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Psöriatik Artrit Tanılı Hastalarda Subklinik Aterosklerozun Değerlendirilmesi

Yıl 2024, Cilt: 34 Sayı: 2, 186 - 189, 30.04.2024
https://doi.org/10.54005/geneltip.1331223

Öz

Amaç: Periferik ve eksenel tutulumlu psoriatik artrit; entezit, daktilit, tırnak ve deri tutulumuna neden olabilen heterojen bir hastalıktır. Sedef hastalığında inflamasyonun devam etmesi, psöriatik artrit, kardiyovasküler hastalık ve metabolik sendrom gibi komorbiditelere yol açar. Çalışmamızda bilinen bir risk faktörü olmayan psöriatik artrit hastalarında subklinik aterosklerozu saptamak ve hastalarda olası morbidite ve mortaliteyi önlemek amaçlandı.
Gereç-Yöntem:Çalışmamıza otuz üç psöriatik artrit tanılı hasta ve yirmi beş sağlıklı kontrol grubu dahil edildi. Diabetes mellitus, hipertansiyon, koroner arter hastalığı, hiperlipidemi tanısı, vücut kitle indeksinin 30'un üzerinde olması ve sigara içme dışlama kriterleri olarak belirlendi. Yaş, cinsiyet, hastalık süresi, hastalık için kullanılan medikal tedavi, yüksek dansiteli lipoprotein, düşük dansiteli lipoprotein, trigliserid ve total kolesterol değerleri, monosit-lenfosit oranı, karotis doppler ultrasonografi ile elde edilen karotis intima-media kalınlık ölçüm sonuçları kaydedildi.
Bulgular: Çalışma ve kontrol grupları arasında yaş, trigliserit, yüksek dansiteli lipoprotein, düşük dansiteli lipoprotein ve monosit-lenfosit oranı açısından karşılaştırma yapıldı ve istatistiksel olarak anlamlı bir fark gözlenmedi. Monosit ve lenfosit düzeyleri çalışma grubunda anlamlı olarak yüksekti (p<0.05). Karotis intima media kalınlığı çalışma grubunda istatistiksel olarak daha yüksekti ve bu fark istatistiksel olarak anlamlıydı (p<0.05).
Sonuç: Psöriatik artritli hastalar, herhangi bir risk faktörü olmayan sağlıklı popülasyona kıyasla artmış ateroskleroz riskine sahiptir. Bu farkındalık hastaların takibinde ve gelişebilecek morbiditelere karşı önlem alınmasında faydalı olacaktır.

