Department of Pediatric Rheumatology, Dokuz Eylul University, Izmir, Turkey.
Department of Pediatric Cardiology, Dokuz Eylul University, Izmir, Turkey.
Clin Rheumatol. 2021 Oct;40(10):4199-4206. doi: 10.1007/s10067-021-05721-8. Epub 2021 Apr 4.
This study aimed to evaluate the risk for atherosclerosis by using echocardiographic arterial stiffness (AS) parameters and serum endocan levels, as a biomarker of endothelial dysfunction (ED) in children with FMF.
Seventy-nine children with FMF (12-18 years) and 41 healthy children were included, and clinical features (age at the first attack, age at the time of diagnosis, diagnosis delay time, colchicine dose, biological agent usage, MEFV mutations, and symptoms of attacks) of patients were noted. Arterial stiffness parameters were calculated by using echocardiographic aortic measurements with blood pressure monitoring. Hemogram parameters, acute phase reactants, blood glucose and lipid levels of 12 hours of fasting, and serum endocan levels were evaluated for all participants.
There were no statistically significance regarding demographic features, acute phase reactants, and hemogram parameters. Blood glucose and lipid levels were similar, except for HDL (lower in FMF group, p=0.029). Serum endocan levels did not differ in two groups (p=0.906). Only stiffness of descending aorta was lower in FMF group (p=0.028), and the other AS parameters were similar between two groups (p>0.05 for each parameters).
Good disease control could be preventive for atherosclerosis in children with FMF. On the other hand, screening for cardiovascular diseases is essential, particularly for uncontrolled cases. Distribution of MEFV gene mutations KEY POINTS: • Exaggerated inflammation is the prominent feature of FMF attacks; moreover, it is shown that subclinical inflammation might also continue in attack-free periods. • Chronic inflammation contributes to atherosclerotic process in almost all stages by activating endothelial cells, producing reactive oxygen species, and accelerating foam cell and atherosclerotic plaque formations. • However, the results of this study showed that there was no difference in terms of atherosclerotic markers such as serum endocan levels and arterial stiffness parameters between pediatric FMF patients and healthy peers. • Good disease control in pediatric FMF patients may prevent early atherosclerotic changes during childhood, which then may lead a probable decreased risk of subsequent CVD in adulthood.
本研究旨在通过超声心动图动脉僵硬度（AS）参数和血清内参水平评估 FMF 患儿发生动脉粥样硬化的风险，内参作为血管内皮功能障碍（ED）的生物标志物。
纳入 79 例 FMF 患儿（12-18 岁）和 41 例健康儿童，记录患者的临床特征（首次发作年龄、诊断时年龄、诊断延迟时间、秋水仙碱剂量、生物制剂使用、MEFV 突变和发作症状）。通过超声心动图主动脉测量和血压监测计算动脉僵硬度参数。评估所有参与者的血常规参数、急性期反应物、12 小时禁食时的血糖和血脂水平以及血清内参水平。
两组在人口统计学特征、急性期反应物和血常规参数方面无统计学差异。两组的血糖和血脂水平相似，除了 HDL（FMF 组较低，p=0.029）。两组血清内参水平无差异（p=0.906）。仅 FMF 组降主动脉僵硬度较低（p=0.028），两组其他 AS 参数相似（各参数 p>0.05）。
良好的疾病控制可能预防 FMF 患儿发生动脉粥样硬化。另一方面，对心血管疾病进行筛查是必要的，特别是对未得到控制的病例。MEFV 基因突变的分布
