Increased progression of carotid intima media thickness in thyroid peroxidase antibodies positive rheumatoid arthritis patients.

European journal of endocrinology / European Federation of Endocrine Societies

PubMedID: 24005313

Raterman HG, Voskuyl AE, Simsek S, Schreurs MW, van Hoogstraten IM, Peters MJ, van Halm VP, Dijkmans BA, Lips P, Lems W, Nurmohamed MT. Increased progression of carotid intima media thickness in thyroid peroxidase antibodies positive rheumatoid arthritis patients. Eur J Endocrinol. 2013;.
Objective - Autoimmune diseases like rheumatoid arthritis (RA) and hypothyroidism tend to cluster, and, this coexistence amplifies the elevated cardiovascular risk in RA. Whether thyroid peroxidase antibodies (TPOabs) are associated with increased CVD risk has not been studied extensively. Therefore, this study determines firstly TPOabs prevalence in RA and secondly whether TPOabs were associated with cardiovascular disease (CVD). Moreover, this study explored whether TPOabs were related to RA characteristics.Design and Methods - Data from the CARRÉ Study, an ongoing study investigating cardiovascular diseases and its risk factors in RA (n = 322) was used to ascertain TPOabs prevalence in RA patients. Additionally, cardiovascular and RA disease characteristics were compared between TPOabs positives and negatives at baseline and at a 2nd visit after 3 years.Results - TPOabs were present in 47/322 (15%) RA patients and TSH levels were higher in TPOabs positives (1.40 mU/l compared to 1.26 mU/l in negatives, p = 0.048). At baseline and after 3 years no association was observed between TPOabs and (risk factors for) CVD. Regression analyses revealed a significantly larger progression of carotid Intima Media Thickness (cIMT) (ß = 0.13mm) in TPOabs positive compared to TPOabs negative patients independently of risk factors for cIMT progression. RA disease activity scores (DAS28) were higher in TPOabs positives compared to negatives (4.4 versus 3.8 p = 0.018)Conclusions - TPOabs were associated with increased cIMT progression. Moreover, an association between TPOabs and DAS28 was observed. Hence, TPOabs seems to have a role in the amplified CV risk in RA patients.