Rheumatology Department, Charles Nicolle Hospital, Tunis, 1007, Tunisia.
Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia.
Clin Rheumatol. 2022 Oct;41(10):3017-3025. doi: 10.1007/s10067-022-06261-5. Epub 2022 Jul 1.
We aimed to investigate the relationship between epicardial adipose tissue (EAT) thickness, flow-mediated dilation (FMD), and carotid intima-media thickness (cIMT) in spondyloarthritis (SpA) patients compared to healthy controls.
We performed a cross-sectional study including SpA patients aged ≤ 50 years without traditional cardiovascular risk factors and healthy controls matched for age and gender. Baseline characteristics, laboratory data, and SpA-related parameters were recorded. All participants underwent ultrasound examination with measurement of EAT thickness, FMD, and cIMT by both an experienced cardiologist and radiologist blinded to clinical data. The relationships between the ultrasound measurements were analyzed using Spearman's correlation coefficient and Person correlation.
The study included 94 subjects (47 SpA and 47 healthy controls). The sex-ratio was 2.35; the median age of patients was 36 years (IQR: 28-46), and the median disease duration was 11 years (IQR: 5-16). Compared to the control group, SpA patients had significantly higher values of EAT thickness (p = 0.001) and cIMT (p < 0.0001). FMD values were significantly lower in SpA patients compared to controls (p = 0.008). The univariate analysis detected a significant negative association between EAT thickness and FMD (p = 0.026; r = - 0.325), and between left cIMT and FMD (p = 0.027; r = - 0.322). No association was found between EAT thickness and cIMT.
EAT thickness, FMD, and cIMT were significantly impaired in SpA patients compared with healthy controls supporting evidence of accelerated atherosclerosis in SpA. EAT thickness was correlated to endothelial dysfunction suggesting the role of EAT in predicting the early reversible stages of atherosclerosis. Key Points • Spondyloarthritis is associated with impaired subclinical atherosclerosis markers accurately increased epicardial fat and carotid intima-media thickness and endothelial dysfunction. • Increased epicardial fat thickness is correlated with impaired endothelial function in spondyloarthritis patients.
我们旨在研究与健康对照组相比，脊柱关节炎（SpA）患者的心外膜脂肪组织（EAT）厚度、血流介导的舒张功能（FMD）和颈动脉内膜中层厚度（cIMT）之间的关系。
我们进行了一项横断面研究，纳入了年龄≤50 岁且无传统心血管危险因素的 SpA 患者和年龄与性别相匹配的健康对照组。记录基线特征、实验室数据和 SpA 相关参数。所有参与者均由一位经验丰富的心脏病专家和放射科医生进行超声检查，测量 EAT 厚度、FMD 和 cIMT，两位医生均对临床数据不知情。使用 Spearman 相关系数和 Person 相关分析来分析超声测量之间的关系。
研究共纳入 94 名受试者（47 名 SpA 患者和 47 名健康对照组）。性别比为 2.35；患者的中位年龄为 36 岁（IQR：28-46），中位病程为 11 年（IQR：5-16）。与对照组相比，SpA 患者的 EAT 厚度（p=0.001）和 cIMT（p<0.0001）显著更高。SpA 患者的 FMD 值明显低于对照组（p=0.008）。单变量分析检测到 EAT 厚度与 FMD 之间存在显著负相关（p=0.026；r=-0.325），左 cIMT 与 FMD 之间存在显著负相关（p=0.027；r=-0.322）。EAT 厚度与 cIMT 之间无相关性。
与健康对照组相比，SpA 患者的 EAT 厚度、FMD 和 cIMT 明显受损，支持 SpA 患者动脉粥样硬化加速的证据。EAT 厚度与内皮功能障碍相关，提示 EAT 在预测动脉粥样硬化早期可逆阶段中的作用。关键点：
脊柱关节炎与亚临床动脉粥样硬化标志物受损有关，包括心外膜脂肪和颈动脉内膜中层厚度增加以及内皮功能障碍。
SpA 患者的 EAT 厚度增加与内皮功能障碍相关。
