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类风湿关节炎患者中心外膜脂肪组织与动脉僵硬度之间的关系。

The relationship between epicardial adipose tissue and arterial stiffness in patients with rheumatoid arthritis.

作者信息

Petra Cristian Vasile, Albu Ariana, Pamfil Cristina, Tamas Maria Magdalena, Vesa Stefan Cristian, Rednic Simona

机构信息

Department of Rheumatology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.

2nd Department of Internal Medicine, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.

出版信息

Med Ultrason. 2019 Nov 24;21(4):427-434. doi: 10.11152/mu-2001.

Abstract

AIM

To evaluate the relationship between epicardial adipose tissue (EAT) and arterial stiffness (AS) in patients with rheumatoid arthritis (RA), considering cardiovascular risk factors and disease characteristics.

MATERIAL AND METHODS

A total of 84 RA patients were included in this cross-sectional study. EAT and carotid intima-media thickness (cIMT) were measured ultrasonographically while aortic pulse wave velocity (aPWV), the main AS parameter, was determined using an oscillometric device.

RESULTS

Mean duration of RA was 12±9.5 years and disease activity score was 4.3±1.4, as assessed by Disease Activity Score-28 using C-reactive protein (DAS-28 CRP). The correlation analysis displayed a significant positive correlation between cIMT, aPWV and EAT (r= 0.037, p<0.001; r= 0.338, p=0.002 and r= 0.317, p=0.003). When a cutoff value of aPWV ≥10 m/s was established, patients with increased aPWV had significantly higher body mass index (p=0.04), waist circumference (p=0.01), triglycerides (p=0.04), EAT (p<0.001), hypertension (p=0.03) and marginally C-reactive protein (CRP) (p=0.05). Multivariate regression analysis showed that hypertension (p=0.033), increased CRP (p=0.016) and EAT (p=0.005) are the only independent predictors for increased aPWV.

CONCLUSIONS

Our study found that increased AS independently correlated with EAT in patients with RA. Although the evaluation of these two parameters awaits further evidence to be included in the risk algorithms for CVD prevention, their role in patients with inflammatory diseases may be even more significant than in the general population.

摘要

目的

考虑心血管危险因素和疾病特征,评估类风湿关节炎(RA)患者的心外膜脂肪组织(EAT)与动脉僵硬度(AS)之间的关系。

材料与方法

本横断面研究共纳入84例RA患者。采用超声测量EAT和颈动脉内膜中层厚度(cIMT),同时使用示波装置测定主要的AS参数主动脉脉搏波速度(aPWV)。

结果

根据使用C反应蛋白的疾病活动评分-28(DAS-28 CRP)评估,RA的平均病程为12±9.5年,疾病活动评分为4.3±1.4。相关性分析显示cIMT、aPWV与EAT之间存在显著正相关(r = 0.037,p<0.001;r = 0.338,p = 0.002;r = 0.317,p = 0.003)。当将aPWV≥10 m/s作为临界值时,aPWV升高的患者体重指数显著更高(p = 0.04)、腰围更大(p = 0.01)、甘油三酯水平更高(p = 0.04)、EAT更厚(p<0.001)、高血压患病率更高(p = 0.03),C反应蛋白(CRP)略高(p = 0.05)。多因素回归分析表明,高血压(p = 0.033)、CRP升高(p = 0.016)和EAT(p = 0.005)是aPWV升高的仅有的独立预测因素。

结论

我们的研究发现,RA患者中AS增加与EAT独立相关。尽管对这两个参数的评估有待进一步证据纳入心血管疾病预防风险算法,但它们在炎症性疾病患者中的作用可能比在一般人群中更为显著。

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