Evaluation of atherosclerosis risk by measurement of intima media thickness and pulse wave velocity in lichen planus patients; A prospective case-control study

Year 2017, Volume: 1 Issue: 3, 40 - 43, 10.12.2017

Saliha Koç Murathan Küçük , Veysel Tosun , Can Ramazan Öncel , Erkan Alpsoy Ertan Yılmaz

https://doi.org/10.28982/josam.344718

Abstract

Aim: Lichen planus (LP) is one of the chronic inflammatory diseases. Chronic inflammation may play an important role in the development of subclinical atherosclerosis. In this study, we aimed to investigate the relationship between LP and atherosclerosis by using carotid intima media thickness (CIMT) and pulse wave velocity (PWV) measurements.

Methods: A controlled study is designed, two groups were formed as LP and control group. Forty LP patients (32 female and 8 male; mean age 44.6±1.2 years) and 40 healthy (control) individuals (32 female and 8 male; mean age 41.2±0.9 years) enrolled in the study. Individuals with atherosclerotic risk factors were excluded from the study for both groups. Demographic and biochemical data were recorded for both groups. CIMT and PWV measurements were compared between healthy and LP patients. 

Results: Maximum and average CIMT values in LP patients were significantly higher than the control group (Right maximum CIMT; 0.77±0.01 vs. 0.74±0.01, p=0.01, Left maximum CIMT; 0.80±0.01 vs. 0.76±0.01, p=0.011, Right average CIMT; 0.65±0.01 vs. 0.63±0.01, p=0.039, Left average CIMT; 0.68±0.01 vs. 0.64±0.01, p=0.005, respectively). No statistically significant difference was found between LP patients and control group for PWV (6.34±0.30 vs. 6.79±0.70 respectively, p=0.131). 

Conclusions: Our study demonstrated that CIMT was increased in patients with LP who had no clinical evidence of heart disease. LP patients were under an increased risk of subclinical atherosclerotic vascular dysfunction and structural changes.

Keywords

lichen planus, carotis intima media thickness, pulse wave velocity, atherosclerosis

Liken planus hastalarında ateroskleroz riskinin intima media kalınlığı ve nabız dalga hızı ile değerlendirilmesi; Prospektif olgu-kontrol çalışması

Abstract

Amaç: Liken Planus (LP) kronik inflamatuar hastalıklardan birisidir. Kronik inflamasyon subklinik ateroskleroz gelişiminde önemli bir role sahip olabilir. Bu çalışmamızda, LP ile ateroskleroz arasındaki ilişkiyi karotis intima medya kalınlığı (KİMK) ve nabız dalga hızı (NDH) ölçümlerini kullanarak araştırmayı amaçladık.

Yöntemler: Kontrollü çalışma planlandı ve LP ve kontrol grubu olmak üzere iki grup oluşturuldu. Kırk LP hastası (ortalama yaşı 44.6±1.2 olan 32 bayan ve 8 erkek) ve 40 sağlıklı birey (ortalama yaşı 41.2±0.9 olan 32 bayan ve 8 erkek) çalışmaya alındı. Her iki grupta da aterosklerotik risk faktörleri olan hastalar çalışmadan dışlandı. Her iki grubun demografik ve biyokimyasal parametreleri kaydedildi. Sağlıklı bireyler ve LP hastalarında KİMK ve NDH ölçümleri karşılaştırıldı. 

Bulgular: Maksimum ve ortalama KİMK değerleri LP hastalarında kontrol grubuna göre anlamlı olarak daha yüksek saptandı (sırasıyla; sağ maksimum KİMK; 0.77±0.01 ve 0.74±0.01 p=0.01, sol maksimum KİMK; 0.80±0.01 ve 0.76±0.01 p=0.011, sağ ortalama KİMK; 0.65±0.01 ve 0.63±0.01 p=0.039, sol ortalama KİMK; 0.68±0.01 vs. 0.64±0.01, p=0.005). LP hastaları ve kontrol grubu arasında NDH ölçümleri açısından anlamlı istatistiksel farklılık gözlenmedi (sırasıyla; 6.34±0.30 ve 6.79±0.70, p=0.131).

Sonuçlar:  Bizim çalışmamıza göre kalp hastalığı olmayan LP hastalarında KİMK değerleri daha yüksek oranlarda gösterildi. LP hastaları subklinik ateroskleroza bağlı vasküler disfonksiyon ve yapısal değişiklikler açısından risk altındadırlar.

