Daza Leonel, Aguirre Martin, Jimenez Martin, Herrera Rafael, Bollain J J
Unidad de Investigación Clínica, Unidad Médica de Alta Especialidad Bajío, Instituto Mexicano del Seguro Social, Av. A. López Mateos e Insurgentes S/N, Col. Los Paraísos, CP 37480, León Guanajuato, Mexico.
Clin Rheumatol. 2007 Apr;26(4):533-7. doi: 10.1007/s10067-006-0338-7. Epub 2006 Jun 7.
High atherosclerosis prevalence was found in rheumatoid arthritis (RA), and the von Willebrand factor (vWF) was shown to be a marker for endothelial damage. The aim of this study was to evaluate the association of intima-media thickness of the left common carotid artery with vWF serum levels in rheumatoid arthritis patients without cardiovascular risk factors. We included 55 RA female patients, each with at least 5 years of duration of the disease, and 20 healthy female subjects as members of the control group. The vWF, cholesterol, triglycerides, and the immune variables-rheumatoid factor and reactive C protein-were evaluated. The media thickness and intima-media thickness (IMT) in patients and in the control subjects were assessed by Doppler ultrasound of the left common carotid artery. Although the ages for RA patients and healthy female controls were not different, the IMT of the left common carotid artery (IMT CCA) in rheumatoid arthritis patients was increased in comparison with healthy control measurements, the mean being 0.67 mm (SD 0.18) vs 0.58 mm (SD 0.10) with a p value 0.01. The vWF serum levels showed differences in RA patients from those in control patients, 145.6 (SD 30.08) vs 121.8 (SD 37.17), respectively, with p=0.007. A correlation was also found between vWF with IMT CCA in the RA patients: r=0.390 and p<0.05. We concluded that the measurements of the left common carotid artery intima-media thickness together with the von Willebrand factor serum levels could give valuable information about the artery status and the atherosclerosis process in early stages in patients with rheumatoid arthritis without cardiovascular risk factors.
类风湿关节炎(RA)患者中动脉粥样硬化患病率较高,血管性血友病因子(vWF)被证明是内皮损伤的标志物。本研究的目的是评估无心血管危险因素的类风湿关节炎患者左颈总动脉内膜中层厚度与vWF血清水平之间的关联。我们纳入了55名女性类风湿关节炎患者,每位患者病程至少5年,以及20名健康女性作为对照组。对vWF、胆固醇、甘油三酯以及免疫变量类风湿因子和反应性C蛋白进行了评估。通过左颈总动脉多普勒超声评估患者和对照者的中层厚度和内膜中层厚度(IMT)。虽然类风湿关节炎患者和健康女性对照的年龄没有差异,但类风湿关节炎患者左颈总动脉的IMT(IMT CCA)与健康对照测量值相比有所增加,平均值分别为0.67 mm(标准差0.18)和0.58 mm(标准差0.10),p值为0.01。类风湿关节炎患者的vWF血清水平与对照患者不同,分别为145.6(标准差30.08)和121.8(标准差37.17),p = 0.007。在类风湿关节炎患者中还发现vWF与IMT CCA之间存在相关性:r = 0.390,p < 0.05。我们得出结论,对于无心血管危险因素的类风湿关节炎患者,测量左颈总动脉内膜中层厚度以及vWF血清水平可以提供有关动脉状态和动脉粥样硬化早期进程的有价值信息。