Kaynakça

  • Aljohani R. Metabolic Syndrome and Its Components in Psoriatic Arthritis. Open Access Rheumatol. 2022 Feb 17;14:7-16.
  • Menter A, Griffiths CE, Tebbey PW, Horn EJ, Sterry W; International Psoriasis Council. Exploring the association between cardiovascular and other disease-related risk factors in the psoriasis population: the need for increased understanding across the medical community. J Eur Acad Dermatol Venereol. 2010 Dec;24(12):1371-7.
  • Haroon M, Gallagher P, Heffernan E, FitzGerald O. High prevalence of metabolic syndrome and of insulin resistance in psoriatic arthritis is associated with the severity of underlying disease. J Rheumatol. 2014 Jul;41(7):1357-65.
  • Tobin AM, Veale DJ, Fitzgerald O, Rogers S, Collins P, O'Shea D, et al. Cardiovascular disease and risk factors in patients with psoriasis and psoriatic arthritis. J Rheumatol. 2010 Jul;37(7):1386-94.
  • Towfighi A, Saver JL. Stroke declines from third to fourth leading cause of death in the United States: historical perspective and challenges ahead. Stroke. 2011 Aug;42(8):2351-5.
  • Kong P, Cui ZY, Huang XF, Zhang DD, Guo RJ, Han M. Inflammation and atherosclerosis: signaling pathways and therapeutic intervention. Signal Transduct Target Ther. 2022 Apr 22;7(1):131.
  • Karaoğlan B, Öztürk GT, Özdoğan V, Cumaoğlu A, Oktar S, Tas N, et al. Investigation of the correlation between ADMA levels and carotid artery intima-media thickness in rheumatoid arthritis patients. Turk J Phys Med Rehab 2011;57:114-8.
  • Nezu T, Hosomi N. Usefulness of Carotid Ultrasonography for Risk Stratification of Cerebral and Cardiovascular Disease. J Atheroscler Thromb. 2020 Oct 1;27(10):1023-1035.
  • Kiran V R, P M N, Shah MI, Sivaprakasam M, Joseph J. Gaussian-Mixture Modelling of A-Mode Radiofrequency Scans for the Measurement of Arterial Wall Thickness. Annu Int Conf IEEE Eng Med Biol Soc. 2021 Nov;2021:5598-5601.
  • Rosvall M, Janzon L, Berglund G, Engström G, Hedblad B. Incident coronary events and case fatality in relation to common carotid intima-media thickness. J Intern Med 2005;257:430-7.
  • Ozkan E, Tuncel P. Erken yaş koroner kalp hastalığı olan erkek hastaların 1. derece erkek akrabalarının da bu riski gösterir ldl oksidasyon duyarlılığının tespiti. International Anatolia Academic Online Journal Health Sciences, 2023, 9(1), 30-42.
  • Libby P. The changing landscape of atherosclerosis. Nature. 2021 Apr;592(7855):524-533.
  • Cosansu NC, Dikicier BS, Yaldiz M, Solak B. Is there any association between the monocyte/lymphocyte ratio and the presence and severity of the disease in patients with psoriasis? A cross-sectional study. Sakarya Tıp Dergisi, 2020, 10(3), 430-436.
  • Urbanowicz T, Michalak M, Olasinska-Wisniewska A, Rodzki M, Krasińska A, Perek B, et al. Monocyte/Lymphocyte Ratio and MCHC as Predictors of Collateral Carotid Artery Disease-Preliminary Report. J Pers Med. 2021 Dec 1;11(12):1266.
  • Zuo B, Zhu S, Meng X, Zhao D, Zhang J. Monocyte/lymphocyte ratio is associated with carotid stenosis in ischemic stroke: A retrospective analysis. Brain Behav. 2019 Oct;9(10):e01429.
  • Urbina EM, Williams RV, Alpert BS, Collins RT, Daniels SR, Hayman L,; American Heart Association Atherosclerosis, Hypertension, and Obesity in Youth Committee of the Council on Cardiovascular Disease in the Young. Noninvasive assessment of subclinical atherosclerosis in children and adolescents: recommendations for standard assessment for clinical research: a scientific statement from the American Heart Association. Hypertension. 2009 Nov;54(5):919-50.
  • Dimitroulas T, Baniotopoulos P, Pagkopoulou E, Soulaidopoulos S, Nightingale P, Sandoo A, et al. Subclinical atherosclerosis in systemic sclerosis and rheumatoid arthritis: a comparative matched-cohort study. Rheumatol Int. 2020 Dec;40(12):1997-2004.
  • Bai R, Zhang Y, Liu W, Ma C, Chen X, Yang J, et al. The Relationship of Ankylosing Spondylitis and Subclinical Atherosclerosis: A Systemic Review and Meta-Analysis. Angiology. 2019 Jul;70(6):492-500.
  • Jamil M, Aslam R, Patel A, Nadir B, Khan S. Prevalence and Extent of Subclinical Atherosclerosis and Associated Cardiovascular Risk Factors in Adult Patients With Psoriatic Arthritis: A Systematic Review. Cureus. 2021 Aug 3;13(8):e16853.
  • Eder L, Jayakar J, Shanmugarajah S, Thavaneswaran A, Pereira D, Chandran V, et al. The burden of carotid artery plaques is higher in patients with psoriatic arthritis compared with those with psoriasis alone. Ann Rheum Dis. 2013 May;72(5):715-20.
  • Si Y, Fan W, Han C, Liu J, Sun L. Atherogenic Index of Plasma, Triglyceride-Glucose Index and Monocyte-to-Lymphocyte Ratio for Predicting Subclinical Coronary Artery Disease. Am J Med Sci. 2021 Sep;362(3):285-290.
  • Tan D, Fu Y, Tong W, Li F. Prognostic significance of lymphocyte to monocyte ratio in colorectal cancer: A meta-analysis. Int J Surg. 2018 Jul;55:128-138.
  • Zhu X, Li R, Zhu Y, Zhou J, Han X, Tong Y, et al. Neutrophil/lymphocyte, platelet/lymphocyte, monocyte/lymphocyte ratios and systemic immune-inflammation index in patients with depression. Bratisl Lek Listy. 2023;124(6):471-474.
  • Kelesoglu Dincer AB, Sezer S. Systemic Immune Inflammation Index as a Reliable Disease Activity Marker in Psoriatic Arthritis. J Coll Physicians Surg Pak. 2022 Jun;32(6):773-778.

