Contessa C, Ramonda R, Lo Nigro A, Modesti V, Lorenzin M, Puato M, Zanon M, Balbi G, Doria A, Punzi L
Dipartimento di Medicina Clinica e Sperimentale, Università di Padova, Italia.
Reumatismo. 2009 Oct-Dec;61(4):298-305. doi: 10.4081/reumatismo.2009.298.
The aim of this study was to evaluate the prevalence of subclinical atherosclerosis in patients with psoriatic arthritis (PsA), correlated with some traditional risk factors of atherosclerosis and with PsA-related disease factors.
Forty-one patients and 41 healthy subjects were evaluated for intima-media thickness (IMT) and flow-mediated dilation (FMD), using carotid duplex scanning. IMT values were expressed like IMT mean (cumulative mean of all the IMT mean) and M-MAX (cumulative mean of all the higher IMT). Subclinical atherosclerosis markers were correlated with age, body mass index (BMI) and blood pressure in both groups, with duration of arthritis, duration of psoriasis, tender and swollen joints, BASDAI (Bath Ankylosing Spondylitis Disease Activity Index), BASFI (Bath Ankylosing Spondylitis Functional Index), erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) in patients.
IMT mean and M-MAX were both higher in PsA patients compared with controls (0.7+/-0.15 vs 0.62+/-0.09 mm; p<0.01 and 0.86+/-0.21 vs. 0.74+/-0.13 mm; p<0.01 respectively). FMD was smaller in patients than in controls (5.9+/-2 vs 7.5+/-2.8%; p<0.01). Univariate analysis showed a correlation between IMT mean and SBP (r=0.217; p=0.05) and a correlation between M-MAX and age (r=0.392; p<0.001), BMI (r=0.252; p<0.05), SBP (r=0.446; p<0.001) in both groups. In PsA patients M-MAX resulted correlated with ESR (r=0.338; p<0.05) and BASDAI (r=0.322; p<0.05).
PsA patients exhibited endothelial dysfunctions which is an early marker of subclinical atherosclerosis, as well as an higher IMT. An interesting correlation between M-MAX and PsA activity index (ESR and BASDAI) was found.
本研究旨在评估银屑病关节炎（PsA）患者亚临床动脉粥样硬化的患病率，并将其与动脉粥样硬化的一些传统危险因素以及PsA相关疾病因素相关联。
采用颈动脉双功超声扫描对41例患者和41名健康受试者进行内膜中层厚度（IMT）和血流介导的血管舒张功能（FMD）评估。IMT值以IMT均值（所有IMT均值的累积均值）和M-MAX（所有较高IMT的累积均值）表示。在两组中，亚临床动脉粥样硬化标志物与年龄、体重指数（BMI）和血压相关，在患者中与关节炎病程、银屑病病程、压痛和肿胀关节数、巴斯强直性脊柱炎疾病活动指数（BASDAI）、巴斯强直性脊柱炎功能指数（BASFI）、红细胞沉降率（ESR）和C反应蛋白（CRP）相关。
与对照组相比，PsA患者的IMT均值和M-MAX均更高（分别为0.7±0.15 vs 0.62±0.09mm；p<0.01和0.86±0.21 vs 0.74±0.13mm；p<0.01）。患者的FMD低于对照组（5.9±2 vs 7.5±2.8%；p<0.01）。单因素分析显示，两组中IMT均值与收缩压（r=0.217；p=0.05）以及M-MAX与年龄（r=0.392；p<0.001）、BMI（r=0.252；p<0.05）、收缩压（r=0.446；p<0.001）之间存在相关性。在PsA患者中，M-MAX与ESR（r=0.338；p<0.05）和BASDAI（r=0.322；p<0.05）相关。
PsA患者表现出内皮功能障碍，这是亚临床动脉粥样硬化的早期标志物，同时IMT也更高。发现M-MAX与PsA活动指数（ESR和BASDAI）之间存在有趣的相关性。
