effect of combined rheumatoid arthritis and metabolic syndrome on endothelial dysfunction and the reliability of platelet endothelial cell adhesion molecule-I and matrix metalloproteinase-8 as markers for this dysfunction

ABSTRACT

Patients with rheumatoid arthritis [RA] and patients with metabolic syndrome [MetS] both are at increased risk for cardiovascular disease [CVD]. The present study aimed to evaluate the effect of association of RA with MetS on endothelial function measured by flow mediated dilatation [FMD] in females, as well as to find the possible role of platelet endothelial cell adhesion molecule-1 [PECAM-1] and matrix metalloproteinase-8 [MMP-8] on this function. forty eight female patients with RA, 21 of them had metabolic syndrome [RAMetS]. Forty nine female cases were enrolled as control cases, 25 of them had MetS [ContMetS]. C-reactive protein [CRP], MMP-8, Cartilage oligomeric matrix protein [COMP] and PECAM-i were assayed. Measurement of brachial artery FMD was performed using ultrasonography. RAMetS group had the highest level of MMP-8, PECAM-1 and CRP but it had the lowest FMD value than the other groups. FMD was found to correlate inversely with the severity of MetS as well as homeostasis model assessment-insulin resistance [HOMA-IR], CRP, MMP8, PECAM-1, rheumatoid factor [RF] and disease activity score in 28 joints [DAS28]. Endothelial cell dysfunction [ECD] proved by FMD impairment could be considered to be a common feature of RA as well as MetS. ECD was aggravated if both conditions were associated. Elevated MMP-8, PECAM-1 and CRP in RA patients and their correlation to FMD, point them to be contributing factors in the pathogenesis of ECD and the possibility to use them as biochemical markers for assessment of ECD in RA and/or MetS