Nesfatin-1 and visfatin expression is associated with reduced atherosclerotic disease risk in patients with rheumatoid arthritis

•Visfatin levels were associated with cardio-metabolic risk in RA.•Nesfatin concentrations were related to reduced carotid IMT in RA.•Nesfatin and visfatin associated with the plaque stability mediator MMP-2 in RA.•Nesfatin and visfatin concentrations were directly correlated in RA.•MMP-2 expression in relation to visfatin may represent a compensatory mechanism in RA. Nesfatin is an anti-inflammatory molecule that reduces atherosclerotic cardiovascular risk. By contrast, visfatin has pro-inflammatory properties and is pro-atherogenic. We examined the potential impact of nesfatin and visfatin on atherosclerotic disease in 232 (113 black and 119 white) consecutive rheumatoid arthritis (RA) patients from 2 centers. Independent relationships of nesfatin and visfatin concentrations with metabolic risk factors, endothelial activation, carotid atherosclerosis and altered plaque stability were determined in multivariable regression models. Rheumatoid factor (RF) positivity was associated with both nesfatin (β = 0.650, p