Evaluation of Subclinical Atherosclerosis in Patients with Psoriatic Arthritis

Yıl 2024, Cilt: 34 Sayı: 2, 186 - 189, 30.04.2024
https://doi.org/10.54005/geneltip.1331223

Öz

Background/Aims: Psoriatic arthritis with peripheral and axial involvement; It is a heterogeneous disease that can cause enthesitis, dactylitis, and nail and skin involvement. The persistence of inflammation in psoriasis leads to comorbidities such as psoriatic arthritis, cardiovascular disease, and metabolic syndrome. Our study aimed to identify subclinical atherosclerosis in psoriatic arthritis patients without a known risk factor and to prevent possible morbidity and mortality in patients.
Methods: Thirty-three patients with psoriatic arthritis and twenty-five healthy control groups were included in our study. Diabetes mellitus, hypertension, coronary artery disease, diagnosis of hyperlipidemia, body mass index above 30, and smoking were determined as exclusion criteria. The age, gender, duration of the disease, medical treatment used for the disease, high-density lipoprotein, low-density lipoprotein, triglyceride, and total cholesterol values, monocyte-lymphocyte ratio, carotid intima-media thickness measurement results obtained by carotid doppler ultrasonography imaging were recorded.
Results: A comparison was made between the study and control groups in terms of age, triglyceride, high-density lipoprotein, low-density lipoprotein, and monocyte-lymphocyte ratio, and no statistically significant difference was observed. Monocyte and lymphocyte levels were significantly higher in the study group (p<0.05). Carotid intima-media thickness was statistically higher in the study group and this difference was statistically significant (p<0.05).
Conclusions: Patients with psoriatic arthritis have an increased risk of atherosclerosis compared to the healthy population without any risk factors. This awareness will be useful in the follow-up of patients and in taking precautions against morbidities that may develop.

