1,2Suad Hannawi, 3Maria Alsalmi, 1Haifa Hannawi
1Emirates Health Services (EHS), 2Ministry Of Health And Prevention (Mohap), 3Health Science College
Background:
Rheumatoid arthritis (RA) is a common systemic autoimmune disease characterized by active synovitis and extra-articular manifestation. RA has genetic and environmental predisposing factors which make the characteristics of the disease different among diverse people, unlike genetic background. Very little is known about RA among the Arab population of the Gulf Cooperation Council and about subclinical atherosclerosis in RA. Therefore, this paper aimed at looking at the RA clinical features, RA disease activity, comorbidities, laboratory values characteristics, and subclinical atherosclerosis in terms of cIMT and carotid atheroma of RA patients compared to their age-sex matched control subjects among RA patients in the United Arab Emirates (UAE).
Method(s):
A total of 100 RA patients who fulfilled the ACR/EULAR 2010 criteria for the classification of RA patients and 154 controls were included. Detailed history, physical examination, laboratory investigations, and carotid intima-media thickness (cIMT) ultrasound examination had been carried out for all the participants. Differences were compared between the two groups; RA and controls were carried out using a t-test and chi2-test.
Result(s):
While there was no difference in age and gender distribution between RA and controls, RA patients showed more sub-clinical atherosclerosis with thicker cIMT (p=0.03), and an increased prevalence of carotid atherosclerotic plaque; 21 (21%) versus 6 (4%) healthy controls (P = 0.00) (table. 1). More CVD comorbidities; medical history showed more hyperlipidemia (p=0.01) (table. 2). physical examination revealed higher measured systolic (p=0.04) and diastolic blood pressure (0.04) (table. 3). And, laboratory results review showed more subclinical hypothyroidism (p=0.03), higher level of fasting glucose level (p=0.04) and glycosylated hemoglobin level (p=0.03). As well, RA patients had more interstitial lung disease (p=0.00), Raynaud’s phenomenon (p=0.00), iron deficiency anemia (p=0.03), and eye scleritis/uveitis (p=0.03) (table 2).
Further blood results indicated that RA patients have higher inflammatory markers; erythrocyte sedimentation rate (ESR) (p=0.00) and C-reactive protein (CRP) (p=0.00), white cell counts (p=0.00), platelet count (p=0.02), neutrophil count-% (p=0.00), neutrophil absolute count (p=0.00), lymphocyte count-% (p=0.01), and monocyte absolute count (p=0.02). More, higher RA-related antibodies like rheumatoid factor (RF) positivity (p=0.00), higher level of RF level (p=0.00), and more positive anti-cyclic citrullinated peptide (anti-CCP) (p=0.00).
On the other side, RA patients had lower red blood cells (p=0.04), total serum protein (p=0.02), albumin (p=0.0338), magnesium (p=0.03) and vitamin-D level (p=0.01).
Conclusion(s):
RA patients have more RA-related systemic manifestations, high disease activity, laboratory values disturbance, CVD comorbidities, and subclinical atherosclerosis.