Correlation between carotid intima-media thickness and serum TNF- levels in female with rheumatoid arthritis of different ethnicities: A single-centre experience in Malaysia

Abstract

Correlation between carotid intima-media thickness and serum TNF- levels in female with rheumatoid arthritis of different ethnicities: A single-centre experience in Malaysia Kek Xin Yi1, Asrul Abdul Wahab2*, Mohamad Norazrin Mohd Abas3, Siti Amira Kamarul Abdul Wahid4, Faridah Hanun Othman5, Mohd Shahrir Mohamed Said6 1. Bintulu Hospital, 97000 Bintulu, Sarawak, Malaysia 2. Department of Medical Microbiology and Immunology, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000 Cheras, Kuala Lumpur, Malaysia 3. Miri Hospital, 98000 Miri, Sarawak, Malaysia 4. Women and Child Hospital Sabah, 88996 Kota Kinabalu, Sabah, Malaysia 5. Balik Pulau Hospital, 11500 Balik Pulau, Penang, Malaysia 6. Department of Internal Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000 Cheras, Kuala Lumpur, Malaysia *E-mail: saw@ppukm.ukm.edu.my Abstract Background: Rheumatoid arthritis (RA) is a destructive chronic inflammatory disease with intra- and extra-articular manifestations. It is associated with accelerated formation of arteriosclerosis. The aim of this study was to ascertain the correlation between endothelial dysfunction using carotid intima–media thickness (cIMT) and tumor necrosis factor-alpha (TNF-α) levels among the three main ethnic groups in Malaysia: Malay, Chinese, and Indian. Methods: This crosssectional study included 23 females with RA belonging to three different ethnic groups who were free from cardiovascular risk factors. Blood sample was taken from each patient to measure serum TNF-α level, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR). Carotid ultrasonography was performed for cIMT analysis. The Disease Activity Score (DAS)-28 scoring system was used to assess disease activity. Results: Patients’ median age and disease duration were 47 and 5 years, respectively. No thickened cIMT was found in any of the patients. The duration of disease, TNF-α level, cIMT, DAS-28 CRP, and DAS-28 ESR showed no significant correlations in the different ethnic groups (p > 0.05). Conclusion: This study indicates that cIMT and serum TNF-α levels among females with RA in Malaysia may not be affected by ethnicity. Keywords: carotid intima–media thickness, ethnic groups, rheumatoid arthritis, tumor necrosis factor-alpha