Mazlan Sadhanah Aqashiah, bin Mohamed Said Mohd Shahrir, Hussein Heselynn, binti Shamsuddin Khadijah, Shah Shamsul Azhar, Basri Hamidon
Hospital Ampang, Medical Department, Kuala Lumpur, Malaysia.
Acta Medica (Hradec Kralove). 2009;52(3):107-16. doi: 10.14712/18059694.2016.114.
Psoriatic Arthritis (PsA) is an inflammatory arthritis associated with Psoriasis. Its recognition as an inflammatory disease distinct from Rheumatoid Arthritis has put forward for consideration several questions regarding its specific CVS mortality and morbidity (9, 11, 16, 26). Carotid intima media thickness is a useful surrogate and sensitive marker to determine atherosclerosis even in its subclinical stages (6, 14, 22, 27, 32).
Prevalence of carotid intima media thickness in patients with Psoriatic arthritis is unknown in Asian population. We aim to identify the presence of subclinical atherosclerosis in patients with psoriatic arthritis and disease activity association and its predictors in a series of patients with PsA attended to the rheumatology clinic, tertiary hospitals.
A total of 63 patients with PsA who fulfilled the CASPAR criteria were recruited from UKM Medical Centre and Hospital Putrajaya. Common carotid intima media thickness (IMT) was measured in both right and left carotid artery by using high resolution B-mode ultrasound. This was a cross sectional study first done in Malaysia for PsA patients.
The positive IMT (IMT > 1.00 mm) among PsA was observed in 10 out of 63 patients (15.9 %) regardless of background cardiovascular risk. The mean +/- SD of IMT was 0.725 +/-0.260 mm for this study. Variables significantly associated with positive IMT (p < 0.05) included age at the time of study (p = 0.005), waist circumference (p = 0.001), Hypertension (p = 0.007), Diabetes (p = 0.002) and Metabolic syndrome (p = 0.001) and not associated with gender, ethnicity, duration of PsA disease, pattern of PsA, disease activity and severity. Above all, only age had positive IMT independent predictor (p = 0.032), with OR 1.116; 95 % CI (1.010-1.234).
There was a significant association between CVS risk and positive Intima Media Thickness in Psoriatic Arthritis patients. Otherwise, there was no association in disease activity, disease severity and DMARDS therapy with positive Intima Media Thickness in Psoriatic Arthritis patients. The study was approved by Research and Ethics Committee of the faculty of medicine, Universiti Kebangsaan Malaysia with project code FF-114-2008 and by Community Research Center (CRC) of National Institutes of Health (NIH) for the case study in Hospital Putrajaya with the project code NMRR-08-970-2125.
银屑病关节炎（PsA）是一种与银屑病相关的炎性关节炎。它被认为是一种有别于类风湿关节炎的炎性疾病，这引发了一些关于其特定心血管系统死亡率和发病率的问题（9, 11, 16, 26）。颈动脉内膜中层厚度是一种有用的替代指标和敏感标志物，即使在亚临床阶段也能用于确定动脉粥样硬化（6, 14, 22, 27, 32）。
在亚洲人群中，银屑病关节炎患者的颈动脉内膜中层厚度患病率尚不清楚。我们旨在确定银屑病关节炎患者中亚临床动脉粥样硬化的存在情况、疾病活动相关性及其预测因素，研究对象为三级医院风湿病门诊的一系列银屑病关节炎患者。
从马来西亚国立大学医学中心和布城医院招募了63例符合CASPAR标准的银屑病关节炎患者。使用高分辨率B型超声测量双侧颈总动脉的内膜中层厚度（IMT）。这是在马来西亚首次针对银屑病关节炎患者进行的横断面研究。
63例银屑病关节炎患者中有10例（15.9%）的IMT呈阳性（IMT > 1.00 mm），与心血管疾病背景风险无关。本研究中IMT的平均值±标准差为0.725±0.260 mm。与IMT呈阳性显著相关（p < 0.05）的变量包括研究时的年龄（p = 0.005）、腰围（p = 0.001）、高血压（p = 0.007）、糖尿病（p = 0.002）和代谢综合征（p = 0.001），与性别、种族、银屑病关节炎病程、银屑病关节炎类型、疾病活动度和严重程度无关。最重要的是，只有年龄是IMT呈阳性的独立预测因素（p = 0.032），比值比为1.116；95%置信区间（1.010 - 1.234）。
银屑病关节炎患者的心血管系统风险与内膜中层厚度呈阳性之间存在显著关联。此外，银屑病关节炎患者的疾病活动度、疾病严重程度和DMARDs治疗与内膜中层厚度呈阳性之间无关联。本研究获得马来西亚国立大学医学院研究与伦理委员会批准，项目代码为FF - 114 - 2008；在布城医院进行的病例研究获得美国国立卫生研究院（NIH）社区研究中心（CRC）批准，项目代码为NMRR - 08 - 970 - 2125。
