Yuksel Murat, Yildiz Abdulkadir, Oylumlu Mustafa, Turkcu Fatih Mehmet, Bilik Mehmet Zihni, Ekinci Aysun, Elbey Bilal, Tekbas Ebru, Alan Sait
Department of Cardiology, Dicle University School of Medicine, Diyarbakir, Turkey.
Dicle Universitesi Kalp Hastanesi, Kardiyoloji klinigi, Sur, 21280, Diyarbakir, Turkey.
Clin Rheumatol. 2016 Mar;35(3):701-8. doi: 10.1007/s10067-015-2907-0. Epub 2015 Mar 7.
The etiology of Behçet's disease (BD) has not been fully elucidated. However, immunological and environmental factors, endothelial dysfunction (ED), and genetic susceptibility have been proposed to play a role. In this study, we aimed to evaluate epicardial fat thickness (EFT) together with serum asymmetric dimethylarginine (ADMA), carotid intima media thickness (CIMT), and neutrophil-to-lymphocyte ratio (NLR) in BD patients with ocular involvement. Thirty-six ocular BD patients (17 active and 19 inactive ocular involvement), and 35 age and sex-matched healthy controls were enrolled to this cross-sectional study. All patients underwent examinations with transthoracic echocardiography and carotid Doppler ultrasound. Serum ADMA levels, CIMT, EFT, and NLR were compared between groups, and their association with disease activity was evaluated. Behçet's disease patients had higher WBC counts, neutrophil counts, NLR, CIMT, EFT values, and serum ADMA levels than do healthy controls. The other biochemical, hematological, and echocardiographic parameters were comparable between the two groups. Behçet's disease duration was positively correlated with EFT and CIMT. Multivariate logistic regression analysis revealed that increased serum ADMA concentration and CIMT are independently associated with BD. Neutrophil counts, NLR, and serum ADMA level were higher, and lymphocyte count was lower in patients with active ocular BD compared to those of inactive ocular BD group. Carotid intima media thickness, serum ADMA level, EFT, and NLR were increased in ocular BD patients compared to healthy subjects. In addition, both serum ADMA level and NLR were associated with disease activity of ocular involvement. Increase in disease duration was associated with increase in CIMT and EFT which suggests that anatomical changes occur in time during the disease course. Increased CIMT, serum ADMA level, EFT, and NLR may provide new clues about the role of ED and inflammation in the etiopathogenesis of BD.
白塞病（BD）的病因尚未完全阐明。然而，免疫和环境因素、内皮功能障碍（ED）以及遗传易感性被认为发挥了作用。在本研究中，我们旨在评估合并眼部受累的BD患者的心外膜脂肪厚度（EFT）、血清不对称二甲基精氨酸（ADMA）、颈动脉内膜中层厚度（CIMT）和中性粒细胞与淋巴细胞比值（NLR）。36例眼部BD患者（17例眼部受累活动期和19例非活动期）以及35例年龄和性别匹配的健康对照者纳入了这项横断面研究。所有患者均接受经胸超声心动图和颈动脉多普勒超声检查。比较各组间的血清ADMA水平、CIMT、EFT和NLR，并评估它们与疾病活动度的相关性。白塞病患者的白细胞计数、中性粒细胞计数、NLR、CIMT、EFT值和血清ADMA水平高于健康对照者。两组间的其他生化、血液学和超声心动图参数具有可比性。白塞病病程与EFT和CIMT呈正相关。多因素逻辑回归分析显示，血清ADMA浓度升高和CIMT与BD独立相关。与眼部BD非活动期患者相比，眼部BD活动期患者的中性粒细胞计数、NLR和血清ADMA水平更高，淋巴细胞计数更低。与健康受试者相比，眼部BD患者的颈动脉内膜中层厚度、血清ADMA水平、EFT和NLR升高。此外，血清ADMA水平和NLR均与眼部受累的疾病活动度相关。病程延长与CIMT和EFT增加相关，这表明在疾病过程中会随着时间发生解剖学变化。CIMT、血清ADMA水平、EFT和NLR升高可能为ED和炎症在BD发病机制中的作用提供新线索。
