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            "entidad" => "Lipid Unit&#44; Department of Internal Medicine&#44; Fipec&#44; Idibell&#44; CiberObn&#44; Universitat de Barcelona&#44; Hospital Universitari de Bellvitge&#44; L&#8217;Hospitalet de Llobregat&#44; Barcelona&#44; Spain"
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        "titulo" => "Alta prevalencia de litiasis biliar en la artritis reumatoide&#58; &#191;una nueva comorbilidad relacionada con la dislipidemia&#63;"
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          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Serum HDL3-c concentrations in female RA patients with and without gallstone disease&#46;</p> <p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">&#42;Adjusted model with age and triglycerides as covariates&#46;</p> <p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Serum HDL3-c concentrations are expressed as mean and 95&#37; confidence interval&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">In recent decades&#44; the presence of comorbidities in patients with rheumatoid arthritis has become more pronounced since the new therapies have changed the natural course of the disease&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Although one of the most significant comorbidities is cardiovascular disease&#44; as a result of a process of accelerated atheromatosis in the context of inflammation and lipid metabolism disorders&#44; other disorders are also common&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> Alterations in lipid metabolism&#44; both quantitative and qualitative&#44; observed in these patients have been linked to the inflammatory process itself&#44; although the mechanisms involved have not been well defined&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> Nevertheless&#44; altered lipid metabolism as well as inflammation can affect other organs or systems&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> In this regard&#44; it is known that&#44; in the context of inflammation&#44; the endothelial function of the gallbladder is altered&#44; and consequently the recycling of lipids could be decreased&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> At the same time&#44; it is known that one of the main risk factors involved in the pathogenesis of cholesterol gallstones&#44; which constitute 80&#37; of stones&#44;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> is alterations in lipid metabolism&#46;<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">7&#44;8</span></a> Thus&#44; patients with chronic inflammatory disease may present a higher prevalence of gallstones&#46; In fact&#44; in a small number of studies&#44; a higher prevalence of gallstones has been observed in patients with systemic lupus&#44; antiphospholipid syndrome&#44; and rheumatoid arthritis&#46;<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">9&#44;10</span></a> In addition&#44; other conditions associated with an increased incidence of gallstones such as age&#44; female gender&#44; sedentary lifestyle and&#44; possibly&#44; chronic intake of non-steroidal antiinflammatory drugs &#40;NSAIDs&#41;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a> are present in rheumatoid arthritis&#46; The purpose of this study was to assess the prevalence of gallstones in patients with established rheumatoid arthritis compared with the general population&#44; and its relationship with lipid metabolism disorders and other risk factors&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Patients</span><p id="par0010" class="elsevierStylePara elsevierViewall">One hundred and eight patients with rheumatoid arthritis were consecutively enrolled in this cross-sectional study from the outpatient rheumatology clinic at the Hospital Universitari de Bellvitge&#44; Barcelona&#46; The manuscript has been accepted for its publication by the Clinical Research Ethics Committee of Bellvitge University Hospital&#46; The data of the patients were anonymized for the purposes of this analysis&#46; The confidential information of the patients was protected according to national normative&#46; All patients met the 1987 revised criteria for RA of the American College of Rheumatology&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Each patient who agreed to participate was systematically assessed through a self-reported questionnaire&#44; a structured interview and a general physical examination&#46; Blood samples were obtained for routine biochemistry and hematologic tests&#46; An abdominal ultrasound was performed in the days following the clinical and biochemical study&#46; The lipid profile included&#58; total cholesterol &#40;TC&#41;&#44; triglyceride &#40;TG&#41;&#44; low-density lipoprotein cholesterol &#40;LDL-c&#41;&#44; very low-density lipoprotein cholesterol &#40;VLDL-c&#41;&#44; high-density lipoprotein cholesterol &#40;HDL-c&#41;&#44; subfraction 2 of high-density lipoprotein cholesterol &#40;HDL2-c&#41;&#44; subfraction 3 of high-density lipoprotein cholesterol &#40;HDL3-c&#41;&#44; apolipoprotein A-I &#40;apoA-I&#41;&#44; apolipoprotein B &#40;apoB&#41; and lipoprotein &#40;a&#41; &#91;lp&#40;a&#41;&#93;&#46; Clinical variables reflecting RA activity including patient overall assessment&#44; physical disability score using the Health Assessment Questionnaire &#40;HAQ&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a> acute-phase reactant levels&#44; number of tender and swollen joints and duration of morning stiffness were assessed&#46; Disease activity was measured using the Disease Activity Score based on the evaluation of 28 joints &#40;DAS28&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> Additionally&#44; data on RA disease duration&#44; menopausal status and history of gastrectomy were collected&#46; The medical records of all patients were reviewed&#46; Height and weight were measured and body mass index was calculated&#46; Sedentary lifestyle was considered if patients did not walk 30<span class="elsevierStyleHsp" style=""></span>min without stopping at least three times a week&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Determination of Serum Lipid Concentrations</span><p id="par0020" class="elsevierStylePara elsevierViewall">Blood