Serum Angiopoietin-2 in Patients with Rheumatoid Arthritis and its Relation to Metabolic Syndrome
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- Category: Vol. 82, December 2014
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Serum Angiopoietin-2 in Patients with Rheumatoid Arthritis and its Relation to Metabolic Syndrome, SALAH A. ARGOON and HESHAM ABD-ELRAHEEM
Abstract
Background: Rheumatoid arthritis (RA) is an inflammatory disease associated with high risk of cardiovascular disease (CVD). Metabolic syndrome (MS), a cluster of risk factors for CVD, is highly prevalent in RA patients. Angiopoietin-2 (Ang-2) is a marker of endothelial cell activation which makes the endothelium responsive to inflammatory cytokines. Ob-jective: This study aims to assess serum level of Ang-2 in patients with RA and its relation to the presence of MS.
Patients and Methods: The study included sixty RA patients and age and sex matched 30 healthy volunteers as control group. All participants were subjected to full history taking, thorough clinical examination and laboratory investi-gations including: Complete blood count (CBC), erthyrocyte sedimentation rate (ESR), rheumatoid factor (RF), C-reactive protein (CRP), fasting lipid profile (total cholesterol, TG, HDL-C, LDL-C), fasting serum glucose, kidney and liver function tests. Enzyme linked immunosorbent assay (ELISA) was used for estimation of serum Ang-2. RA patients were classified according to the presence of MS, as recommended by the National Cholesterol Education Program (Adult Treat-ment Panel III), into 24 RA patients with MS and 36 RA patients without MS. RA activity was measured using Disease Activity Score-28 (DAS-28).
Results: The study showed that RA patients had signifi-cantly higher serum Ang-2 level than control group (p=0.000). Also, the study found that RA patients either with or without MS had significantly higher serum Ang-2 level than control group (p=0.000 for each). Also, the study revealed that RA patients with MS had significantly higher serum Ang-2 level than RA patients without MS (p=0.001). In RA patients, the study showed that serum Ang-2 level had significant positive correlation to the following components of the MS; systolic blood pressure (r=0.361, p=0.001), diastolic blood pressure (r=0.352, p=0.001), fasting serum glucose (r=0.290. p=0.009), and serum triglyceride levels (r=0.241, p=0.031). Also, serum Ang-2 level was positively correlated to RA disease activity (DAS-28) (r=0.225 and p=0.045). Conclusion; we concluded that serum angiopoietin-2 levels are elevated in patients with rheumatoid arthritis. This elevation is more prominent in the presence of metabolic syndrome and may be used as a marker of increased cardiovascular risk. Further studies should be done targeting serum angiopoietin-2 as a drug candidate where functional blockade could seem to protect against endothelial damage in such patients.