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Microalbuminuria in rheumatoid arthritis in the post penicillamine/gold era: association with hypertension, but not therapy or inflammation

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Abstract

Rheumatoid arthritis (RA) associates with excess cardiovascular (CV) morbidity and mortality. New screening tools are needed to better identify patients at increased CV risk. Microalbuminuria (MA) has been shown to associate with inflammation and future cardiovascular disease (CVD). In the present study, we assessed the prevalence of MA in a secondary care cohort of RA patients, aimed to identify factors associated with its presence and addressed its relationship to CVD and the metabolic syndrome (MetS). A total of 342 RA patients were studied. MA was defined as an albumin-creatinine ratio ≥22 (males) or ≥31 (females) milligrams per gram creatinine. The independence of the associations of MA was evaluated using binary logistic regression analysis. Prevalence of MA was 11.9%. Subjects with MA had increased prevalence of hypertension (HT), insulin resistance and type 2 diabetes. In binary logistic regression, only HT (OR = 5.22, 95%CI: 1.51–18.07, p = 0.009) was significantly associated with MA. There was no association between prevalent CVD and MA, but patients with MA had twofold increased odds of having the MetS. MA is relatively common in RA patients and is independently associated with the presence of HT. Given the association of MA with MetS, future prospective studies are needed to establish the use of MA as a screening tool for RA patients at increased CVD risk.

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Acknowledgements/Funding

This study was funded by the Dudley Group of Hospitals R&D Directorate cardiovascular program grant. The Department of Rheumatology is in receipt of infrastructure support from the Arthritis Research Campaign (grant number: 17682). Dr V. Panoulas is supported by a PhD scholarship from Empirikion Institute, Athens, Greece. Holly John is in receipt of an Arthritis Research Campaign (arc) Educational Research Fellowship (number 17883). Tracey Toms is in receipt of an Arthritis Research Campaign (arc) Clinical Fellowship grant (number 18848).

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Authors and Affiliations

  1. Department of Rheumatology, Dudley Group of Hospitals NHS Trust, Russells Hall Hospital, Pensnett Road, Dudley, West Midlands, DY1 2HQ, UK

    Dimitrios Daoussis, Vasileios F. Panoulas, Holly John, Tracey E. Toms, Ioannis Antonopoulos, Gareth Treharne, Karen M. J. Douglas & George D. Kitas

  2. Department of Internal Medicine, School of Medicine, University of Ioannina, Ioannina, Greece

    Vasileios F. Panoulas

  3. Wolfson Computer Laboratory, University Hospital Birmingham NHS Foundation Trust, Birmingham, UK

    Peter Nightingale

  4. ARC Epidemiology Unit, Manchester University, Manchester, UK

    George D. Kitas

Authors
  1. Dimitrios Daoussis
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  2. Vasileios F. Panoulas
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  3. Holly John
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  4. Tracey E. Toms
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  5. Ioannis Antonopoulos
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  6. Gareth Treharne
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  7. Peter Nightingale
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  8. Karen M. J. Douglas
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  9. George D. Kitas
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Correspondence to George D. Kitas.

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Daoussis, D., Panoulas, V.F., John, H. et al. Microalbuminuria in rheumatoid arthritis in the post penicillamine/gold era: association with hypertension, but not therapy or inflammation. Clin Rheumatol 30, 477–484 (2011). https://doi.org/10.1007/s10067-010-1446-y

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  • DOI: https://doi.org/10.1007/s10067-010-1446-y

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