specimens were obtained after a fast of at least 12<span class="elsevierStyleHsp" style=""></span>h&#44; collected into tubes without anticoagulant&#44; centrifuged at 1200<span class="elsevierStyleHsp" style=""></span>g for 10<span class="elsevierStyleHsp" style=""></span>min at room temperature and stored at 4<span class="elsevierStyleHsp" style=""></span>&#176;C until analysis&#46; A modular system analyzer &#40;Roche Diagnostics&#44; Basel&#44; Switzerland&#41; was used to perform all procedures&#44; which are specified below&#46; Serum TC and VLDL were isolated by preparative ultracentrifugation at a density gradient of 1006<span class="elsevierStyleHsp" style=""></span>kg<span class="elsevierStyleHsp" style=""></span>L<span class="elsevierStyleSup">&#8722;1</span> and their cholesterol content was quantified by an enzymatic colorimetric method &#40;CHOD-PAP&#44; Roche Diagnostics&#44; Basel&#44; Switzerland&#41;&#44; such as used for measurement of TG concentrations &#40;GPO-PAP&#44; Roche Diagnostics&#44; Basel&#44; Switzerland&#41;&#46; A direct colorimetric enzymatic method was performed to quantify the serum HDL-c concentrations &#40;HDL-c plus&#44; Roche Diagnostics&#44; Basel&#44; Switzerland&#41;&#46; Serum HDL3-c concentrations were measured in the supernatant obtained after precipitation of the HDL2 subfraction through the addition of a 15&#37; polyethylene glycol solution &#40;PEG 20 000&#41; at pH 7&#46;5&#46; The difference between concentrations of HDL-c and HDL3-c was applied to calculate the serum HDL2-c concentrations&#44; and the Friedewald equation was used to estimate the serum LDL-c concentrations &#40;although it was considered inaccurate when TG level exceeded 2&#46;3<span class="elsevierStyleHsp" style=""></span>mmol<span class="elsevierStyleHsp" style=""></span>L<span class="elsevierStyleSup">&#8722;1</span>&#41;&#46; Finally&#44; ApoA-I&#44; apoB and lp&#40;a&#41; were quantified by immunoturbidimetric methods &#40;Roche Diagnostics&#44; Basel&#44; Switzerland&#41;&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Abdominal Ultrasound</span><p id="par0025" class="elsevierStylePara elsevierViewall">Ultrasonography was performed by a trained operator unaware of the medical history of the patients&#44; except that all had RA&#46; The examination was performed with the subject in the supine and left lateral decubitus positions&#44; after a fast of at least 6<span class="elsevierStyleHsp" style=""></span>h&#46; The gallbladder was examined in both longitudinal and transverse planes using a real-time&#44; linear array scanner with a 3&#46;5<span class="elsevierStyleHsp" style=""></span>MHz probe&#46; Ultrasonographic findings were classified as follows&#58; normal gallbladder &#40;lumen without echoes&#41;&#44; presence of gallstones and absent gallbladder &#40;non-visualization of the gallbladder lumen without high-density echoes and acoustic shadow in the gallbladder fossa&#41;&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Gallstone disease was defined as the presence of gallstones on ultrasonography or cholecystectomy&#46; Cholecystectomy was defined as a positive patient history of cholecystectomy in which&#44; furthermore&#44; the gallbladder lumen was not visualized on ultrasonography&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Statistical Analysis</span><p id="par0035" class="elsevierStylePara elsevierViewall">The Statistical Package for Windows 18&#46;0 &#40;SPSS&#44; Chicago&#44; IL&#41; was used to analyze the data&#46; Normality of variables was tested by the Kolmogorov&#8211;Smirnov test&#46; Normally-distributed continuous variables were analyzed using an analysis of variance &#40;ANOVA&#41; or analysis of covariance &#40;ANCOVA&#41;&#46; Continuous variables not normally distributed and ordinal variables were compared with non-parametric tests &#40;Mann&#8211;Whitney <span class="elsevierStyleItalic">U</span> test&#41;&#46; Categorical variables were analyzed by chi-square test or Fisher&#39;s exact test&#46; <span class="elsevierStyleItalic">P</span>-values less than &#46;05 were considered significant&#46; Results of categorical and ordinal variables are shown as relative frequency &#40;&#37;&#41;&#44; continuous variables are expressed as mean<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>standard deviation &#40;SD&#41; and continuous variables not normally distributed by median &#40;interquartile range&#41;&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Data from a study of the Spanish population<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a> consisting of 275 women aged between 30 and 79 years were used to compare the prevalence of GS in patients with RA matched by age groups&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">The association between RA and gallstone disease &#40;which includes gallstones and cholecystectomy&#41; has been analyzed using odds ratio &#40;OR&#41; calculated by logistic regression analysis&#46; A model has been made for each age group&#44; another for an overall group and another adjusted for age &#40;&#60;60 years versus<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>60 years&#41;&#46;</p></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Results</span><p id="par0050" class="elsevierStylePara elsevierViewall">Of 108 patients with RA&#44; 84 were women and 24 men&#46; Only two men had gallstone disease and none had undergone cholecystectomy&#46; Therefore&#44; only women were included in the study&#46; The main demographic&#44; clinical and laboratory features of RA participants are summarized in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46; Patients in the two groups&#44; with and without gallstone disease&#44; were similar in most variables assessed&#44; except for age and menopausal status&#44; which were significantly greater in the patients with GD&#46; None had a history of gastrectomy&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0055" class="elsevierStylePara elsevierViewall">Serum lipid&#44; lipoprotein and apolipoprotein values in women with RA and in controls are shown in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#46; No significant differences in TC&#44; LDL-c and its main protein&#44; apoB&#44; values were found between