الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 175 |  |  |
| | | from | 175 | | |
Abstract
The aims of this study were to assess the serum level of irisin in RA patients, and to determine the relationship of irisin level with disease activity, cardiovascular risk in RA patients.
Methods: Sixty RA patients fulfilling the 2010 ACR/EULAR RA Classification Criteria were included in this study. Thirty age- and sex-matched healthy volunteers were enrolled as the control group. All subjects underwent full history taking and clinical examination. BMI was calculated. Waist/hip ratio was measured. RA disease activity was assessed by DAS28-ESR. Disability was assessed by HAQ-DI in its Arabic version and ACR classification of functional status. The following laboratory investigations were done for all patients and control: HbA1c, lipid profile, insulin level and serum irisin level were measured. Insulin resistance was assessed with the HOMA Index. SENS and US7 score were assessed for all patients. Measurement of carotid intimal medial thickness (C-IMT) by carotid doppler ultrasonography was performed for cardiovascular risk assessment. Echocardiography for cardiac abnormalities. Our RA patients subdivided according to cardiovascular abnormalities and according to cut-off values of DAS28.
Results Serum irisin levels were found to be significantly lower in RA patients (9.84 ± 10.56) than healthy controls (20.48±13.82) (p<0.001**). There was a negative correlation between serum irisin and disease activity & disability indices. There was a negative correlation between serum irisin level and parameters of cardiovascular risk including anthropometric measurements (BMI and waist/hip ratio), HOMA-IR and C-IMT. No correlation could be detected between it and lipid profile. The frequency of cardiovascular (CV) involvement in our RA patients was 45% (27 patients) (11.6 % with echocardiographic abnormalities and 40% of our patients with increased C-IMT). Patients with CV involvement showed increased disease activity assessed by DAS28 and lower serum irisin level with a statistically significant difference (P < 0.001** and P < 0.05* respectively).
Conclusion The serum irisin level was significantly lower in RA patients and may be an indicator for increased disease activity. Serum irisin level may be responsible for increased cardiovascular risk in RA patients.