P>0.05). So was between RA combined with hypertension group, simple RAgroup and control group in age and gender (P>0.05).2The serum levels of ET-1, sTM and GMP-1402.1Compared between RA group and normal controls: The serum levels ofET-1in RA group(67.14±17.89)ng/L were significantly higher (P=0.001) than normal controls(51.89±11.26)ng/L. The serum levels of sTM in RAgroup(3.79±0.95)ng/L were significantly higher (P=0.010) than normalcontrols(3.09±0.84)ng/L. The serum levels of GMP-140in RA group(10.39±2.08)μg/L were significantly higher (P=0.012) than normal controls(8.88±2.00)μg/L.2.2Compared between simple RA group, RA combined with hypertensiongroup and normal controls:2.2.1Both of the serum levels of ET-1in simple RA group (66.69±18.35) ng/Land RA combined with hypertension group (67.99±17.82) ng/L weresignificantly higher than normal control(s51.89±11.26)ng/L(P<0.05). Therewas no significant difference between simple RA group and RA combinedwith hypertension group(P>0.05).2.2.2Both of the serum levels of sTM in simple RA group (3.73±1.05) ng/Land RA combined with hypertension group (3.90±0.76) ng/L weresignificantly higher than normal controls(3.09±0.84)ng/L(P<0.05). Therewas no significant difference between simple RA group and RA combinedwith hypertension group(P>0.05).2.2.3Both of the serum levels of GMP-140in simple RA group(10.20±2.17)μg/L and RA combined with hypertension group(10.78±1.94)μg/L weresignificantly higher than normal control(s8.88±2.00)μg/L(P<0.05). There wasno significant difference between simple RA group and RA combined withhypertension group(P>0.05).3Linear correlation analysis of ET-1, sTM and GMP-140in RA group3.1The serum level of ET-1was positively correlated with sTM and GMP-140(r=0.466,P=0.007; r=0.511,P=0.003),and the serum level of sTM waspositively correlated with GMP-140(r=0.544,P=0.001).3.2Correlation analysis of ET-1, sTM, GMP-140and clinic parameters3.2.1Except the positive correlation between ET-1and ESR, CRP, DAS28(r=0.512,P=0.003；r=0.392,P=0.027；r=0.395,P=0.025), the positivecorrelation between sTM and ESR, DAS28(r=0.377,P=0.034；r=0.388,P=0.028), the positive correlation between GMP-140and ESR, DAS28 (r=0.557,P=0.001；r=0.592,P=0.000), there was no correlation between thethree indicators and other clinical parameters.3.2.2In simple RA group, except the positive correlation between ET-1andESR (r=0.516,P=0.017), the positive correlation between sTM and ESRr=0.496,P=0.022), the positive correlation between GMP-140and ESR,DAS28(r=0.497,P=0.022；r=0.508,P=0.019), there was no correlationbetween the three indicators and other clinical parameters.3.2.3In RA combined with hypertension group, the serum level of GMP-140was positively correlated with ESR and DAS28(r=0.665,P=0.025；r=0.946,P=0.000), there was no correlation between the three indicators and otherclinical parameters.Conclusions:1There were high level ET-1, sTM and GMP-140in RA. The study showeddemage of endothelial function and platelet activation in RA.And the risk ofCCVD was increased in RA patients.2The serum levels of ET-1, sTM and GMP-140in RA were positivelycorrelated with each other. The high risk of CCVD was caused by theinteraction of these factors in RA.3The serum levels of ET-1, sTM and GMP-140were related with diseaseactivity of RA,and not related with hypertension.4The risk of CCVD maybe decrease through controlling disease activity ofRA. |
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