groups&#46; However&#44; although no significant differences were found in plasma levels of HDL-c and its main protein&#44; apoA-I&#44; between patients with or without gallstone disease&#44; a significantly higher HDL3-c subfraction and higher apoA-I&#47;HDL and HDL3-c&#47;TC ratios were observed in the former&#46; This difference in the HDL3-c subfraction remained after adjustment for age and triglycerides &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0060" class="elsevierStylePara elsevierViewall">The prevalence of gallstone disease stratified by age in RA patients and controls is shown in <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#46; Female RA patients aged 60 or over had a significantly higher prevalence of gallstone disease compared to the general population of the same age&#46; It could also been observed&#44; that these patients present a higher prevalence of cholecystectomy than controls&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall">Female RA patients ages 60 or over&#44; compared to controls&#44; presented an OR of 2&#46;8 &#40;95&#37; CI&#58; 1&#46;3&#8211;6&#46;0&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41; to have gallstone disease&#46; Adjusting for age female RA patients had an OR of 2&#46;3 &#40;95&#37; CI&#58; 1&#46;3&#8211;4&#46;1&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Discussion</span><p id="par0070" class="elsevierStylePara elsevierViewall">To our knowledge&#44; this is the first study to assess the prevalence of GD in patients with RA in western countries&#46; It shows that female patients with RA &#8805;60 years of age had a significantly higher prevalence of gallstone disease compared to the general population of the same age and gender&#46; This high prevalence is independent of age &#40;OR age-adjusted 2&#46;3&#41;&#46; General population studies have shown age and female sex to be among some of the most important risk factors for developing GD&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a> Thus&#44; as would be expected&#44; older and menopausal RA women would have a higher prevalence of GD&#46; Nevertheless&#44; the present study shows that this prevalence is higher than expected in the general population compared for age and gender&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Biliary lithiasis in RA has received little attention and few studies have been conducted on this topic&#46; A study by Ito et al&#46; in 224 RA patients in Japan &#40;182 female&#41;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> showed a significantly higher incidence of gallstones &#40;including post-cholecystectomy patients&#41; mainly cholesterol stones in female RA patients than in female control &#40;15&#46;4&#37; and 5&#46;2&#37;&#44; respectively&#41;&#46; In that study&#44; RA patients were older and had an increased incidence of hypercholesterolemia than controls and&#44; in agreement with our study&#44; the prevalence of GD in male RA patients was very low&#46; Pamuk et al&#46; studied the prevalence of GD in 113 RA patients in Turkey &#40;92 female&#41;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> and possible related factors&#46; That study showed female RA patients to have a significantly higher prevalence of gallstone disease &#40;including cholecystectomy&#41; compared to controls &#40;22&#46;8&#37; and 11&#46;7&#37;&#44; respectively&#41; and only older age was significantly associated with the presence of GD in RA&#46; In our study&#44; female RA patients also had a higher prevalence of GS than controls&#44; although higher than that observed in the abovementioned studies &#40;33&#46;3&#37; in RA and 15&#46;6&#37; in controls&#41;&#46; This difference could be explained by the fact that GD is more common in western countries and its incidence continues to rise&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a></p><p id="par0080" class="elsevierStylePara elsevierViewall">Gallstone disease is a common digestive disorder worldwide&#44;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a> and&#44; although there are different types of gallstones depending on their composition&#44; most biliary stones in western societies are made of cholesterol&#44; which has been reported in up to 80&#37;&#8211;90&#37; of gallstones found at cholecystectomy&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a> Even though GD is a multifactorial disease derived from complex interactions between many genetic and environmental factors&#44; impaired cholesterol metabolism has been one of the mechanisms involved in the formation of cholesterol gallstones&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a> The first and essential requirement is the supersaturation of bile in cholesterol&#59; however&#44; enhanced cholesterol nucleation&#44; impaired gallbladder emptying with stasis and intestinal hypomotility have also been associated&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a> In supersaturated bile&#44; phospholipids solubilize cholesterol into vesicles&#44; which may precipitate in monohydrate crystals and become entrapped in gallbladder mucin gel with bilirubinate&#44; and finally agglomerate into a macroscopic gallstone&#46; Hence&#44; cholesterol gallstone&#44; composed predominantly of cholesterol crystals&#44; results from a biochemical imbalance between lipids and bile salts in the gallbladder bile&#46; Notwithstanding&#44; no definitive association trends between serum lipids and gallstones have been found&#44; except for a high frequency of gallstones in subjects with hypertriglyceridemia &#40;type IV hyperlipoproteinemia&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0105"><span class="elsevierStyleSup">21&#44;22</span></a> It has been described that nearly all patients with hypertriglyceridemia have supersaturated gallbladder bile even if they are slim&#46; In this respect&#44; female RA patients with GS in the present study displayed a higher plasma TG level compared to those without GD&#59; however&#44; the differences were not statistically significant&#46; On the other hand&#44; it has been suggested that the gallstone risk varies inversely with plasma total HDL or HDL3 cholesterol&#44; attributing to HDL cholesterol a protective effect against gallstone formation&#46;<a