Fatty acid binding protein 4, resistin, diastolic dysfunction, and cardiovascular risk in patients with rheumatoid arthritis.

Abstract

Cardiovascular (CV) risk assessment and early detection of subclinical cardiac involvement in rheumatoid arthritis (RA) patients enable timely intervention and improve prognosis. This study evaluated associations of serum levels of fatty acid binding protein 4 (FABP4) and resistin with both echocardiographic parameters of left ventricular diastolic dysfunction (LVDD) and CV risk quantified using four validated scores (ERS-RA, QRISK3, modified SCORE2, LIFE-CVD2) in a cohort of RA patients. Additionally, we sought to identify the most informative LVDD parameter for CV risk stratification. Fifty-one RA patients (46 females, 5 males; mean age 48.8± 8.2 years; median disease duration of 12 years) were enrolled. Serum FABP4 and resistin levels were analysed for associations with CV risk scores using univariable and multivariable linear regression, while relationships with LVDD parameters were assessed via univariable regression analyses. FABP4 demonstrated a positive association with ERS-RA risk score in both univariable (β = 0.09, p = 0.01) and multivariable (β = 0.08, p = 0.007) models. FABP4 was negatively associated with E/A ratio (β = -0.005, p = 0.04), and positively with left atrial volume index (β = -0.09, p = 0.04). Among LVDD parameters, lateral e' velocity showed the strongest associations with all CV risk scores, exhibiting the lowest p-values. FABP4 is significantly associated with increased RA-specific CV risk (ERS-RA) and abnormal echocardiographic parameters of LVDD. Lateral e' velocity represents the most informative echocardiographic LVDD parameter associated with CV risk.