Background Whereas chemerin contributes to the pathophysiology of rheumatoid arthritis (RA) (1), its role in the enhanced cardiovascular disease risk in RA is unknown. In non-RA subjects, dependent on physiological context, chemerin can reduce or enhance cardiovascular risk (2).

Objectives We investigated whether chemerin concentrations represent cardiovascular disease risk in RA.

Methods We assessed ELISA determined chemerin concentrations and those of 4 early endothelial activation molecules as well as angiopoietin 2, which mediates angiogenesis and thereby contributes to advanced atherosclerosis, and the common carotid artery intima-media thickness (cIMT) and carotid artery plaque by ultrasound in 236 (114 black and 122 white) patients with RA. Relationships were identified in potential confounder and mediator adjusted mixed regression models.

Results Chemerin concentrations were consistently associated with those of angiopoietin 2 (partial R=0.250, p=0.0002 in all patients). The presence of major conventional cardiovascular risk factors, generalized and abdominal obesity, and RA severity markers modified the independent chemerin-cardiovascular risk relations (interaction p<0.05). Consequently, chemerin concentrations were associated with cIMT in those with but not without generalized and abdominal obesity (partial R=0.360, p=0.006 and partial R=0.344, p=0.0008 versus partial R=0.015, p=0.9 and partial R=-0.047, p=0.6), and with plaque in those without but not with generalized obesity (OR (95%CI)=1.008 (1.000-1.016), p=0.04 and 1.004 (0.991-1.017), p=0.6, respectively). The standardized b (SE) for the chemerin-intima-media thickness relations in those with generalized and abdominal obesity (0.372 (0.130) and 0.350 (0.101), respectively) were larger than in those without these characteristics (0.015 (0.084) and -0.047 (0.094), p value=0.01 and 0.004, respectively).

Conclusions Chemerin is a cardiovascular risk biomarker in RA. High chemerin concentrations represent different atherosclerotic phenotypes (3-8) in obese compared to non-obese patients with RA.

References

1. Kaneko K et al. Arthritis Res Ther 2011;13:R158.

2. Rourke JL et al. Obesity Rev 2013;14:245-62.

3. Riccio SA et al. Cardiovasc Ultrasound 2006;4:44.

4. Ebrahim S et al. Stroke 1999;30:841-50

5. Spence JD et al. Arterioscler Thromb Vasc Biol 2004;24:e188.

6. Johnsen SH et al. Curr Cardiol Rep 2009;11:21-7.

7. Simon A et al. Arterioscler Thromb Biol Vasc Biol 2010;30:182-5.

8. Johnsen SH et al. Stroke 2007;38:2873-80.

Acknowledgements The study was supported by the South African Medical Research Council and the National Research Foundation.

Disclosure of Interest None declared

DOI 10.1136/annrheumdis-2014-eular.2510