A novel inflammatory biomarker, GlycA, associates with disease activity in rheumatoid arthritis and cardio-metabolic risk in BMI-matched controls.

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Date

2016-04-12

Authors

Bartlett, David B
Connelly, Margery A
AbouAssi, Hiba
Bateman, Lori A
Tune, K Noelle
Huebner, Janet L
Kraus, Virginia B
Winegar, Deborah A
Otvos, James D
Kraus, William E

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Abstract

BACKGROUND: RA and CVD both have inflammation as part of the underlying biology. Our objective was to explore the relationships of GlycA, a measure of glycosylated acute phase proteins, with inflammation and cardiometabolic risk in RA, and explore whether these relationships were similar to those for persons without RA. METHODS: Plasma GlycA was determined for 50 individuals with mild-moderate RA disease activity and 39 controls matched for age, gender, and body mass index (BMI). Regression analyses were performed to assess relationships between GlycA and important markers of traditional inflammation and cardio-metabolic health: inflammatory cytokines, disease activity, measures of adiposity and insulin resistance. RESULTS: On average, RA activity was low (DAS-28 = 3.0 ± 1.4). Traditional inflammatory markers, ESR, hsCRP, IL-1β, IL-6, IL-18 and TNF-α were greater in RA versus controls (P < 0.05 for all). GlycA concentrations were significantly elevated in RA versus controls (P = 0.036). In RA, greater GlycA associated with disease activity (DAS-28; RDAS-28 = 0.5) and inflammation (RESR = 0.7, RhsCRP = 0.7, RIL-6 = 0.3: P < 0.05 for all); in BMI-matched controls, these inflammatory associations were absent or weaker (hsCRP), but GlycA was related to IL-18 (RhsCRP = 0.3, RIL-18 = 0.4: P < 0.05). In RA, greater GlycA associated with more total abdominal adiposity and less muscle density (Rabdominal-adiposity = 0.3, Rmuscle-density = -0.3, P < 0.05 for both). In BMI-matched controls, GlycA associated with more cardio-metabolic markers: BMI, waist circumference, adiposity measures and insulin resistance (R = 0.3-0.6, P < 0.05 for all). CONCLUSIONS: GlycA provides an integrated measure of inflammation with contributions from traditional inflammatory markers and cardio-metabolic sources, dominated by inflammatory markers in persons with RA and cardio-metabolic factors in those without.

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Subjects

Biomarker, Glycosylation, Inflammation, Metabolic syndrome, Rheumatoid arthritis, Acute-Phase Proteins, Adiposity, Adult, Aged, Arthritis, Rheumatoid, Biomarkers, Body Mass Index, Cardiovascular Diseases, Cross-Sectional Studies, Female, Glycosylation, Humans, Inflammation, Insulin Resistance, Magnetic Resonance Spectroscopy, Male, Middle Aged, Obesity, Risk Factors

Citation

Published Version (Please cite this version)

10.1186/s13075-016-0982-5

Publication Info

Bartlett, David B, Margery A Connelly, Hiba AbouAssi, Lori A Bateman, K Noelle Tune, Janet L Huebner, Virginia B Kraus, Deborah A Winegar, et al. (2016). A novel inflammatory biomarker, GlycA, associates with disease activity in rheumatoid arthritis and cardio-metabolic risk in BMI-matched controls. Arthritis Res Ther, 18. p. 86. 10.1186/s13075-016-0982-5 Retrieved from https://hdl.handle.net/10161/11953.

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Scholars@Duke

Bartlett

David Bruce Bartlett

Adjunct Assistant Professor in the Department of Medicine

David Bartlett is an Assistant Professor in the Department of Medicine, Division of Medical Oncology. He earned his PhD in Immunology from the University of Birmingham, England where he specialized in the effects of exercise and lifestyles on immune function and systemic inflammation in the elderly. He was awarded a coveted Marie Curie Outgoing Fellowship from the European Union which brought him to Duke under the guidance of William Kraus, MD where he assessed the immunological and physiological responses of exercise training in patients with prediabetes and rheumatoid arthritis. His laboratory studies the effects of exercise and energy balance on immune function and physiology of patient groups including cancer, arthritis and diabetes. His research program is focused on human studies employing a wide range of techniques including human physiological testing, exercise training to in vitro and ex vivo cellular assays. 

Abou Assi

Hiba Abou Assi

Assistant Professor of Medicine
Kraus

Virginia Byers Kraus

Mary Bernheim Distinguished Professor of Medicine

Virginia Byers Kraus, MD, PhD, is the Mary Bernheim Distinguished Professor of Medicine, Professor of Orthopaedic Surgery, Professor of Pathology and a faculty member of the Duke Molecular Physiology Institute in the Duke University School of Medicine. She is a practicing Rheumatologist with over 30 years’ experience in translational musculoskeletal research focusing on osteoarthritis, the most common of all arthritides. She trained at Brown University (ScB 1979), Duke University (MD 1982, PhD 1993) and the Duke University School of Medicine (Residency in Internal Medicine and Fellowship in Rheumatology). Her career has focused on elucidating osteoarthritis pathogenesis and translational research into the discovery and validation of biomarkers for early osteoarthritis detection, prediction of progression, monitoring of disease status, and facilitation of therapeutic developments. She is co-PI of the Foundation for NIH Biomarkers Consortium Osteoarthritis project. Trained as a molecular biologist and a Rheumatologist, she endeavors to study disease from bedside to bench.


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