Giannelou Maira, Tseronis Dimitrios, Antypa Eleni, Mavragani Clio P
Department of Pathophysiology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
Department of Rheumatology, General Hospital of Athens "G. Gennimatas", Athens, Greece.
Front Psychiatry. 2018 Jun 19;9:246. doi: 10.3389/fpsyt.2018.00246. eCollection 2018.
Patients with systemic lupus erythematosus (SLE) are characterized by increased cardiovascular disease (CVD) risk as well as heightened rates of psychological distress. Since a link between psychological issues and CV morbidity has been previously suggested, the influence of psychological burden on subclinical atherosclerosis in SLE patients was investigated. 71 SLE patients were assessed for the presence of subclinical atherosclerosis-defined either as carotid and/or femoral plaque formation or arterial wall thickening [Intima Media Thickness (IMT) levels > 0.90 mm by Doppler ultrasound]; personality traits, anxiety and depression, sleeping habits and fatigue levels were also evaluated by specific questionnaires including Eysenck Personality Questionnaire Scale, State-Trait Anxiety Inventory (STAI), Zung Depression Scale, Athens Insomnia Scale and Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F). Disease related clinical and laboratory features and traditional risk factors for atherosclerosis were documented. Univariate and multivariate analysis were performed. SLE patients with arterial wall thickening displayed higher STAI anxiety scores (either as a current state or as a personality trait) compared to those without (49.8 ± 5.6 vs. 46.9 ± 5.4, -value: 0.03 and 49.2 ± 4.4 vs. 45.7 ± 6.8, value: 0.009, respectively). In a multivariate model, trait anxiety and extraversion personality scores were found to be independently associated with arterial wall thickening and plaque formation, respectively [OR95%(CI):1.2(1.0-1.5) and 0.7(0.6-1.0), respectively], following adjustment for potential confounders. No other associations were detected. Anxiety and extraversion personality traits have been independently associated with subclinical atherosclerosis in lupus patients, implying psychoneuroimmunological interactions as contributors in SLE related atherosclerosis.
系统性红斑狼疮（SLE）患者的特征是心血管疾病（CVD）风险增加以及心理困扰发生率升高。由于此前已有人提出心理问题与心血管疾病之间存在联系，因此研究了心理负担对SLE患者亚临床动脉粥样硬化的影响。对71例SLE患者进行评估，以确定是否存在亚临床动脉粥样硬化，其定义为颈动脉和/或股动脉斑块形成或动脉壁增厚[通过多普勒超声测量内膜中层厚度（IMT）> 0.90 mm]；还通过包括艾森克人格问卷量表、状态-特质焦虑量表（STAI）、zung抑郁量表、雅典失眠量表和慢性病治疗功能评估-疲劳量表（FACIT-F）在内的特定问卷对人格特质、焦虑和抑郁、睡眠习惯及疲劳水平进行了评估。记录了与疾病相关的临床和实验室特征以及动脉粥样硬化的传统危险因素。进行了单因素和多因素分析。与无动脉壁增厚的SLE患者相比，有动脉壁增厚的患者STAI焦虑评分更高（无论是当前状态还是人格特质）（分别为49.8±5.6对46.9±5.4，P值：0.03；49.2±4.4对45.7±6.8，P值：0.009）。在多因素模型中，在对潜在混杂因素进行调整后，发现特质焦虑和外向型人格评分分别与动脉壁增厚和斑块形成独立相关[OR95%（CI）：分别为1.2（1.0 - 1.5）和0.7（0.6 - 1.0）]。未检测到其他关联。焦虑和外向型人格特质与狼疮患者的亚临床动脉粥样硬化独立相关，这意味着心理神经免疫学相互作用是SLE相关动脉粥样硬化的促成因素。
