Presence of anticitrullinated protein antibodies in a large population-based cohort from the Netherlands. Issue 7 (2nd January 2017)

• Record Type: Journal Article
• Authors: van Zanten, A; Arends, S; Roozendaal, C; Limburg, P C; Maas, F; Trouw, L A; Toes, R E M; Huizinga, T W J; Bootsma, H; Brouwer, E
• Is Part Of: Annals of the rheumatic diseases. Volume 76:Issue 7(2017)
• Page Start: 1184
• Page End: 1190
• Publication Date: 2017-01-02
• Subjects: Epidemiology -- Ant-CCP -- Smoking; Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2016-209991
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Objectives: To determine the prevalence of anticitrullinated protein antibodies (ACPAs) and their association with known rheumatoid arthritis (RA) risk factors in the general population. Methods: Lifelines is a multidisciplinary prospective population-based cohort study in the Netherlands. Cross-sectional data from 40 136 participants were used. The detection of ACPA was performed by measuring anti-CCP2 on the Phadia-250 analyser with levels ≥6.2 U/mL considered positive. An extensive questionnaire was taken on demographic and clinical information, including smoking, periodontal health and early symptoms of musculoskeletal disorders. RA was defined by a combination of self-reported RA, medication use for the indication of rheumatism and visiting a medical specialist within the last year. Results: Of the total 40 136 unselected individuals, 401 (1.0%) had ACPA level ≥6.2 U/mL. ACPA positivity was significantly associated with older age, female gender, smoking, joint complaints, RA and first degree relatives with rheumatism. Of the ACPA-positive participants, 22.4% had RA (15.2% had defined RA according to our criteria and 7.2% self-reported RA only). In participants without RA, 311 (0.8%) were ACPA-positive. In the non-RA group, older age, smoking and joint complaints remained significantly more frequently present in ACPA-positive compared with ACPA-negative participants. Conclusions: In this large population-based study, the prevalence of ACPA levels ≥6.2 U/mL was 1.0% for the total group and 0.8% when excluding patients with RA. Older age, smoking and joint complaints were more frequently present in ACPA-positive Lifelines participants. To our knowledge, this study is the largest study to date on ACPA positivity in the general, mostly Caucasian population.