Keywords

liken planus, karotis intima medya kalınlığı, nabız dalga hızı, ateroskleroz

References

• 1. Lehman JS, Tollefson MM, Gibson LE. Lichen planus. Int J Dermatol 2009; 48: 682-94.
• 2. Arias-Santiago S, Buendía-Eisman A, Aneiros-Fernández J, Girón-Prieto MS, Gutiérrez-Salmerón MT, Mellado VG et al. Cardiovascular risk factors in patients with lichen planus. Am J Med 2011; 124: 543-8.
• 3. Arias-Santiago S, Buendía-Eisman A, Aneiros-Fernández J, Girón-Prieto MS, Gutiérrez-Salmerón MT, García-Mellado V et al. Lipid levels in patients with lichen planus: a case-control study. J Eur Acad Dermatol Venereol 2011; 25: 1398-401.
• 4. Kuller L, Borhani N, Furberg C, Gardin J, Manolio T, O'Leary D et al. Prevalence of subclinical atherosclerosis and cardiovascular disease and association with risk factors in the Cardiovascular Health Study. Am J Epidemiol 1994; 139: 1164-79.
• 5. Maradit-Kremers H, Crowson CS, Nicola PJ, Ballman KV, Roger VL, Jacobsen SJ et al. Increased unrecognized coronary heart disease and sudden deaths in rheumatoid arthritis: a population-based cohort study. Arthritis Rheum 2005; 52: 402-11.
• 6. Roman MJ, Shanker BA, Davis A, Lockshin MD, Sammaritano L, Simantov R et al. Prevalence and correlates of accelerated atherosclerosis in systemic lupus erythematosus. N Engl J Med 2003; 349: 2399-406.
• 7. Ebrahim S, Papacosta O, Whincup P, Wannamethee G, Walker M, Nicolaides AN et al. Carotid plaque, intima media thickness, cardiovascular risk factors, and prevalent cardiovascular disease in men and women: the British Regional Heart Study. Stroke 1999; 30: 841-50.
• 8. Wright CI, Brouwerde Cock KA, Kroner CI, Hoeks AP, Draijer R. The relation of arterial stiffness to endothelial function in healthy subjects. Physiol Meas 2007; 28: 573-82.
• 9. Duprez DA, Cohn JN. Arterial stiffness as a risk factor for coronary atherosclerosis. Curr Atheroscler Rep 2007; 9: 139-44.
• 10. Poredos P. Intima-media thickness: indicator of cardiovascular risk and measure of the extent of atherosclerosis. Vasc Med 2004; 9: 46-54.
• 11. Boyd AS, Neldner KH. Lichen planus. J Am Acad Dermatol 1991; 25: 593-619.
• 12. McCartan BE, Healy CM. The reported prevalence of oral lichen planus: a review and critique. J Oral Pathol Med 2008; 37: 447-53.
• 13. Dreiher J, Shapiro J, Cohen AD. Lichen planus and dyslipidaemia: a case-control study. Br J Dermatol 2009; 161: 626-9.
• 14. Aly DG, Shahin RS. Oxidative stress in lichen planus. Acta Dermatovenerol Alp Pannonica Adriat 2010; 19: 3-11.
• 15. Balta S, Cakar M, Demirkol S, Unlu M, Kucuk U, Arslan Z. Arterial stiffness itself without other inflammatory markers may not provide information to clinicians. J Clin Hypertens 2013; 15: 303.
• 16. Gisondi P, Tessari G, Conti A, Piaserico S, Schianchi S, Peserico A et al. Prevalence of metabolic syndrome in patients with psoriasis: a hospital-based case-control study. Br J Dermatol 2007; 157: 68-73.
• 17. Arias Santiago S, Ruiz Carrascosa JC, Giron Prieto MS, Almazan Fernandez F, Naranjo Sintes R. Prevalance of metabolic syndrome in patients with severe psoriasis. Actual Medica 2009; 94: 12-7.
• 18. Contessa C, Ramonda R, Lo Nigro A, Modesti V, Lorenzin M, Puato M et al. Subclinical atherosclerosis in patients with psoriatic arthritis: a case-control study. Preliminary data. Reumatismo 2009; 61: 298-305.
• 19. Mazlan SA, bin Mohamed Said MS, Hussein H, binti Shamsuddin K, Shah SA, Basri H. A study of intima media thickness and their cardiovascular risk factors in patients with psoriatic arthritis. Acta Medica (Hradec Kralove) 2009; 52: 107-16.
• 20. Altekin ER, Koç S, Karakaş MS, Yanıkoğlu A, Başarıcı I, Demir I et al. Determination of subclinical atherosclerosis in plaque type psoriasis patients without traditional risk factors for atherosclerosis. Turk Kardiyol Dern Ars 2012; 40: 574-80.
• 21. Koseoglu C, Erdogan M, Koseoglu G, Kurmus O, Ertem AG, Efe TH et al. The Relationship between Lichen Planus and Carotid Intima Media Thickness. Acta Cardiol Sin 2016; 32: 738-743.
• 22. Soy M, Yildiz M, Sevki Uyanik M, Karaca N, Güfer G, Piskin S. Susceptibility to atherosclerosis in patients with psoriasis and psoriatic arthritis as determined by carotid-femoral (aortic) pulse-wave velocity measurement. Rev Esp Cardiol 2009; 62: 96-9.