Cleveland Clinic, Cleveland, Ohio.
Arthritis Care Res (Hoboken). 2014 Jan;66(1):97-103. doi: 10.1002/acr.22144.
To determine the differences in carotid intima-media thickness (CIMT) between patients with psoriatic diseases with and without metabolic syndrome.
Eligible patients from the Cardiometabolic Outcome Measures in Psoriatic Arthritis Study database, which is comprised of both psoriasis and psoriatic arthritis (PsA) patients enrolled at 2 academic medical centers, were included. Detailed cardiovascular (CV) risk factors, including metabolic syndrome profiles, medication use, disease activity, and CIMT, were examined.
A total of 343 patients with psoriatic disease were evaluated (42.28% with psoriasis and 57.72% with PsA). PsA patients were significantly older, with longer disease duration and higher blood pressure, body mass index, and C-reactive protein (CRP) level. PsA patients took more disease-modifying antirheumatic drugs (DMARDs) and corticosteroids and underwent more CV procedures. There were no differences in prior CV events, family history of CV risk, and Framingham/Adult Treatment Panel III Risk Score. PsA patients had a higher risk of metabolic syndrome (univariate odds ratio [OR] 1.78 [95% confidence interval (95% CI) 1.08-2.95], P = 0.025). Even after adjusting for age, CRP level, and diastolic blood pressure, PsA patients not taking DMARDs were twice as likely to have metabolic syndrome compared to psoriasis patients (adjusted OR 2.09 [95% CI 0.78-5.59], P = 0.049). PsA patients with metabolic syndrome had the thickest CIMT compared to any other group (P < 0.001).
PsA patients had an increased prevalence of metabolic syndrome with significantly greater CIMT measurements compared to patients with psoriasis. Furthermore, PsA patients with metabolic syndrome had the greatest CIMT measurements compared to PsA patients without metabolic syndrome and psoriasis patients with or without metabolic syndrome. Incremental increases in inflammatory pathways in PsA may contribute to a higher CV risk as compared to psoriasis patients.
确定患有代谢综合征和无代谢综合征的银屑病患者之间颈动脉内膜中层厚度（CIMT）的差异。
从心血管代谢结局在银屑病关节炎研究数据库中纳入符合条件的患者，该数据库由在 2 所学术医疗中心就诊的银屑病和银屑病关节炎（PsA）患者组成。检查了详细的心血管（CV）危险因素，包括代谢综合征谱、药物使用、疾病活动度和 CIMT。
共评估了 343 例银屑病患者（42.28%为银屑病，57.72%为 PsA）。PsA 患者年龄明显较大，疾病持续时间较长，血压、体重指数和 C 反应蛋白（CRP）水平较高。PsA 患者服用更多的疾病修饰抗风湿药物（DMARDs）和皮质类固醇，并接受更多的 CV 治疗。既往 CV 事件、CV 风险的家族史和弗雷明汉/成人治疗小组 III 风险评分无差异。PsA 患者代谢综合征的风险更高（单因素优势比 [OR] 1.78[95%置信区间（95%CI）1.08-2.95]，P = 0.025）。即使在校正年龄、CRP 水平和舒张压后，未服用 DMARDs 的 PsA 患者发生代谢综合征的可能性仍是银屑病患者的两倍（校正 OR 2.09[95%CI 0.78-5.59]，P = 0.049）。患有代谢综合征的 PsA 患者的 CIMT 最厚，与其他任何组相比差异均有统计学意义（P < 0.001）。
与银屑病患者相比，PsA 患者代谢综合征的患病率更高，CIMT 测量值明显更大。此外，与无代谢综合征的 PsA 患者和有或无代谢综合征的银屑病患者相比，患有代谢综合征的 PsA 患者的 CIMT 测量值最大。与银屑病患者相比，PsA 患者中炎症通路的递增可能导致更高的 CV 风险。
