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Systemic inflammation and disease activity seem to
contribute to excessive prevalence of cardiovascular
diseases in patients with rheumatoid arthritis.
RA is currently regarded as a novel, independent CVD
risk factor. Accelerated atherosclerosis, considered as an extraarticular
manifestation of RA, occurs as a result of interaction
between traditional CV risk factors and inflammatory activity
of joint disease. Both atherosclerosis and RA have in common
inflammatory mediators. The mechanisms which induce
synovial inflammation are similar to those in unstable
This study represents one of the studies that aimed to
detect the value of serum Glycated Albumin measurement as a
marker for RA associated coronary artery atherosclerosis and
also a marker for RA disease activity.
The present study included thirty middle aged RA
patients who were selected from outpatient clinic of
Rheumatology, Physical Medicine and Rehabilitation of Ain
Shams University Hospitals, diagnosed according to the 2010
American College of Rheumatology (ACR) and European
League Against Rheumatism (EULAR) criteria and fifteen age
matched patients known to have established coronary artery
disease were taken as controls from the cardiology department
of Ain Shams University Hospitals.All patients were subjected to detailed history taking,
clinical examination, laboratory investigations as CBC, ESR,
CRP, lipid profile, liver and kidney functions and calculation of
Serum Glycated Albumin (GA) level was measured in all
RA patients and controls by ELISA technique.
All RA patients and controls underwent carotid
ultrasound to measure the carotid intima-media thickness
Statistical analysis of the obtained clinical and laboratory
data showed a significant elevation of serum GA level in the
case group ranging from 28 to 120 pg/ml mean (48.333 ±
19.808) compared to the control group 15 to 30 pg/ml mean
(21.733 ± 4.891) pg/ml, as well as a significant difference in
the ESR results between the RA patients 12 - 93 and the control
group (19.7 - 32).
A statistically high significant correlation was found
between the GA and the DAS-28 disease activity scores among
the patients and also a significant positive correlation between
the GA and ESR and GA and CRP.
A highly significant difference was noticed regarding the
mean cIMT between the patients results 0.35-1.115mm and the
control group results 0.715-0.115mm with a statistically high
significant correlation between the GA and the mean cIMT.A positive correlation between the mean cIMT and the
disease duration of the rheumatoid patients was detected
denoting the more the disease duration the more the risk of
developing subclinical atherosclerosis.
The comparison between the presence of soft
atheromatous plaque and the mean cIMT gave positive increase
but negative results with the disease duration.
The correlation between the severe disease activity and
the mean cIMT was statistically significant while it revealed a
non-significant difference between mild and moderate disease
activity and mean cIMT.
In conclusion, our study highlighted that serum Glycated
Albumin sensitivity and specificity were 83.33% and 87.50% .
According to these findings serum GA is correlated with
disease activity and provides an additional diagnostic value in
detecting the subclinical atherosclerosis in RA patients.