Sari Ismail, Kebapcilar Levent, Alacacioglu Ahmet, Bilgir Oktay, Yildiz Yasar, Taylan Ali, Yuksel Arif, Kozaci Didem L
Department of Internal Medicine, Izmir Bozyaka Training and Research Hospital, Turkey.
Intern Med. 2009;48(16):1363-8. doi: 10.2169/internalmedicine.48.2193. Epub 2009 Aug 17.
Endothelial dysfunction is present in ankylosing spondylitis (AS). However, the etiology of events is still unclear. The aim of the present study was to investigate whether there are abnormalities in nitric oxide (NO) metabolism and endothelin-1 (ET-1) in AS patients.
Subjects without any classical cardiovascular (CV) risk factors were studied. Fasting glucose, serum lipids, high sensitive CRP (hsCRP), ESR, asymmetric dimethylarginine (ADMA) and ET-1 were studied. Patients were also evaluated with the Bath Ankylosing Spondylitis Metrology Index, Bath Ankylosing Spondylitis Functional Index, and the Bath Ankylosing Spondylitis Disease Activity Index.
A total of 48 AS patients (38.6+/-10.6 years; 36M/12F) and 38 controls (36.4+/-11.1 years; 27M/11F) were studied. Acute phase reactants including hsCRP, and ESR were significantly increased in the patients group (p<0.05). Serum ADMA concentrations were also significantly higher in AS than in controls. Plasma levels of ET-1 did not differ between the groups (p>0.05). Comparison of three groups (conventional and anti-TNF treatment groups and controls) revealed that ADMA was significantly higher in the conventional treated AS than in controls. The levels of ADMA were not different between anti-TNF group and healthy subjects. Plasma ET-1 concentrations were similar between groups (p>0.05). Correlation analysis yielded significant correlations between ADMA, hsCRP, LDL cholesterol, HDL cholesterol and triglycerides (p<0.05).
The increased ADMA levels obtained in a group of relatively young AS patients who did not have classical CV risk factors suggest that NO metabolism is impaired in AS. On the other hand, anti-TNF treatments may have a beneficial effect on vascular function in AS.
强直性脊柱炎（AS）患者存在内皮功能障碍。然而，其发病机制仍不清楚。本研究旨在探讨AS患者一氧化氮（NO）代谢和内皮素-1（ET-1）是否存在异常。
研究对象为无任何经典心血管（CV）危险因素的受试者。检测空腹血糖、血脂、高敏C反应蛋白（hsCRP）、红细胞沉降率（ESR）、不对称二甲基精氨酸（ADMA）和ET-1。同时采用巴斯强直性脊柱炎测量指数、巴斯强直性脊柱炎功能指数和巴斯强直性脊柱炎疾病活动指数对患者进行评估。
共研究了48例AS患者（38.6±10.6岁；36例男性/12例女性）和38例对照者（36.4±11.1岁；27例男性/11例女性）。患者组包括hsCRP和ESR在内的急性期反应物显著升高（p<0.05）。AS患者血清ADMA浓度也显著高于对照组。两组间血浆ET-1水平无差异（p>0.05）。三组（传统治疗组、抗TNF治疗组和对照组）比较显示，传统治疗的AS患者ADMA显著高于对照组。抗TNF组与健康受试者之间ADMA水平无差异。各组间血浆ET-1浓度相似（p>0.05）。相关性分析显示ADMA、hsCRP、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇和甘油三酯之间存在显著相关性（p<0.05）。
在一组无经典CV危险因素的相对年轻的AS患者中获得的ADMA水平升高表明AS患者的NO代谢受损。另一方面，抗TNF治疗可能对AS患者的血管功能有有益作用。