class="elsevierStyleCrossRefs" href="#bib0115"><span class="elsevierStyleSup">23&#44;24</span></a> Furthermore&#44; some studies in mice showed a genetic link between bile acid synthesis and HDL-cholesterol levels through the gene that regulates the expression of the cholesterol 7-alpha hydroxylase &#40;the rate-limiting enzyme for bile acid biosynthesis and cholesterol elimination&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a> Other studies found no association between serum HDL-c concentrations and gallstone disease&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a> In line with this&#44; our patients with gallstones had a slightly higher plasma concentration of total HDL-c than those without gallstone disease&#44; although these differences were not statistically significant&#46; By contrast&#44; female RA patients with gallstone in the present study displayed significantly higher HDL3-c levels&#44; even after adjustment for age and triglycerides and apoA-I&#47;HDL and HDL3-c&#47;TC ratios than those without gallstone disease&#46; HDL-c is a source of biliary cholesterol&#44; which forms gallstones&#46;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">25</span></a> Nascent HDL particles are transformed into HDL3 and HDL2 particles as they acquire cholesterol esters from other lipoproteins and cells&#46; In turn&#44; the large and spherical HDL2 particles are transformed into the smaller HDL3 particles after delivering their cholesterol content to the liver where this cholesterol is incorporated into bile&#46; Thus&#44; a higher HDL3-c concentration in patients with GS could be related to a higher rate of liver cholesterol delivery from HDL&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Other studies support the hypothesis of increased biliary catabolism of cholesterol in subjects with gallbladder disease characterized by lower ApoB and higher ApoA-I serum concentrations&#46;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">26</span></a> RA patients with gallstone disease in this study also showed lower ApoB and higher ApoA-I values&#44; but no significant differences were found compared with those without gallstone disease&#46; However&#44; RA patients with GS display a higher apoA-I&#47;HDL-c ratio than those without gallstone disease&#44; which may be explained by the higher protein&#47;lipid ratio of HDL3 particles&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">In addition to an excess supply of cholesterol in the liver&#44; impaired gallbladder emptying with stasis could contribute to the formation of gallstones&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a> Biliary lipid secretion is regulated by an elaborate network of ATP-binding cassette &#40;ABC&#41; transporters on the hepatocyte canalicular membrane&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a> It has been observed that the expression and function of ABC transporters could be decreased in liver in adjuvant-induced arthritis rats<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">27</span></a> as an animal model for inflammation&#44; thereby hindering the secretion of bile salts and favoring the formation of gallstones&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Furthermore&#44; higher blood concentrations of inflammatory cytokines &#40;IL-1&#945;&#44; IL-6 and TNF-&#945;&#41; in menopausal women with GS have been observed&#46;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">28</span></a> Moreover&#44; it has been reported that the endothelial functions of the gallbladder for recycling of lipids could be diminished in an inflammatory context&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> Thus&#44; the chronic inflammatory state present in RA patients&#44; related to lipid profile and gallbladder function&#44; might explain the higher prevalence of GS in older female RA patients&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Albeit not the purpose of this study&#44; a further major aspect to mention is that an association of gallstones with cardiovascular disease has been suggested&#46;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">29</span></a> This would be very interesting to consider&#44; taking into account that patients with RA have increased cardiovascular risk compared to the general population&#44;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">30</span></a> as has been widely reported in the literature&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">A potential limitation of this manuscript is that the data obtained was compared with the information available from a study of several years&#46; Nevertheless&#44; to our knowledge&#44; it is the only existing reference up to the date in the Spanish population&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Conclusions</span><p id="par0110" class="elsevierStylePara elsevierViewall">Women with RA may have a predisposition to gallstone disease that can manifest in middle age or older compared with women in the general population&#46; This situation could be related to chronic inflammation and HDL metabolism&#46; Gallstone disease could be considered a new co-morbidity in female RA patients which has received little attention&#44; although it contributes greatly to health care costs and patient morbidity&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Ethical Responsibilities</span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Protection of human and animal subjects</span><p id="par0115" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this study&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Confidentiality of data</span><p id="par0120" class="elsevierStylePara elsevierViewall">The authors declare that they have followed the protocols of their work center on the publication of patient data&#46;</p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Right to privacy and informed consent</span><p id="par0125" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article&#46;</p></span></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Conflicts of Interest</span><p id="par0130" class="elsevierStylePara elsevierViewall">None of the authors has any conflicts of interest&#46;</p></span></span>"
