AB0370 Low serum igf1 is associated with higher cardiovascular risk in the middle-aged women with rheumatoid arthritis independently of the disease related parameters. (12th June 2018)

• Record Type: Journal Article
• Authors: Erlandsson, M.C.; Silfverswärd, S.T.; Nadali, M.; Pullerits, R.; Bokarewa, M.I.
• Is Part Of: Annals of the rheumatic diseases. Volume 77(2018)Supplement 2
• Page Start: 1355
• Page End: 1355
• Publication Date: 2018-06-12
• Subjects: Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2018-eular.6397
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Objectives: To analyse the relation between serum levels of IGF1 and cardiovascular risk (CVR) in women with rheumatoid arthritis (RA). Methods: The risk of dying of CV disease within 5 years was calculated using the strategy proposed by Pocock et al. BMJ 2001 in 185 women with RA (mean age 51.7 years) with no previous history of CV events. The CVR and characteristics related to it were analysed with respect to serum IGF1. IGF1 levels below the median of the total cohort were considered low. Results: The RA women with low IGF1 (n=91, mean 104 pg/ml) had significantly higher CVR compared to those with normal IGF1 (n=94, mean 194 pg/ml) with the predicted risk of 0.51% and 0.17%, respectively (p>10–5). Among the traditional CVR factors, the low IGF1 group was 10 years older (mean 56.8 vs. 46.9 y, p=10–5), lower in height (165 vs. 168 cm, p=0.013, 21% of the patients being <160 cm) and had high prevalence of hypertension (24% vs. 8.5%, p=0.004), while current smoking was similar between the groups (15% vs. 14%). The low IGF1 group displayed the unfavourable metabolic profile with higher BMI (p=0.002) and obesity in 22%, higher predicted body fat content (mean 39.5 vs. 35%, p=10–5), and higher total and LDL cholesterol (p=0.0014 and p=0.0053, respectively). The levels of adiponectin (p=0.032) and HDL-cholesterol (p=0.25) tended to be higher in the low IGF1 group, which resulted in the comparable total cholesterol to HDL ratio between the groups. This could also explain that the prevalence of diabetes mellitus and metabolic syndrome were low. With exception of the disease duration, the groups displayed no significant difference in the RA-related CVR factors such as the disease activity measured by DAS28 (3.29 vs 2.99), systemic inflammation measured by serum IL6 (mean 8.46 vs. 5.99 pg/ml) and IL1β (mean 19.47 vs. 23.1 ng/ml), and the prevalence of seropositivity (91% vs. 92%). The prevalence of treatment with MTX monotherapy was higher in the low IGF1 group (56% vs. 39%, p=0.024), while the use of TNF-inhibitors and other biologic and synthetic anti-rheumatic drugs was similar within the groups. Conclusions: Serum IGF1 levels in the normal low range are associated with higher CVR in RA female patients. This increase in CVR seems to be independent of the RA-related characteristics. The combination of low height and hypertension argues for the important role of congenital factors in defining serum IGF1 levels in the studied RA women. Reference: [1] Pocock SJ, McCormack V, Gueyffier F, Boutitie F, Fagard RH, Boissel JP. A score for predicting risk of death from cardiovascular disease in adults with raised blood pressure, based on individual patient data from randomised controlled trials. BMJ2001;323:75–81. Disclosure of Interest: None declared