Endocan as an Early Predictor of Endothelial Dysfunction and Atherosclerosis in Egyptian Patients with Rheumatoid Arthritis.

Background: Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease. Inflammation leads to endothelial cells activation. Activated endothelial cells with increased leukocytes adhesion molecules expression, which can induce endothelial dysfunction (ED) and atherosclerosis. Aim: to measure the serum level of Human endothelial cell-specific molecule-1 (endocan) in patients with rheumatoid arthritis and to evaluate its relation to endothelial dysfunction and atherosclerosis. Materials and methods: the study included 30 consecutive RA patients, and 30 healthy control subjects. RA disease activity was measured by the DAS-28 score. Serum endocan was measured by enzyme-linked immunosorbent assay (ELISA). The collected data were statistically analyzed using SPSS program version 16. Results: There was a significant elevation in Endocan level in RA patients (1.81 ± 0.66 ng/ml) compared to control group (1.41 ± 0.59ng/ml) (P= 0.012). Serum endocan levels showed significant positive correlation with disease activity score-28(DAS-28), ESR, CRP, LDL and carotid intima media thickness (cIMT) (P = 0.015, 0.004, <0.001, 0.008, 0.005 respectively). Linear regression analysis revealed that the serum endocan level, age and disease activity were independent predictors for cIMT, and atherosclerosis development in RA patients.  Conclusion: Endocan is a useful marker to predict endothelial dysfunction and atherosclerosis in patients with rheumatoid arthritis.