Chronic inflammatory autoimmune disorders and atherosclerosis
Chronic inflammatory autoimmune disorders and atherosclerosis
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DOI：
10.1196/annals.1381.007
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发表时间：
2007-01-01
期刊：
影响因子：
--
通讯作者：
Abuelkheir, H.
中科院分区：
文献类型：
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作者：
Abu-Raya, S.;Abou-Raya, A.;Abuelkheir, H.
类风湿关节炎（RA）、牙周病（PD）和冠状动脉疾病（CAD）是常见的慢性炎症性疾病。RA与血管风险加速相关，导致冠心病患病率增加，伴随早期死亡率和高发病率。RA和PD具有共同的病理生物学。因此，本研究的目的是评估RA、PD和CAD之间的关系以及全身炎症因子的影响。对100例活动期RA患者进行PD评估，其中50例已确诊CAD， 50例未确诊CAD。所有受试者均接受了临床、心脏、牙科、实验室和放射学评估。采集血样，检测高敏c反应蛋白（hs-CRP）、总白细胞计数（WBC）、红细胞沉降率（ESR）、纤维蛋白原、肿瘤坏死α (tnf - α)、总胆固醇（TC）、高密度脂蛋白（HDL）水平。本研究结果表明RA、PD和CAD之间存在关联。合并CAD的RA患者PD明显高于未合并CAD的RA患者，P < 0.001。炎症标志物hs-CRP、ESR、WBC、纤维蛋白原和tnf - α在所有患者中均升高，但在RA合并CAD并患有PD的患者中，即在炎症性疾病负担更重的患者中，炎症标志物hs-CRP、ESR、WBC、纤维蛋白原和tnf - α显著升高。与无CAD的RA患者相比，合并CAD的RA患者HDL水平较低，P < 0.005。本研究的证据显示RA、PD、CAD和全身炎症介质水平之间存在关联。这意味着炎症可能是慢性炎症性自身免疫性疾病和动脉粥样硬化之间的中心联系。
Rheumatoid arthritis (RA), periodontal disease (PD), and coronary artery disease (CAD) are common chronic inflammatory diseases. RA is associated with accelerated vascular risk resulting in an increased prevalence of CAD with attendant early mortality and excess morbidity. RA and PD have a common pathobiology. Accordingly, the aim of this study was to evaluate the association between RA, PD, and CAD and the influence of systemic inflammatory factors. A total of 100 active RA patients of which 50 had established CAD and 50 had no CAD were assessed for PD. All subjects underwent a clinical, cardiac, dental, laboratory, and radiological evaluation. Blood samples were obtained and the level of high-sensitivity C-reactive protein (hs-CRP), total white blood counts (WBC), erythrocyte sedimentation rate (ESR), fibrinogen and tumor necrosis alpha (TNF-alpha), total cholesterol (TC), and high-density lipoprotein (HDL) were assayed. The findings of this study demonstrated an association between RA, PD, and CAD. The RA patients with CAD had significantly more PD than RA patients without CAD, P < 0.001. The inflammatory markers hs-CRP, ESR, WBC, fibrinogen, and TNF-alpha were raised in all patients but were significantly higher in RA patients with CAD who also had PD, that is, in those with more inflammatory disease burden. HDL levels were lower in RA patients with CAD when compared to RA patients without CAD, P < 0.005. Evidence from this study shows an association between RA, PD, CAD, and systemic levels of the inflammatory mediators. The implication is that inflammation may be the central link between the chronic inflammatory autoimmune disorders and atherosclerosis.