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首页> 外文期刊>American Journal of Nephrology >Association of Antibodies to Citrullinated Protein Antigens with Blood Pressure in First-Degree Relatives of Rheumatoid Arthritis Patients: The Studies of the Etiology of Rheumatoid Arthritis
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Association of Antibodies to Citrullinated Protein Antigens with Blood Pressure in First-Degree Relatives of Rheumatoid Arthritis Patients: The Studies of the Etiology of Rheumatoid Arthritis

机译：抗体蛋白抗原与类风湿性关节炎患者的一级亲属血压抗体与血压的缔合的关联：类风湿性关节炎病因研究

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Background: Hypertension is more common in patients with rheumatoid arthritis (RA) than in the general population. It is unknown whether hypertension is due to RA-related medications or the disease itself. Therefore, we sought to investigate associations between RA-related autoantibodies, specifically antibodies to citrullinated protein antigens (ACPA) and systolic blood pressure (SBP) and diastolic blood pressure (DBP) in first-degree relatives of RA patients, who were free of RA and RA-related medications. We hypothesized that a greater number of detectable ACPA would be associated with high SBP and DBP, independent of other risk factors in these first-degree relatives. Methods: We evaluated associations between ACPA and SBP and DBP in a cross-sectional study of 72 first-degree relatives (defined as parent, child, or sibling) of RA patients. Fifteen ACPA were measured using a Bio-Plex bead-based assay; each was dichotomized as positive/negative based on pre-specified cut-points. Analysis of covariance was used to evaluate associations between ACPA positivity and SBP and DBP, adjusting for age, sex, race, body mass index (BMI), pack-years of smoking, high sensitivity C-reactive protein (hsCRP), and current use of anti-hypertensive medications. Results: Average age was 51 and 69% were women. Mean SBP was 119 +/- 18 and DBP was 74 +/- 9 mm Hg. Thirty-three (46%) first-degree relatives were positive for = 1 ACPA; and were younger, had lower BMI, more pack-years of smoking, and higher hsCRP concentrations compared to ACPA negative first-degree relatives. For each additional positive ACPA, SBP was 0.98 +/- 0.5 mm Hg (p = 0.05) higher, and DBP was 0.66 +/- 0.3 mm Hg (p = 0.04) higher. Anti-cit-fibrinogen A (211-230) positive and anti-cit-filaggrin positive first-degree relatives had 11.5 and 13.9 mm Hg higher SBP (p = 0.02) respectively. Anti-cit-clusterin, cit-filaggrin, and cit-vimentin positive first-degree relatives had 7-8 mm Hg higher DBP (p = 0.03, 0.05, 0.05 respectively), compared to being negative for these individual ACPA. Consistent with associations between ACPA, SBP, and DBP, anti-cyclic citrullinated peptides (anti-CCP2) positive first-degree relatives had 16.4 +/- (p = 0.03) higher SBP and 12.1 +/- mm Hg (p = 0.01) higher DBP than anti-CCP2 negative first-degree relatives. Conclusion: In first-degree relatives without RA, ACPA positivity is associated with higher SBP and DBP. Subclinical autoimmune processes and ACPA may play a role in the vascular changes potentially leading to hypertension prior to RA onset. (C) 2017 S. Karger AG, Basel
机译：背景：高血压在类风湿性关节炎（RA）患者比在一般人群中更常见。尚不清楚高血压是否是由于RA相关的药物或疾病本身。因此，我们试图调查RA相关的自身抗体，特别是抗菌蛋白抗原（ACPA）和收缩压（SBP）和收缩压（SBP）和舒张压（DBP）的一致性亲属的抗体，他是没有RA的和ra相关的药物。我们假设大量可检测的ACPA与高SBP和DBP相关，与这些一级亲属中的其他风险因素无关。方法：我们在横截面研究中评估了ACPA和SBP和DBP的缔截面研究的横断面研究（定义为RA患者的父母，儿童或兄弟姐妹）。使用Bio-Plex珠粒的测定测量十五个ACPA;每个都基于预先指定的切割点作为正/阴性分化为正/阴性。协方差分析用于评估ACPA阳性和SBP和DBP之间的关联，调整年龄，性别，种族，体重指数（BMI），包装多年的吸烟，高敏感性C-反应蛋白（HSCRP）和电流使用抗高血压药物。结果：平均年龄为51岁，69％是女性。平均SBP为119 +/- 18，DBP为74 +/- 9毫米HG。三十三（46％）的一级亲属对＆ = 1 acpa;并且较年轻，较低的BMI，更多的软饮料，较高的吸烟，以及较高的HSCRP浓度与ACPA负一的一级亲属相比。对于每种额外的阳性ACPA，SBP高0.98 +/- 0.5mm Hg（p = 0.05），DBP为0.66 +/- 0.3mm Hg（p = 0.04）。抗Cit-Fibrinogen A（211-230）阳性和抗熊蛋白阳性第一度亲属分别具有11.5和13.9mm Hg较高的SBP（P = 0.02）。与这些单独的ACPA的阴性相比，抗Cit-Filaggrin和Cit-VimentIn阳性一级亲属具有7-8mm Hg较高的DBP（分别为P = 0.03,0.05,0.05，0.05,0.05。与ACPA，SBP和DBP之间的关联，抗循环柑橘肽（抗CCP2）阳性一级亲属的缔合物一致具有16.4 +/-（P = 0.03）较高的SBP和12.1 +/- mm Hg（P = 0.01）比抗CCP2负一级亲属更高的DBP。结论：在没有RA的一级亲属，ACPA阳性与较高的SBP和DBP相关。亚临床自身免疫过程和ACPA可能在血管变化中发挥作用，可能在ra发作之前导致高血压。 （c）2017年S. Karger AG，巴塞尔

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