Department of Cardiology, Meram School of Medicine, Necmettin Erbakan University, Konya, Turkey.
Department of Cardiology, Konya City Hospital, Konya, Turkey.
Medicine (Baltimore). 2024 Jan 19;103(3):e37019. doi: 10.1097/MD.0000000000037019.
Despite advances in the diagnosis and treatment of ankylosing spondylitis (AS), the risk of cardiovascular complications in AS patients is still higher than in the general population. Macrophages are at the intersection of the basic pathogenetic processes of AS and atherosclerosis. Although syndecan-4 (SDC4) mediates a variety of biological processes, the role of SDC4 in macrophage-mediated atherogenesis in AS patients remains unclear. Herein, we aimed to investigate the role of SDC4 in subclinical atherosclerosis in AS patients.
Subjects were selected from eligible AS patients and control subjects without a prior history of AS who were referred to the rheumatology outpatient clinics. All participants' past medical records and clinical, and demographic characteristics were scanned. In addition, carotid intima-media thickness (CIMT) measurement and disease activity index measurement were applied to all patients.
According to our data, serum SDC4 level was significantly higher among AS patients compared with the control group (6.7 [1.5-35.0] ng/mL vs 5.1 [0.1-12.5] ng/mL, P < .001). The calculated CIMT was also significantly higher in AS patients than in the control group (0.6 [0.3-0.9] mm vs 0.4 (0.2-0.7), P < .001]. Additionally, serum C-reactive protein level and SDC4 level were independent predictors of AS and strongly associated with CIMT. Linear regression analysis showed that serum SDC4 level was the best predictor of CIMT (P = .004).
Our data indicate that serum SDC4 levels provide comprehensive information about the clinical activity of the disease and subclinical atherosclerosis in AS patients.
尽管强直性脊柱炎（AS）的诊断和治疗取得了进展，但 AS 患者发生心血管并发症的风险仍高于普通人群。巨噬细胞处于 AS 和动脉粥样硬化基本发病过程的交汇处。尽管硫酸乙酰肝素蛋白聚糖 4（SDC4）介导多种生物学过程，但 SDC4 在 AS 患者中巨噬细胞介导的动脉粥样硬化形成中的作用尚不清楚。在此，我们旨在研究 SDC4 在 AS 患者亚临床动脉粥样硬化中的作用。
从风湿科门诊就诊的符合条件的 AS 患者和无 AS 既往史的对照者中选择受试者。扫描所有参与者的既往病史和临床及人口统计学特征。此外，对所有患者进行颈动脉内膜中层厚度（CIMT）测量和疾病活动指数测量。
根据我们的数据，与对照组相比，AS 患者的血清 SDC4 水平显著升高（6.7[1.5-35.0]ng/mL 比 5.1[0.1-12.5]ng/mL，P<0.001）。AS 患者的计算 CIMT 也明显高于对照组（0.6[0.3-0.9]mm 比 0.4[0.2-0.7]，P<0.001）。此外，血清 C 反应蛋白水平和 SDC4 水平是 AS 的独立预测因子，与 CIMT 强烈相关。线性回归分析显示，血清 SDC4 水平是 CIMT 的最佳预测因子（P=0.004）。
我们的数据表明，血清 SDC4 水平提供了关于 AS 患者疾病临床活动和亚临床动脉粥样硬化的综合信息。
