Cuomo G, Di Micco P, Niglio A, La Montagna G, Valentini G
Unità Operativa di Reumatologia, Seconda Università degli Studi di Napoli, 80131 Naples.
Reumatismo. 2004 Oct-Dec;56(4):242-6. doi: 10.4081/reumatismo.2004.242.
To investigate the intima-media thickness of the common carotid arteries (IMT-CCA) in patients with Rheumatoid Arthritis (RA), and its relationships with classical atherosclerosis risk factors and disease features i.e. duration, activity and disability.
48 RA patients (35 F, 13 M; age ed 26-69 years median 55; disease duration 1-18 years, median 8), and 22 controls (16 F, 6 M; age 28-66, median 50) matched for classical atherosclerosis risk factors, i.e. age, sex, smoking, blood pressure, body mass index, diabetes, familiarity, and for postmenopausal status, were studied. IMT and plaques were measured in the left and right common carotid arteries. Serum total cholesterol, triglyceride, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, apoliporotein AI, apolipoprotein B, and rheumatoid factor were determined in patients and controls. The DAS28, the HAQ-DI and disease duration were considered as clinical parameters reflecting disease status.
The IMT-CCA (mean +/- SD) was significantly greater in the 48 RA patients than in the 22 controls subjects (1.00+/-0.25 vs. 0.78+/-0.21; p=0.0007). In the 70 subjects investigated CCA-IMT resulted to be significantly correlated with diastolic blood pressure, body mass index, triglyceride and RA status. In the 48 RA patients no correlation was detected with either disease duration or activity or disability.
our study confirms an increased IMT in RA patients without any clinically evident manifestation of cardiovascular disease. It supports the existence of subclinical atherosclerosis in RA.
研究类风湿关节炎(RA)患者的颈总动脉内膜中层厚度(IMT-CCA),及其与经典动脉粥样硬化危险因素和疾病特征(即病程、活动度和残疾情况)之间的关系。
研究48例RA患者(35例女性,13例男性;年龄26 - 69岁,中位数55岁;病程1 - 18年,中位数8年)和22例对照者(16例女性,6例男性;年龄28 - 66岁,中位数50岁),这些对照者在经典动脉粥样硬化危险因素(即年龄、性别、吸烟、血压、体重指数、糖尿病、家族史)以及绝经状态方面进行了匹配。测量左右颈总动脉的IMT和斑块情况。测定患者和对照者的血清总胆固醇、甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、载脂蛋白AI、载脂蛋白B和类风湿因子。将疾病活动度评分(DAS28)、健康评估问卷残疾指数(HAQ-DI)和病程作为反映疾病状态的临床参数。
48例RA患者的IMT-CCA(均值±标准差)显著高于22例对照者(1.00±0.25 vs. 0.78±0.21;p = 0.0007)。在70例被研究对象中,颈总动脉IMT与舒张压、体重指数、甘油三酯和RA状态显著相关。在48例RA患者中,未检测到与病程、活动度或残疾情况的相关性。
我们的研究证实,RA患者的IMT增加,且无任何心血管疾病的临床明显表现。这支持了RA患者存在亚临床动脉粥样硬化。