Kaynakça

  • Aljohani R. Metabolic Syndrome and Its Components in Psoriatic Arthritis. Open Access Rheumatol. 2022 Feb 17;14:7-16.
  • Menter A, Griffiths CE, Tebbey PW, Horn EJ, Sterry W; International Psoriasis Council. Exploring the association between cardiovascular and other disease-related risk factors in the psoriasis population: the need for increased understanding across the medical community. J Eur Acad Dermatol Venereol. 2010 Dec;24(12):1371-7.
  • Haroon M, Gallagher P, Heffernan E, FitzGerald O. High prevalence of metabolic syndrome and of insulin resistance in psoriatic arthritis is associated with the severity of underlying disease. J Rheumatol. 2014 Jul;41(7):1357-65.
  • Tobin AM, Veale DJ, Fitzgerald O, Rogers S, Collins P, O'Shea D, et al. Cardiovascular disease and risk factors in patients with psoriasis and psoriatic arthritis. J Rheumatol. 2010 Jul;37(7):1386-94.
  • Towfighi A, Saver JL. Stroke declines from third to fourth leading cause of death in the United States: historical perspective and challenges ahead. Stroke. 2011 Aug;42(8):2351-5.
  • Kong P, Cui ZY, Huang XF, Zhang DD, Guo RJ, Han M. Inflammation and atherosclerosis: signaling pathways and therapeutic intervention. Signal Transduct Target Ther. 2022 Apr 22;7(1):131.
  • Karaoğlan B, Öztürk GT, Özdoğan V, Cumaoğlu A, Oktar S, Tas N, et al. Investigation of the correlation between ADMA levels and carotid artery intima-media thickness in rheumatoid arthritis patients. Turk J Phys Med Rehab 2011;57:114-8.
  • Nezu T, Hosomi N. Usefulness of Carotid Ultrasonography for Risk Stratification of Cerebral and Cardiovascular Disease. J Atheroscler Thromb. 2020 Oct 1;27(10):1023-1035.
  • Kiran V R, P M N, Shah MI, Sivaprakasam M, Joseph J. Gaussian-Mixture Modelling of A-Mode Radiofrequency Scans for the Measurement of Arterial Wall Thickness. Annu Int Conf IEEE Eng Med Biol Soc. 2021 Nov;2021:5598-5601.
  • Rosvall M, Janzon L, Berglund G, Engström G, Hedblad B. Incident coronary events and case fatality in relation to common carotid intima-media thickness. J Intern Med 2005;257:430-7.
  • Ozkan E, Tuncel P. Erken yaş koroner kalp hastalığı olan erkek hastaların 1. derece erkek akrabalarının da bu riski gösterir ldl oksidasyon duyarlılığının tespiti. International Anatolia Academic Online Journal Health Sciences, 2023, 9(1), 30-42.
  • Libby P. The changing landscape of atherosclerosis. Nature. 2021 Apr;592(7855):524-533.
  • Cosansu NC, Dikicier BS, Yaldiz M, Solak B. Is there any association between the monocyte/lymphocyte ratio and the presence and severity of the disease in patients with psoriasis? A cross-sectional study. Sakarya Tıp Dergisi, 2020, 10(3), 430-436.
  • Urbanowicz T, Michalak M, Olasinska-Wisniewska A, Rodzki M, Krasińska A, Perek B, et al. Monocyte/Lymphocyte Ratio and MCHC as Predictors of Collateral Carotid Artery Disease-Preliminary Report. J Pers Med. 2021 Dec 1;11(12):1266.
  • Zuo B, Zhu S, Meng X, Zhao D, Zhang J. Monocyte/lymphocyte ratio is associated with carotid stenosis in ischemic stroke: A retrospective analysis. Brain Behav. 2019 Oct;9(10):e01429.
  • Urbina EM, Williams RV, Alpert BS, Collins RT, Daniels SR, Hayman L,; American Heart Association Atherosclerosis, Hypertension, and Obesity in Youth Committee of the Council on Cardiovascular Disease in the Young. Noninvasive assessment of subclinical atherosclerosis in children and adolescents: recommendations for standard assessment for clinical research: a scientific statement from the American Heart Association. Hypertension. 2009 Nov;54(5):919-50.
  • Dimitroulas T, Baniotopoulos P, Pagkopoulou E, Soulaidopoulos S, Nightingale P, Sandoo A, et al. Subclinical atherosclerosis in systemic sclerosis and rheumatoid arthritis: a comparative matched-cohort study. Rheumatol Int. 2020 Dec;40(12):1997-2004.
  • Bai R, Zhang Y, Liu W, Ma C, Chen X, Yang J, et al. The Relationship of Ankylosing Spondylitis and Subclinical Atherosclerosis: A Systemic Review and Meta-Analysis. Angiology. 2019 Jul;70(6):492-500.
  • Jamil M, Aslam R, Patel A, Nadir B, Khan S. Prevalence and Extent of Subclinical Atherosclerosis and Associated Cardiovascular Risk Factors in Adult Patients With Psoriatic Arthritis: A Systematic Review. Cureus. 2021 Aug 3;13(8):e16853.
  • Eder L, Jayakar J, Shanmugarajah S, Thavaneswaran A, Pereira D, Chandran V, et al. The burden of carotid artery plaques is higher in patients with psoriatic arthritis compared with those with psoriasis alone. Ann Rheum Dis. 2013 May;72(5):715-20.
  • Si Y, Fan W, Han C, Liu J, Sun L. Atherogenic Index of Plasma, Triglyceride-Glucose Index and Monocyte-to-Lymphocyte Ratio for Predicting Subclinical Coronary Artery Disease. Am J Med Sci. 2021 Sep;362(3):285-290.
  • Tan D, Fu Y, Tong W, Li F. Prognostic significance of lymphocyte to monocyte ratio in colorectal cancer: A meta-analysis. Int J Surg. 2018 Jul;55:128-138.
  • Zhu X, Li R, Zhu Y, Zhou J, Han X, Tong Y, et al. Neutrophil/lymphocyte, platelet/lymphocyte, monocyte/lymphocyte ratios and systemic immune-inflammation index in patients with depression. Bratisl Lek Listy. 2023;124(6):471-474.
  • Kelesoglu Dincer AB, Sezer S. Systemic Immune Inflammation Index as a Reliable Disease Activity Marker in Psoriatic Arthritis. J Coll Physicians Surg Pak. 2022 Jun;32(6):773-778.
Toplam 24 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Radyoloji ve Organ Görüntüleme, Romatoloji ve Artrit
Bölüm Original Article
Yazarlar

İrfan Atik 0000-0002-9026-2076

Seda Atik 0000-0002-7164-6592

Enes Gül 0000-0002-5562-2697

Erken Görünüm Tarihi 27 Nisan 2024
Yayımlanma Tarihi 30 Nisan 2024
Gönderilme Tarihi 24 Temmuz 2023
Yayımlandığı Sayı Yıl 2024 Cilt: 34 Sayı: 2

Kaynak Göster

Vancouver Atik İ, Atik S, Gül E. Evaluation of Subclinical Atherosclerosis in Patients with Psoriatic Arthritis. Genel Tıp Derg. 2024;34(2):186-9.