Nassef Eman Mostafa, Elabd Hemmat Ahmed, El Nagger Basma Mohamed Mohamed Ali, Elzomor Hala Mohamed, Kotb Hend Gamal, Sabry Seham, Zaghloul Boshra Ahmed, Hassan Asmaa S, Mohamed Eman El Sayed
Internal Medicine Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt.
Rheumatology and Rehabilitation Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt.
Int J Gen Med. 2022 Aug 18;15:6653-6659. doi: 10.2147/IJGM.S373863. eCollection 2022.
Behçet disease (BD) is a rare chronic relapsing-remitting inflammatory systemic vasculitis. BD patients were reported to have marked acceleration of subclinical atherosclerosis (SCA). Endocan is a soluble proteoglycan mainly secreted by the activated endothelium. The present study aimed to assess the relation between serum endocan levels and SCA in BD patients.
The study included 40 adult BD patients in addition to twenty age- and sex-matched healthy controls. BD was diagnosed according to International Study Group criteria. Upon recruitment, all participants were subjected to careful history taking and thorough clinical examination. BD activity was assessed using Behçet Syndrome Activity Score. Measurement of serum endocan was performed using quantitative double-antibody sandwich ELISA kit. CIMT measurement was done using B-mode ultrasound.
Comparison between patients and controls regarding serum endocan levels revealed significantly higher endocan levels in BD patients [median (IQR): 155.0 (69.3-610.0) versus 73.8 (51.9-94.6)]. Using ultrasound assessment, SCA was found in 14 BD patients (35.0%). Comparison between patients with SCA and patients without regarding the clinical and laboratory data revealed that the former group had significantly higher CRP [median (IQR): 36.5 (26.8-43.5) versus 21.0 (11.8-26.8) mg/dL, p < 0.001] and endocan [median (IQR): 622.0 (107.4-974.8) versus 104.5 (64.0-342.0) mg/dL, p = 0.004] levels. Logistic regression analysis recognized endocan [OR (95% CI): 1.0 (1.0-1.012), p0.035] levels as significant predictor of SCA in multivariate analysis.
The present study identified the clinical value of serum endocan levels as a possible early marker of vascular involvement in BD patients.
白塞病（BD）是一种罕见的慢性复发-缓解性炎症性全身性血管炎。据报道，BD患者的亚临床动脉粥样硬化（SCA）有明显加速。内脂素是一种主要由活化内皮细胞分泌的可溶性蛋白聚糖。本研究旨在评估BD患者血清内脂素水平与SCA之间的关系。
该研究除了纳入20名年龄和性别匹配的健康对照者外，还包括40名成年BD患者。BD根据国际研究组标准进行诊断。招募时，所有参与者都接受了详细的病史采集和全面的临床检查。使用白塞综合征活动评分评估BD活动度。使用定量双抗体夹心ELISA试剂盒检测血清内脂素。使用B型超声测量颈动脉内膜中层厚度（CIMT）。
患者与对照者血清内脂素水平的比较显示，BD患者的内脂素水平显著更高[中位数（四分位间距）：155.0（69.3 - 610.0）对73.8（51.9 - 94.6）]。通过超声评估，在14名BD患者（35.0%）中发现了SCA。有SCA的患者与无SCA的患者在临床和实验室数据方面的比较显示，前一组的C反应蛋白[中位数（四分位间距）：36.5（26.8 - 43.5）对21.0（11.8 - 26.8）mg/dL，p < 0.001]和内脂素[中位数（四分位间距）：622.0（107.4 - 974.8）对104.5（64.0 - 342.0）mg/dL，p = 0.004]水平显著更高。逻辑回归分析在多变量分析中确认内脂素[比值比（95%置信区间）：1.0（1.0 - 1.012），p = 0.035]水平是SCA的显著预测指标。
本研究确定了血清内脂素水平作为BD患者血管受累可能的早期标志物的临床价值。