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              "identificador" => "sec0030"
              "titulo" => "Statistical Analysis"
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          "titulo" => "Results"
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        7 => array:2 [
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          "titulo" => "Discussion"
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          "titulo" => "Conclusions"
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          "identificador" => "sec0050"
          "titulo" => "Ethical Responsibilities"
          "secciones" => array:3 [
            0 => array:2 [
              "identificador" => "sec0055"
              "titulo" => "Protection of human and animal subjects"
            ]
            1 => array:2 [
              "identificador" => "sec0060"
              "titulo" => "Confidentiality of data"
            ]
            2 => array:2 [
              "identificador" => "sec0065"
              "titulo" => "Right to privacy and informed consent"
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        ]
        10 => array:2 [
          "identificador" => "sec0070"
          "titulo" => "Conflicts of Interest"
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        11 => array:2 [
          "identificador" => "xack394766"
          "titulo" => "Acknowledgments"
        ]
        12 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2016-12-30"
    "fechaAceptado" => "2017-06-21"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec1084040"
          "palabras" => array:6 [
            0 => "Rheumatoid arthritis"
            1 => "Comorbidity"
            2 => "Gallstones"
            3 => "Cholecystectomy"
            4 => "Lipids"
            5 => "Lipoproteins"
          ]
        ]
      ]
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec1084039"
          "palabras" => array:6 [
            0 => "Artritis reumatoide"
            1 => "Comorbilidad"
            2 => "Litiasis biliar"
            3 => "Colecistectom&#237;a"
            4 => "L&#237;pidos"
            5 => "Lipoprote&#237;nas"
          ]
        ]
      ]
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    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">To assess the prevalence of gallstone disease and identify associated risk factors in rheumatoid arthritis &#40;RA&#41; patients compared to the general population&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Eighty-four women with rheumatoid arthritis were included in the study&#46; Each patient was assessed via a structured interview&#44; physical examination&#44; abdominal ultrasound and blood test including lipid profile&#46; The prevalence of gallstone disease in rheumatoid arthritis was compared with data from a study of the Spanish population matched by age groups&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Twenty-eight of the 84 women had gallstone disease &#40;33&#46;3&#37;&#41;&#46; RA women with and without gallstone disease were similar in most of the variables assessed&#44; except for older age and menopausal status in the former&#46; A greater prevalence of gallstone disease was seen in rheumatoid arthritis patients compared to the general population of the same age&#59; however&#44; the differences were significant only in women aged 60 or older &#40;45&#46;5&#37; versus 23&#46;1&#37; respectively&#44; <span class="elsevierStyleItalic">P</span>-value &#46;008&#41;&#46; The age-adjusted OR of developing gallstone disease in RA women compared with general population women was 2&#44;3 &#40;95&#37; CI&#58; 1&#46;3&#8211;4&#46;1&#41;&#46; A significantly higher HDL3-c subfraction and higher apoA-I&#47;HDL and HDL3-c&#47;TC ratios were observed in patients with gallstone disease&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusion</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Women with rheumatoid arthritis may have a predisposition to gallstones that can manifest in middle or older age compared with women in the general population&#46; This situation could be related to chronic inflammation and HDL metabolism&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Objective"
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          1 => array:2 [
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            "titulo" => "Methods"
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          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Results"
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            "identificador" => "abst0020"
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      "es" => array:3 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objetivo</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Evaluar la prevalencia de litiasis biliar e identificar los factores de riesgo asociados en pacientes con artritis reumatoide &#40;AR&#41; en comparaci&#243;n con la poblaci&#243;n general&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">M&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Ochenta y cuatro mujeres con AR fueron incluidas en el estudio&#46; Cada paciente fue evaluada a trav&#233;s de una entrevista estructurada&#44; un examen f&#237;sico&#44; una ecograf&#237;a abdominal y un an&#225;lisis de sangre que inclu&#237;a el perfil lip&#237;dico&#46; La prevalencia de litiasis biliar en AR se compar&#243; con los datos de un estudio de la poblaci&#243;n espa&#241;ola emparejada por grupos de edad&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Veintiocho de las 84 mujeres ten&#237;an litiasis biliar &#40;33&#44;3&#37;&#41;&#46; Las pacientes con y sin colelitiasis fueron similares en la mayor&#237;a de las variables evaluadas&#44; a excepci&#243;n de la edad m&#225;s avanzada y mayor prevalencia de estado menop&#225;usico en las pacientes con AR&#46; Las pacientes con AR presentaban una mayor prevalencia de litiasis biliar en comparaci&#243;n con la poblaci&#243;n general de la misma edad&#59; sin embargo&#44; estas diferencias solo fueron significativas en mujeres de 60 a&#241;os o m&#225;s &#40;45&#44;5&#37; vs&#46; 23&#44;1&#37; respectivamente&#44; p-valor 0&#44;008&#41;&#46; La OR ajustada por edad de presentar litiasis biliar en mujeres con AR respecto a mujeres de la poblaci&#243;n general fue de 2&#44;3 &#40;IC del 95&#37;&#58; 1&#44;3-4&#44;1&#41;&#46; Se observ&#243; una subfracci&#243;n de c-HDL3 significativamente m&#225;s alta y una relaci&#243;n mayor de apoA-I&#47;HDL y c-HDL3&#47;TC en las pacientes con litiasis biliar&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusi&#243;n</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Las mujeres con AR pueden tener una mayor predisposici&#243;n a la presencia de litiasis biliar en comparaci&#243;n con las mujeres en la poblaci&#243;n general&#44; sobre todo en edades m&#225;s avanzadas&#46; Esta situaci&#243;n podr&#237;a estar relacionada con la inflamaci&#243;n cr&#243;nica y el metabolismo de las HDL&#46;</p></span>"
