Patients with rheumatoid arthritis (RA) have an increased risk of cardiovascular (CV) events and CV mortality. Subclinical carotid atherosclerosis is independently associated with rates of incident CV events among patients with RA. The complement system has been related to both the etiopathogenesis of RA and CV disease. In this study, we aimed to evaluate the association between a comprehensive assessment of the complement system and carotid intima media thickness and carotid plaque in patients with RA. 430 patients with RA were recruited. Functional assays of the three pathways of the complement system, utilizing new-generation techniques, were assessed. Additionally, serum levels of individual components of the complement system belonging to the three pathways were measured: C1q (classical), lectin (lectin), C2, C4, and C4b (classical and lectin), factor D and properdin (alternative), C3 and C3a (common), C5, C5a, and C9 (terminal), as well as regulators factor I and C1-inhibitor. Subclinical carotid atherosclerosis was evaluated by ultrasonography. Multivariable linear regression analysis was conducted to investigate the association between the complement system and carotid intima media thickness and carotid plaque. After multivariable adjustment, which included traditional CV risk factors and disease-related data, C3a and C5a exhibited significant positive correlations with carotid intima media thickness. Additionally, higher values of C1-inhibitor, properdin, C3, C5, and C5a were independently associated with the presence of carotid plaque. The complement system and subclinical carotid atherosclerosis are linked in patients with RA.

中文翻译：

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类风湿性关节炎患者补体系统与亚临床颈动脉粥样硬化的关系


类风湿性关节炎 (RA) 患者发生心血管 (CV) 事件和 CV 死亡率的风险增加。亚临床颈动脉粥样硬化与 RA 患者的心血管事件发生率独立相关。补体系统与 RA 和 CV 疾病的发病机制有关。在本研究中，我们旨在评估 RA 患者补体系统的综合评估与颈动脉内膜中层厚度和颈动脉斑块之间的关联。招募了 430 名 RA 患者。利用新一代技术对补体系统的三个途径进行功能测定。此外，还测量了属于三种途径的补体系统各个成分的血清水平：C1q（经典）、凝集素（凝集素）、C2、C4 和 C4b（经典和凝集素）、因子 D 和备解素（替代）、C3和 C3a（常见）、C5、C5a 和 C9（末端），以及调节因子 I 和 C1 抑制剂。通过超声检查评估亚临床颈动脉粥样硬化。进行多变量线性回归分析以研究补体系统与颈动脉内膜中层厚度和颈动脉斑块之间的关联。经过多变量调整（包括传统心血管危险因素和疾病相关数据）后，C3a 和 C5a 与颈动脉内膜中层厚度呈显着正相关。此外，较高的 C1 抑制剂、备解素、C3、C5 和 C5a 值与颈动脉斑块的存在独立相关。 RA 患者的补体系统与亚临床颈动脉粥样硬化有关。