Internal Medicine Department, GATA Haydarpasa Training Hospital, Uskudar, 34688, Istanbul, Turkey.
Gastroenterology Department, GATA Haydarpasa Training Hospital, Uskudar, 34668, Istanbul, Turkey.
Clin Rheumatol. 2017 Sep;36(9):2071-2077. doi: 10.1007/s10067-016-3532-2. Epub 2017 Jan 10.
It has been suggested that there is an ongoing subclinical inflammation in familial Mediterranean fever (FMF) patients also in attack-free periods as well. Due to this ongoing inflammation, endothelial dysfunction (ED) may develop. Previously, ED has been suggested to increase the risk of the atherosclerosis and cardiovascular disease (CVD). Endocan is recognized as a specific molecule of the endothelium and has been shown to increase in some cases associated with inflammation. However, there is not sufficient data whether those with FMF could develop ED in the early period of life. In this study, we aimed to investigate ED and its relation with endocan in young FMF patients. A total of 57 male patients diagnosed with FMF according to the Tel Hashomer criteria and a total of 33 healthy males with similar characteristics to the patient group were included in this research. Complete blood count, erythrocyte sedimentation rate (ESR), fibrinogen, serum glucose, serum LDL cholesterol (LDL-C) and triglyceride (TG), asymmetric dimethylarginine (ADMA), and endocan levels were tested from fasting blood samples. Moreover, carotid intima-media thickness (CIMT) and flow-mediated dilatation (FMD) were measured. The endocan levels of the FMF patients during an attack-free period were significantly higher than those of the control group (p < 0.001). On the other hand, FMD measurements were significantly lower among FMF patients (p < 0.001). ADMA levels were higher in the patient group; however, this difference was similar (p > 0.05). CIMT values were similar among FMF patients and healthy controls (p > 0.05). These results have suggested that ED may develop in the patients with FMF who have no additional CVD risk, even during young adulthood, and endocan may be a favorable biomarker at demonstration of ED than ADMA among FMF patients.
有人认为，在家族性地中海热（FMF）患者无发作期也存在持续的亚临床炎症。由于这种持续的炎症，内皮功能障碍（ED）可能会发展。此前，已有研究表明 ED 会增加动脉粥样硬化和心血管疾病（CVD）的风险。Endocan 被认为是内皮的特异性分子，在某些与炎症相关的情况下其水平会升高。然而，目前尚无足够的数据表明 FMF 患者是否会在生命早期出现 ED。在这项研究中，我们旨在研究年轻 FMF 患者的 ED 及其与 Endocan 的关系。共有 57 名男性 FMF 患者（根据 Tel Hashomer 标准诊断）和 33 名与患者组特征相似的健康男性纳入本研究。从空腹血样中检测全血细胞计数、红细胞沉降率（ESR）、纤维蛋白原、血糖、血清 LDL 胆固醇（LDL-C）和甘油三酯（TG）、不对称二甲基精氨酸（ADMA）和 Endocan 水平。此外，还测量了颈动脉内膜中层厚度（CIMT）和血流介导的扩张（FMD）。无发作期 FMF 患者的 Endocan 水平明显高于对照组（p<0.001）。另一方面，FMF 患者的 FMD 测量值明显较低（p<0.001）。患者组 ADMA 水平较高，但差异相似（p>0.05）。FMF 患者和健康对照组的 CIMT 值相似（p>0.05）。这些结果表明，即使在年轻成年期，无其他 CVD 风险的 FMF 患者也可能发生 ED，并且在 FMF 患者中，Endocan 可能是比 ADMA 更能反映 ED 的有利生物标志物。