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            "titulo" => "Resultados"
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          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Serum HDL3-c concentrations in female RA patients with and without gallstone disease&#46;</p> <p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">&#42;Adjusted model with age and triglycerides as covariates&#46;</p> <p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Serum HDL3-c concentrations are expressed as mean and 95&#37; confidence interval&#46;</p>"
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          "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Odds ratio of gallstone disease in female RA patients compared to female controls&#46;</p>"
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          "leyenda" => "<p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">HAQ&#58; Health Assessment Questionnaire&#59; DAS&#58; Disease Activity Score&#59; ESR&#58; erythrocyte sedimentation rate&#59; CRP&#58; C-reactive protein&#59; GGT&#58; gamma-glutamyl transferase&#59; ALP&#58; alkaline phosphatase&#59; TNF&#58; tumor necrosis factor&#46;</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Gallstone disease &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>28&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">No gallstone disease &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>56&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">P</span>-value&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Age&#44; yrs</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">65 &#40;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">58 &#40;12&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;007&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Disease duration&#44; yrs</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11 &#40;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13 &#40;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;343&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Rheumatoid factor</span><span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#37;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">71&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">84&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;179&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Nodular disease&#44; &#37;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">21&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">36&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;182&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Erosive disease&#44; &#37;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">81&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">81&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;969&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">HAQ 0&#8211;3</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;41 &#40;0&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;38 &#40;0&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;900&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">DAS 28</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#46;5 &#40;1&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#46;0 &#40;1&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;204&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Current smoker&#44; &#37;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Systolic blood pressure&#44; mm Hg</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">158 &#40;23&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">148 &#40;25&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;075&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Diastolic blood pressure&#44; mm Hg</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">88 &#40;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">85 &#40;10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;245&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Body mass index&#44; kg&#47;m</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">2</span></span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">28&#46;3 &#40;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">27&#46;5 &#40;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;491&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Sedentary&#44; &#37;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">29&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">29&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Menopausal&#44; &#37;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">93&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">73&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;035&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">ESR&#44; mm&#47;h</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">38 &#40;19&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">37 &#40;23&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;924&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">CRP&#44; mg&#47;l</span><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11 &#40;3&#8211;22&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8 &#40;4&#8211;27&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;757&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Glucose&#44; mmol&#47;l</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#46;3 &#40;0&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#46;2 &#40;0&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;669&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">GGT&#44; &#956;kat&#47;L</span><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;28 &#40;0&#46;22&#8211;0&#46;59&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;26 &#40;0&#46;19&#8211;0&#46;41&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;220&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">ALP&#44; &#956;kat&#47;L</span><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;4 &#40;1&#46;1&#8211;1&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;2 &#40;1&#46;0&#8211;1&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;115&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Creatinine</span>&#44; <span class="elsevierStyleItalic">&#956;mol&#47;L</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">78 &#40;14&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">83 &#40;22&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;281&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">RA treatment&#44; &#37;&#58;</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Glucocorticosteroids&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">82&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">84&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;836&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Methotrexate&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">64&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">47&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;142&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>TNF-alpha blockers&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;478&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Other disease-modifying antirheumatic drugs&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">21&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">44&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;046&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "en" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Clinical Characteristics of Female RA Patients&#46;</p>"
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          "leyenda" => "<p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">LDL-c&#58; low-density lipoprotein cholesterol&#59; VLDL-c&#58; very-low-density lipoprotein cholesterol&#59; HDL-c&#58; high-density lipoprotein cholesterol&#59; ApoA-I&#58; apolipoprotein A-I&#46;</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Gallstone disease &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>28&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">No gallstone disease &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>56&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">P</span>-value&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Cholesterol&#44; mmol&#47;l&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#46;47 &#40;0&#46;85&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#46;60 &#40;0&#46;96&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;528&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Triglyceride&#44; mmol&#47;l<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;20 &#40;0&#46;90&#8211;1&#46;70&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;05 &#40;0&#46;80&#8211;1&#46;40&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;405&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">LDL-c &#40;mmol&#47;l&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#46;21 &#40;0&#46;76&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#46;41 &#40;0&#46;82&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;286&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">VLDL-c&#44; mmol&#47;l<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;26 &#40;0&#46;20&#8211;0&#46;40&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;22 &#40;0&#46;13&#8211;0&#46;37&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;180&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">HDL-c&#44; mmol&#47;l&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;93 &#40;0&#46;36&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;89 &#40;0&#46;53&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;685&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">HDL2-c&#44; mmol&#47;l&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;08 &#40;0&#46;30&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;08 &#40;0&#46;49&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;943&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">HDL3-c&#44; mmol&#47;l&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;86 &#40;0&#46;13&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;77 &#40;0&#46;20&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;032&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Apolipoprotein A-I&#44; g&#47;L&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;76 &#40;0&#46;25&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;65 &#40;0&#46;34&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;129&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Apolipoprotein B&#44; g&#47;L&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;89 &#40;0&#46;21&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;92 &#40;0&#46;19&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;488&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Lipoprotein &#40;a&#41;&#44; g&#47;L<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;34 &#40;0&#46;15&#8211;0&#46;68&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;34 &#40;0&#46;14&#8211;0&#46;65&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;655&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">HDL-c&#47;cholesterol&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;36 &#40;0&#46;08&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;34 &#40;0&#46;09&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;292&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">ApoA-I&#47;HDL&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;33 &#40;0&#46;06&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;30 &#40;0&#46;06&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;038&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">HDL3-c&#47;cholesterol&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;16 &#40;0&#46;03&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;14 &#40;0&#46;04&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;036&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "en" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Comparison of Serum Lipid&#44; Lipoprotein and Apolipoprotein Values in Female RA Patients With and Without Gallstone Disease&#46;</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col">Age &#40;years&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Female participants</th><th class="td" title="table-head  " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Gallstones</th><th class="td" title="table-head  " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Cholecystectomy</th><th class="td" title="table-head  " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Gallstone disease</th></tr><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">RA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Control&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">RA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Control&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">P</span>-value&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">RA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Control&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">P</span>-value&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">RA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Control&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">P</span>-value&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">30&#8211;39&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">63&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#37; &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#46;9&#37; &#40;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#37; &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#46;2&#37; &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#37; &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11&#46;1&#37; &#40;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">40&#8211;49&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">61&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">25&#37; &#40;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9&#46;8&#37; &#40;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;161&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#37; &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#46;3&#37; &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">25&#37; &#40;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&#46;1&#37; &#40;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;374&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">50&#8211;59&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">24&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">60&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&#46;3&#37; &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10&#37; &#40;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&#46;5&#37; &#40;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;7&#37; &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;068&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">20&#46;8&#37; &#40;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11&#46;7&#37; &#40;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;210&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">&#8805;60&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">44&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">91&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11&#46;4&#37; &#40;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&#46;2&#37; &#40;12&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;765&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">34&#46;1&#37; &#40;15&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9&#46;9&#37; &#40;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">45&#46;5&#37; &#40;20&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">23&#46;1&#37; &#40;21&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;008&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">84&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">275&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11&#46;9&#37; &#40;10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10&#46;5&#37; &#40;29&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;726&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">21&#46;4&#37; &#40;18&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#46;1&#37; &#40;14&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33&#46;3&#37; &#40;28&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15&#46;6&#37; &#40;43&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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          "en" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">Comparison of Gallstone Prevalence by Age Groups Between RA and Controls&#46;</p>"
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                            2 => "T&#46;M&#46; Nikitenko"
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                  "host" => array:1 [
                    0 => array:1 [
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                            2 => "S&#46; Nozawa"
                            3 => "H&#46; Ishikawa"
                            4 => "C&#46; Tohyama"
                            5 => "K&#46; Nakazono"
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                    0 => array:1 [
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                        "tituloSerie" => "J Rheumatol"
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                      "titulo" => "An increased frequency of gallbladder stones in rheumatoid arthritis patients&#46; Factors related to gallbladder stone formation"
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                            2 => "E&#46; Unl&#252;"
                            3 => "I&#46;H&#46; K&#246;ker"
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                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
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