ISSN 2149-2263 | E-ISSN 2149-2271
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Rheumatoid factor mediates excess serum lipoprotein(a) for independent association with type 2 diabetes in men [Anatol J Cardiol]
Anatol J Cardiol. 2015; 15(10): 782-788 | DOI: 10.5152/akd.2014.5826

Rheumatoid factor mediates excess serum lipoprotein(a) for independent association with type 2 diabetes in men

Altan Onat1, Evin Ademoğlu2, Günay Can3, Servet Altay4, Ahmet Karagöz5, Bayram Köroğlu6, Hüsniye Yüksel1
1Department of Cardiology, Cerrahpaşa Faculty of Medicine, İstanbul University; İstanbul-Turkey
2Department of Biochemistry, İstanbul Faculty of Medicine, İstanbul University; İstanbul-Turkey
3Department of Public Health, Cerrahpaşa Faculty of Medicine, İstanbul University; İstanbul-Turkey
4Department of Cardiology, Edirne Education Hospital; Edirne-Turkey
5Department of Cardiology, Faculty of Medicine, Giresun University; Giresun-Turkey
6Department of Cardiology, Dr. Siyami Ersek Chest and Cardiovascular Surgery Training and Research Hospital; İstanbul-Turkey

Objective: The potential association of rheumatoid factor (RF) and lipoprotein (Lp)(a) levels, as well as with the likelihood of type 2 diabetes and hypertension, needs exploring. Methods: Cross-sectional associations were sought in this unselected and population-based 1539-adult cohort (age 58.8±10.6 years). RF was assayed nephelometrically. Multiple logistic regression analyses were used for covariates of RF positivity and for the latter’s association with diabetes and hypertension. Results: RF-positive individuals were older, fewer current smokers, had significantly lower fasting triglycerides (by 13%), higher fibrinogen, and tended to higher sex hormone-binding globulin (SHBG) levels. Whereas, women had a similar risk profile irrespective of RF status, RF-positive men had significantly higher Lp(a). In contrast to Lp(a) being positively correlated with SHBG in RF-negative subjects (r=0.08; p=0.007), an inverse correlation existed in seropositive individuals (r=-0.32, p=0.011), suggesting the interplay of an immune complex. In regression analyses, RF positivity was associated with Lp(a) in men but not in women, [OR 1.53 (1.19; 1.96)], independent of age, SHBG, and C-reactive protein (CRP). RF positivity was further associated with diabetes [OR 1.98 (95% CI 1.11; 3.52)] in the whole sample, additively to waist circumference and CRP, major determinants of diabetes. RF-positive subjects were not significantly associated independently with hypertension. Conclusion: Autoimmune activation linked to Lp(a) is mediated by the autoantibody RF in contributing to the development of type 2 diabetes.

Keywords: autoimmune activation, diabetes type 2, lipoprotein(a), rheumatoid factor, rheumatoid arthritis

Romatoid faktör artmış serum lipoprotein (a)’nın  tip 2 diyabet ile bağımsız ilişkisine erkekte aracılık ediyor

Altan Onat1, Evin Ademoğlu2, Günay Can3, Servet Altay4, Ahmet Karagöz5, Bayram Köroğlu6, Hüsniye Yüksel1
1Department of Cardiology, Cerrahpaşa Faculty of Medicine, İstanbul University; İstanbul-Turkey
2Department of Biochemistry, İstanbul Faculty of Medicine, İstanbul University; İstanbul-Turkey
3Department of Public Health, Cerrahpaşa Faculty of Medicine, İstanbul University; İstanbul-Turkey
4Department of Cardiology, Edirne Education Hospital; Edirne-Turkey
5Department of Cardiology, Faculty of Medicine, Giresun University; Giresun-Turkey
6Department of Cardiology, Dr. Siyami Ersek Chest and Cardiovascular Surgery Training and Research Hospital; İstanbul-Turkey

Amaç: Romatoid faktör’ün (RF) lipoprotein (Lp)(a) düzeyi ile potansiyel ilişkisi ve tip 2 diyabet ve hipertansiyon ile ilişki olasılığı araştırılmaya muhtaçtır. Yöntemler: Popülasyona-dayalı 1539 yetişkin içeren bu kohortta (yaş 58,8±10,6) kesitsel ilişkiler incelendi. RF nefelometrik yöntemle ölçüldü. RF pozitifliğinin kovaryatları ve pozitifliğin diyabet ve hipertansiyon ilişkilerini incelemede çoklu lojistik regresyon kullanıldı. Bulgular: RF-pozitif bireyler daha yaşlı, daha az sigara içicisi olup, anlamlı biçimde daha düşük (%13 oranında) açlık trigliseride, daha yüksek fibrinojene sahip olup daha yüksek seks hormon-bağlayıcı globülin (SHBG) düzeylerine eğilimli idi. Kadınlarda, RF durumu diğer bakımlardan benzer bir risk profili sergilemediyse de, RF-pozitif erkeklerde Lp(a) düzeyi yüksekti. Lp(a)’nın RF-negatif kişilerde SHBG ile doğrusal korelasyonuna karşılık (r=0,08; p=0,007), seropozitif bireylerde –immün kompleks oluşumunu düşündüren- ters bir korelasyon (r=-0,32, p=0,011) kaydedildi. Lojistik regresyon analizlerinde RF pozitifliği, kadında değil, ama erkeklerde –yaş, SHBG ve C-reaktif protein (CRP)’den bağımsız olarak– Lp(a) ile ilişkiliydi [OR 1,53 (%95 GA 1,19; 1,96)]. RF pozitifliği ayrıca tüm örneklemde, diyabetin başlıca belirleyicileri olan bel çevresi ile CRP’ye ek olarak, diyabet olasılığı ile [OR 1,98 (1,11; 3,52)] ilişkili bulundu. RF-pozitif bireyler hipertansiyonla anlamlı ve bağımsız olarak ilişkili değildi. Sonuç: Lp(a) ile bağlantılı otoimmün etkinleşme, RF otoantikoru aracılığıyla tip 2 diyabet gelişmesine katkıda bulunmaktadır.

Anahtar Kelimeler: otoimmün etkinleşme, diyabet tip 2, lipoprotein(a), romatoid faktör, romatoid artrit

Altan Onat, Evin Ademoğlu, Günay Can, Servet Altay, Ahmet Karagöz, Bayram Köroğlu, Hüsniye Yüksel. Rheumatoid factor mediates excess serum lipoprotein(a) for independent association with type 2 diabetes in men. Anatol J Cardiol. 2015; 15(10): 782-788
Manuscript Language: English


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