Kaşıkçı Efe E, Özışık Melih, Bayrak Değirmenci Papatya
Department of Allergy and Immunology, Tepecik Education and Research Hospital, İzmir, Turkey.
Postepy Dermatol Alergol. 2024 Dec;41(6):610-616. doi: 10.5114/ada.2024.145572. Epub 2024 Dec 24.
The idea that chronic inflammatory processes may play a role in the etiopathogenesis of both treatment - refractory chronic spontaneous urticaria and cardiovascular diseases is an important research topic.
Within the scope of this research, we aimed to elucidate a new perspective on the follow-up of chronic urticaria patients by evaluating the 10-year cardiovascular risk and metabolic syndrome in resistant chronic spontaneous urticaria patients who were unresponsive to maximum antihistamine treatment.
A total of 170 individuals who applied to our institution's Health Science University, Tepecik Education and Research Hospital, allergy and immunology outpatient clinic have been analysed in this retrospective case-control study. Metabolic syndrome was calculated according to the National Cholesterol Education Program -- Adult Treatment Panel III, and the cardiovascular risk was calculated according to the Framingham Heart Study of the National Heart, Lung and Blood Institute.
The study included 85 patients diagnosed with chronic spontaneous urticaria (CSU) alongside 85 control subjects. Comparative analysis between the CSU patient group and the control group revealed substantial differences in terms of gender distribution, smoking habits, metabolic syndrome prevalence, waist circumference measurements, body mass index (BMI), hypertension incidence, and levels of C-reactive protein (CRP) ( < 0.05). However, factors such as patient age, fasting blood glucose, diabetes status, triglyceride (TAG), high density lipoprotein (HDL), low density lipoprotein (LDL), and the percentage risk of cardiovascular events over 10 years were not found to influence CSU ( > 0.05).
Regarding the outcomes of this study, the presence of hypertension, obesity, waist circumference and C-reactive protein values associated with metabolic syndrome should be followed for antihistamine-refractory CSU. Early diagnosis and treatment of metabolic syndrome and its components in these patients may play a role in preventing potential complications. No significant increase in the 10-year cardiovascular risk was observed.
慢性炎症过程可能在难治性慢性自发性荨麻疹和心血管疾病的病因发病机制中起作用，这一观点是一个重要的研究课题。
在本研究范围内，我们旨在通过评估对最大剂量抗组胺治疗无反应的难治性慢性自发性荨麻疹患者的10年心血管风险和代谢综合征，阐明慢性荨麻疹患者随访的新视角。
在这项回顾性病例对照研究中，对总共170名前往我们机构（健康科学大学特佩奇克教育与研究医院过敏与免疫门诊）就诊的个体进行了分析。根据美国国家胆固醇教育计划成人治疗小组第三次报告计算代谢综合征，根据美国国立心肺血液研究所的弗雷明汉心脏研究计算心血管风险。
该研究纳入了85例被诊断为慢性自发性荨麻疹（CSU）的患者以及85名对照受试者。CSU患者组与对照组之间的比较分析显示，在性别分布、吸烟习惯、代谢综合征患病率、腰围测量值、体重指数（BMI）、高血压发病率和C反应蛋白（CRP）水平方面存在显著差异（P<0.05）。然而，未发现患者年龄、空腹血糖、糖尿病状态、甘油三酯（TAG）、高密度脂蛋白（HDL）、低密度脂蛋白（LDL）以及10年心血管事件风险百分比等因素对CSU有影响（P>0.05）。
关于本研究的结果，对于抗组胺药难治性CSU患者，应关注与代谢综合征相关的高血压、肥胖、腰围和C反应蛋白值。在这些患者中早期诊断和治疗代谢综合征及其组成部分可能有助于预防潜在并发症。未观察到10年心血管风险有显著增加。
