Upala Sikarin, Yong Wai Chung, Sanguankeo Anawin
Department of Internal Medicine, Bassett Medical Center and Columbia University College of Physicians and Surgeons, Cooperstown, NY, USA.
Department of Preventive and Social Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Korean Circ J. 2017 Jul;47(4):477-482. doi: 10.4070/kcj.2017.0004. Epub 2017 Jul 27.
Behçet's disease (BD) is a systemic vasculitis that is characterized by genital, oral, or skin lesions, uveitis, and vascular complications. Studies have shown that increased arterial stiffness is common in systemic immune and inflammatory diseases such as rheumatoid arthritis and systemic lupus erythematosus. However, current research has not yet determined whether patients with BD have increased arterial stiffness. This meta-analysis compares arterial stiffness parameters in subjects with a BD diagnosis to normal subjects.
A comprehensive search of the MEDLINE and EMBASE databases was performed from the database beginning through May 2016. Observation studies were included in this analysis if they assessed the association between BD and arterial stiffness in adult subjects. BD patients met the International Study Group criteria for a diagnosis of Behçet's disease. Aortic stiffness was assessed using carotid-femoral pulse wave velocity (PWV) measurements as an indicator. Pooled mean difference (MD) of PWV and 95% confidence intervals (CI) were calculated using a random-effect, generic inverse variance meta-analysis. The between-study heterogeneity of effect-size was quantified using the Q statistic and I.
Data were extracted from four observational studies that included 303 subjects. PWV is significantly higher in patients with Behçet's disease compared with controls (MD=0.74;95%, CI: 0.28-1.20, p=0.002, I=63%).
In this meta-analysis, we observed that PWV, an ideal indicator of arterial stiffness, is increased in patients with Behçet's disease compared with the controls. Prospective studies in a large population should be done to determine the pathophysiological and prognostic implications of increased arterial stiffness in BD.
白塞病（BD）是一种全身性血管炎，其特征为生殖器、口腔或皮肤病变、葡萄膜炎及血管并发症。研究表明，动脉僵硬度增加在类风湿关节炎和系统性红斑狼疮等全身性免疫和炎症性疾病中较为常见。然而，目前的研究尚未确定BD患者的动脉僵硬度是否增加。本荟萃分析比较了BD诊断患者与正常受试者的动脉僵硬度参数。
从数据库起始至2016年5月，对MEDLINE和EMBASE数据库进行了全面检索。如果观察性研究评估了成年受试者中BD与动脉僵硬度之间的关联，则纳入本分析。BD患者符合国际研究组的白塞病诊断标准。使用颈股脉搏波速度（PWV）测量作为指标评估主动脉僵硬度。采用随机效应、通用逆方差荟萃分析计算PWV的合并平均差（MD）和95%置信区间（CI）。使用Q统计量和I2对研究间效应大小的异质性进行量化。
数据来自四项观察性研究，共303名受试者。与对照组相比，白塞病患者的PWV显著更高（MD = 0.74；95%CI：0.28 - 1.20，p = 0.002，I2 = 63%）。
在本荟萃分析中，我们观察到，与对照组相比，白塞病患者的动脉僵硬度理想指标PWV增加。应开展大规模人群的前瞻性研究，以确定BD患者动脉僵硬度增加的病理生理和预后意义。
