Association between follistatin-related protein 1 and the functional status of patients with anti-neutrophil cytoplasmic antibody-associated vasculitis

Background:Follistatin-like 1(FSTL1)plays both pro-inflammatory and anti-inflammatory roles in the inflammatory processes.We investigated whether serum FSTL1 could predict the current anti-neutrophil cytoplasmic antibody-associated vasculitis(AAV)-specific indices.Methods:We randomly selected 74 patients with AAV from a prospective and observational cohort of Korean patients with AAV.Clinical and laboratory data and AAV-specific indices were recorded.FSTL1 concentration was determined using the stored sera.The lowest tertile of the short-form 36-item health survey(SF-36)was defined as the current low SF-36.The cutoffs of serum FSTL1 for the current low SF-36 physical component summary(PCS)and SF-36 mental component summary(MCS)were extrapolated by the receiver operator characteristic curve.Results:The median age was 62.5 years(55.4%were women).Serum FSTL1 was significantly correlated with SF-36 PCS(r=-0.374),SF-36 MCS(r=-0.377),and C-reactive protein(CRP)(r=0.307),but not with Birmingham vasculitis activity score(BVAS).In the multivariable linear regression analyses,BVAS,CRP,and serum FSTL1 were independently associated with the current SF-36 PCS(β=-0.255,β=-0.430,andβ=-0.266,respectively)and the current SF-36 MCS(β=-0.234,β=-0.229,andβ=-0.296,respectively).Patients with serum FSTL1≥779.8 pg/mL and those with serum FSTL1≥841.6 pg/mL exhibited a significantly higher risk of having the current low SF-36 PCS and SF-36 MCS than those without(relative risk 7.583 and 6.200,respectively).Conclusion:Serum FSTL1 could predict the current functional status in AAV patients.

Incidence, prevalence and risk of stroke in patients with Takayasu arteritis: a nationwide population-based study in South Korea

Background Takayasu arteritis(TAK)is a disease associated with increased risk of cardiovascular complications.We aimed to evaluate the incidence,prevalence and risk of stroke in patients with TAK.Methods Data from 1065 patients were obtained from a national database(2010–2018).The annual incidence and prevalence per 100000 persons were estimated using the registration population in the midst of every year,and the standardised incidence ratio(SIR)of stroke was compared with the general population based on the data from the 2006 national report for cardiovascular and cerebrovascular diseases.Age-adjusted incidence rate ratio(IRR)of stroke based on the time interval after diagnosis was also calculated.A time-dependent Cox regression was conducted to investigate predictive factors of stroke.Results The overall incidence rate of TAK ranged between 0.2 and 0.3/100000 person-years annually;the prevalence of TAK gradually increased,reaching 3.25/100000 person-years in 2018.Seventy-three(6.9%)patients experienced stroke during follow-up,and the risk of developing stroke was higher than the general population(overall SIR 7.39,95%CI 5.79 to 9.29;men:SIR 5.70,95%CI 2.84 to 10.20;women:SIR 7.06,95%CI 5.41 to 9.05).Most stroke events(90.9%)were cerebral infarction for men,whereas the proportion of cerebral infarction was lower(62.9%)in women.Over half of stroke events occurred within 6 months after diagnosis,and stroke was more common within 6 months of diagnosis compared with after 3 years in women(IRR 13.46,95%CI 6.86 to 26.40).In Cox regression analysis,age was the sole predictor of stroke(adjusted HR 1.02,95%CI 1.00 to 1.04,p=0.043).Conclusions The annual incidence of TAK was similar to the previous studies from Asia,and the risk of stroke increased in TAK.Different patterns of subtype and incidence of stroke were found according to sex,although age was the only predictor.