OP0117 HDL-C and HBA1C predict the development of inflammatory polyarthritis: Results from the european prospective investigation of cancer (norfolk) and the norfolk arthritis register (EPIC-2-NOAR study). (23rd January 2014)

• Record Type: Journal Article
• Authors: Gati, T.; Morgan, C.; Luben, R.N.; Lahiri, M.; Verstappen, S.M.; Bunn, D.K.; Lunt, M.; Symmons, D.P.; Wareham, N.J.; Khaw, K.-T.; Bruce, I.N.
• Is Part Of: Annals of the rheumatic diseases. Volume 71(2012)Supplement 3
• Page Start: 92
• Page End: 92
• Publication Date: 2014-01-23
• Subjects: Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2012-eular.1800
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Background: Rheumatoid Arthritis (RA) is associated with accelerated atherosclerosis and inflammation associated with RA may increase the propensity to develop dyslipidaemia and insulin resistance. In established RA, HDL-C (HDL) and ApoA-1 are negatively correlated with disease activity and insulin resistance is increased in RA patients. A few studies have suggested that lipid and glucose handling may be impaired prior to the onset of RA with Apo-B and triglyceride levels being found to be higher and HDL levels lower in those individuals who later develop inflammatory polyarthritis (IP). Objectives: To investigate the association between lipid levels, diabetes and glycated haemoglobin on future risk of IP. Methods: In the European Prospective Investigation of Cancer in Norfolk (EPIC-Norfolk) cohort, all participants completed a questionnaire at baseline and provided a non-fasting blood sample for routine lipid analysis. In subsets, additional biomarkers were measured including HbA1c, Apo-A1 and ApoB. Individuals with incident IP were identified by linkage with the Norfolk Arthritis Register (NOAR), a primary-care based disease register with an overlapping catchment area. We assessed the association of HDL, Apo-A1, ApoB and HbA1c with future risk of IP using Cox proportional hazard models. Confounders included age, gender, smoking status, smoking intensity, self-reported diabetes (DM) and Body Mass Index (BMI) and were controlled for in the final analyses. Results: 25, 455 EPIC participants aged 40-79 years were followed for a median (IQR) of 14.2 (12.9, 15.3) years (342, 916 person-years of follow-up). 184 developed incident IP (69.6% women). Univariately, HbA1c [HR=1.3 (95% CI: 1.09, 1.55) per 1% increase] was associated with an increased risk of IP, remaining significant after further adjustment for confounders [HR=1.24 (95% CI: 1.05, 1.47) per 1% increase]. Univariately, neither Apo-A1, Apo-B nor HDL levels predicted IP onset. When multiple biomarkers were included in a single multivariable model, both HDL and HbA1c were significantly associated with incident IP [HR 0.76 (95%CI: 0.57, 1.00) per 0.4mmol/l and 1.24 (95% CI: 1.05, 1.47) per 1% respectively]. Conclusions: In a prospective population-based cohort study low HDL and high HbA1c were identified as being associated with subsequent IP development. Several anti-inflammatory properties of HDL may be of relevance to its potential protective role. Glycated haemoglobin reflects insulin resistance which can promote a pro-inflammatory state in an at-risk population. Disclosure of Interest: None Declared