Laboratory of Experimental Rheumatology and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genova, and IRCCS Rheumatology Unit San Martino Polyclinic, Genova, and Anaesthesia and Intensive Care, San Martino Policlinico Hospital, IRCCS for Oncology and Neuroscience, Genova, Italy.
Laboratory of Experimental Rheumatology and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genova, and IRCCS Rheumatology Unit San Martino Polyclinic, Genova, Italy.
Clin Exp Rheumatol. 2023 Apr;41(4):812-820. doi: 10.55563/clinexprheumatol/uq9p1q. Epub 2023 Apr 18.
[18F] Fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) can detect the presence of large-vessel vasculitis (LVV) in patients with polymyalgia rheumatica (PMR), giant cell arteritis (GCA) and fever of unknown origin (FUO). The aim of this study was to evaluate whether statins could reduce FDG-PET/CT-assessed vascular inflammation in this group of patients.
Clinical, demographic, laboratory data, current pharmacological treatments, and cardiovascular risk factors of patients with PMR, GCA and FUO, who underwent FDG-PET/CT, were recorded. FDG uptake was measured at prespecified arterial sites with the mean standardised uptake value (SUV), and with a qualitative visual score, summed up to obtain a total vascular score (TVS). LVV was diagnosed if arterial FDG visual uptake was equal or higher of liver uptake.
129 patients were included (96 with PMR, 16 with GCA, 13 with both PMR and GCA, and 4 with FUO), of whom 75 (58.1%) showed LVV. Twenty out of 129 (15.5%) patients were taking statins. TVS was significantly lower in patients treated with statins (p=0.02), especially in the aorta (p=0.023) and femoral arteries (p=0.027).
Our preliminary results suggest that statins may exert a potential protective role on vascular inflammation in patients with PMR and GCA. Statin use could spuriously decrease FDG uptake of the vessel walls.
[18F]氟代脱氧葡萄糖（FDG）正电子发射断层扫描/计算机断层扫描（PET/CT）可检测巨细胞动脉炎（GCA）、多发性肌痛（PMR）和发热待查（FUO）患者大血管血管炎（LVV）的存在。本研究旨在评估他汀类药物是否可以减少这组患者的 FDG-PET/CT 评估的血管炎症。
记录接受 FDG-PET/CT 的 PMR、GCA 和 FUO 患者的临床、人口统计学、实验室数据、当前药物治疗以及心血管危险因素。使用平均标准化摄取值（SUV）在预设动脉部位测量 FDG 摄取，并使用定性视觉评分将其相加以获得总血管评分（TVS）。如果动脉 FDG 视觉摄取等于或高于肝脏摄取，则诊断为 LVV。
共纳入 129 例患者（96 例 PMR、16 例 GCA、13 例 PMR 和 GCA 并存、4 例 FUO），其中 75 例（58.1%）存在 LVV。129 例患者中有 20 例（15.5%）正在服用他汀类药物。服用他汀类药物的患者 TVS 明显较低（p=0.02），尤其是在主动脉（p=0.023）和股动脉（p=0.027）。
我们的初步结果表明，他汀类药物可能对 PMR 和 GCA 患者的血管炎症发挥潜在的保护作用。他汀类药物的使用可能会使血管壁的 FDG 摄取假性降低。
