Das Shubhabrata, Sarkar Rathindranath, Paul Rudrajit, Bagri Parul, Dey Ashutosh, Mukherjee Anindya, Das Ankita
Clinical Fellow, University of Alberta, Edmonton, Canada; Corresponding Author.
Professor and Head, Department of Medicine, Medical College and Hospital, Kolkata, West Bengal.
J Assoc Physicians India. 2018 Jul;66(7):63-66.
Chronic inflammation in spondyloarthropathy (SpA) is associated with accelerated atherosclerotic cardiovascular disease (CVD). Flow mediated vasodilatation (FMD) and carotid intima-media thickness (cIMT) detects endothelial dysfunction and subclinical atherosclerosis respectively, responsible for atherosclerotic CVD.
We aimed to examine the association of disease activity in SpA with surrogate markers of CVD, i.e., FMD and cIMT.
Fifty patients of Axial SpA (Assessment of SpondyloArthritis Society-ASAS 2009 criteria) (<5 years disease duration) and 50 control subjects, matched for age (33.7±8.8 vs. 33.7±8.4 years) and sex, with no CV risk factors were recruited. Ultrasound assessment of FMD of brachial artery and cIMT of both common carotid arteries were performed. Measurements were compared between patients and controls by Student's t test. Association of disease activity in SpA patients with FMD and cIMT, were evaluated by Pearson/Spearman's correlation.
FMD (4.9±1.4 vs. 8.7±1.6 %) and cIMT (0.52±0.04 vs. 0.44±0.11 mm), were impaired in SpA patients than healthy controls (all p<0.05). However, subjects in both the groups had no difference in age and body mass index with similar, within normal range blood pressure and lipid profile.
We observed that FMD and cIMT were deranged in SpA, and higher disease activity in SpA was associated with impaired FMD and cIMT. However, a larger population with a prospective study-design would further confirm this relationship between SpA disease activity and CVD surrogate markers.
脊柱关节炎（SpA）中的慢性炎症与动脉粥样硬化性心血管疾病（CVD）加速有关。血流介导的血管舒张（FMD）和颈动脉内膜中层厚度（cIMT）分别检测内皮功能障碍和亚临床动脉粥样硬化，它们是动脉粥样硬化性CVD的病因。
我们旨在研究SpA疾病活动与CVD替代标志物即FMD和cIMT之间的关联。
招募了50例轴向SpA患者（根据2009年脊柱关节炎评估协会 - ASAS标准）（病程<5年）和50名年龄（33.7±8.8岁 vs. 33.7±8.4岁）和性别匹配、无心血管危险因素的对照受试者。对肱动脉的FMD和双侧颈总动脉的cIMT进行超声评估。采用学生t检验比较患者和对照之间的测量值。通过Pearson/Spearman相关性评估SpA患者疾病活动与FMD和cIMT的关联。
SpA患者的FMD（4.9±1.4% vs. 8.7±1.6%）和cIMT（0.52±0.04 mm vs. 0.44±0.11 mm）较健康对照受损（所有p<0.05）。然而，两组受试者在年龄和体重指数方面无差异，血压和血脂水平相似且在正常范围内。
我们观察到SpA患者的FMD和cIMT紊乱，SpA中较高的疾病活动与FMD和cIMT受损有关。然而，更大规模的前瞻性研究人群将进一步证实SpA疾病活动与CVD替代标志物之间的这种关系。
