Sarp Ümit, ÜstÜner Evren, Kutlay Sehim, Ataman Şebnem, Kutlay Sim
Department of Physical Medicine and Rehabilitation, Ankara University School of Medicine, Ankara, Turkey.
Department of Radiology, Ankara University School of Medicine, Ankara, Turkey.
Arch Rheumatol. 2020 Jun 25;35(3):435-439. doi: 10.46497/ArchRheumatol.2020.7868. eCollection 2020 Sep.
This study aims to evaluate the inflammatory status and clinical and vascular alterations using tonometry and B-mode sonography in patients with ankylosing spondylitis (AS).
The study included 71 AS patients (57 males, 14 females; mean age 40.1±10.8 years; range, 29 to 51 years) without cardiovascular disease and 30 healthy controls (24 males, 6 females; mean age 41.2±9.3 years; range, 32 to 50 years). We evaluated participants' clinical, biological and functional status along with laboratory data and measured both the arterial stiffness using carotid-femoral pulse wave velocity (PWV) measured by applanation tonometry and carotid intima-media thickness (CIMT) as a preclinical atherosclerosis marker.
The mean disease duration of AS patients was 10.6±4.2 years. CIMT (p=0.03) and PWV (p=0.04) data showed significant differences between AS patients and healthy controls. Multiregression analysis showed that PWV correlated with age (r=0.42; p=0.03) and disease duration (r=0.31; p=0.04), while CIMT correlated with disease duration (r=0.37; p=0.03) and Bath Ankylosing Spondylitis Disease Activity Index (r=0.3; p=0.04).
This study demonstrated an increase in early preclinical atherosclerosis in AS patients without cardiovascular (CV) disease compared to healthy controls. Therefore, screening AS patients with noninvasive methods for atherosclerosis and subclinical vasculopathy would allow us to take primary prevention measures. We found that the major determinant for increased CV risk was the disease duration, while there was no difference between different treatment modalities.
本研究旨在通过眼压测量法和B型超声检查评估强直性脊柱炎(AS)患者的炎症状态、临床及血管改变。
本研究纳入71例无心血管疾病的AS患者(57例男性,14例女性;平均年龄40.1±10.8岁;范围29至51岁)和30例健康对照者(24例男性,6例女性;平均年龄41.2±9.3岁;范围32至50岁)。我们评估了参与者的临床、生物学和功能状态以及实验室数据,并使用经平板眼压测量法测量的颈股脉搏波速度(PWV)和作为临床前期动脉粥样硬化标志物的颈动脉内膜中层厚度(CIMT)来测量动脉僵硬度。
AS患者的平均病程为10.6±4.2年。CIMT(p = 0.03)和PWV(p = 0.04)数据显示AS患者与健康对照者之间存在显著差异。多元回归分析显示,PWV与年龄(r = 0.42;p = 0.03)和病程(r = 0.31;p = 0.04)相关,而CIMT与病程(r = 0.37;p = 0.03)和巴斯强直性脊柱炎疾病活动指数(r = 0.3;p = 0.04)相关。
本研究表明,与健康对照者相比,无心血管疾病的AS患者早期临床前期动脉粥样硬化有所增加。因此,采用非侵入性方法对AS患者进行动脉粥样硬化和亚临床血管病变筛查,将使我们能够采取一级预防措施。我们发现心血管风险增加的主要决定因素是病程,而不同治疗方式之间没有差异。