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类风湿关节炎患者及对照组的心血管风险标志物(计算机断层扫描冠状动脉钙化和颈动脉内膜中层厚度)

Cardiovascular risk markers (computed tomography‑coronary artery calcium and carotid intima‑media thickness) in patients with rheumatoid arthritis and controls.

作者信息

Fatima Jalees, Shukla Vaibhav, Siddiqi Zeba, Shamsi Mohammad Zakariya, Mateen Saboor, Jabbar Aaliya Abdul, Usmani Zeenat

机构信息

Department of Medicine, Era's Lucknow Medical College and Hospital, Lucknow, Uttar Pradesh 226003, India.

Department of Cardiology, Mahatma Gandhi Medical College and Hospital, Jaipur, Rajasthan 302022, India.

出版信息

Med Int (Lond). 2024 Jul 12;4(5):52. doi: 10.3892/mi.2024.176. eCollection 2024 Sep-Oct.

Abstract

Chronic inflammatory diseases, such as arthritis have been linked to a higher risk of developing cardiovascular disease. The present study examined the association between carotid intima-media thickness (CIMT) and coronary artery calcium (CAC), as well as the cardiovascular risk in patients with rheumatoid arthritis (RA). Additionally, the present study used 28 measures to calculate the disease activity score (DAS). To compare healthy controls with patients with RA, a case-control study was conducted that assessed CAC and CIMT in patients with the disease. A total of 45 healthy individuals and 45 patients with a diagnosis of RA were included in the study. With an average age of 50.66±12.35 years, the ages of the participants varied from 24 to 80 years. In both the control and RA patient groups, the sex ratio was 60%. The RA patient group had 53.3% female participants. There were significant variations in the levels of serum urea, potassium, magnesium, serum alkaline phosphatase, serum glutamic pyruvic transaminase, total leucocyte count, erythrocyte sedimentation rate, C-reactive protein (CRP) and lipids [apart from triglycerides and very low-density lipoprotein (VLDL)]. There was a substantial difference in the scores between patients with RA and the controls as regards CAC. A mild-severe risk of coronary artery disease was observed in 55.6% of RA cases and 4.4% of the controls (all mild). Both CIMT thickness and the CAC score exhibited a significant correlation with CRP, serum cholesterol, serum triglycerides, serum low-density lipids and serum VLDL. The DAS of patients ranged between 4.4 and 8.2 (mean, 5.81±0.91). A moderate disease activity was noted in the remaining patients, whereas 66.7% exhibited a high disease activity (DAS >5.2). On the whole, the present study demonstrates that conventional risk factors for cardiovascular disease, such as dyslipidemia, are consistent with both CIMT and CAC. The risk of developing atherosclerosis may be substantially increased by chronic inflammation, as the DAS score corresponds with CIMT and CAC.

摘要

慢性炎症性疾病,如关节炎,与患心血管疾病的风险较高有关。本研究调查了类风湿性关节炎(RA)患者的颈动脉内膜中层厚度(CIMT)与冠状动脉钙化(CAC)之间的关联以及心血管风险。此外,本研究使用28项指标来计算疾病活动评分(DAS)。为了比较健康对照者与RA患者,进行了一项病例对照研究,评估了疾病患者的CAC和CIMT。该研究共纳入45名健康个体和45名确诊为RA的患者。参与者的平均年龄为50.66±12.35岁,年龄范围在24至80岁之间。在对照组和RA患者组中,性别比例均为60%。RA患者组女性参与者占53.3%。血清尿素、钾、镁、血清碱性磷酸酶、血清谷丙转氨酶、白细胞总数、红细胞沉降率、C反应蛋白(CRP)和血脂[除甘油三酯和极低密度脂蛋白(VLDL)外]水平存在显著差异。RA患者与对照组在CAC评分方面存在显著差异。55.6%的RA病例和4.4%的对照组(均为轻度)观察到冠状动脉疾病的轻度至重度风险。CIMT厚度和CAC评分均与CRP、血清胆固醇、血清甘油三酯、血清低密度脂蛋白和血清VLDL显著相关。患者的DAS范围在4.4至8.2之间(平均值为5.81±0.91)。其余患者表现为中度疾病活动,而66.7%表现为高度疾病活动(DAS>5.2)。总体而言,本研究表明,心血管疾病的传统危险因素,如血脂异常,与CIMT和CAC均相关。由于DAS评分与CIMT和CAC相对应,慢性炎症可能会大幅增加患动脉粥样硬化的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2ca3/11273241/f4b0bee00c59/mi-04-05-00176-g00.jpg

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