Assessment of Subclinical Vascular Disease Associated with Ankylosing Spondylitis
Assessment of Subclinical Vascular Disease Associated with Ankylosing Spondylitis
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DOI：
10.3899/jrheum.100668
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发表时间：
2011-04-01
影响因子：
3.9
通讯作者：
Szanto, Sandor
中科院分区：
文献类型：
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作者：
Bodnar, Nora;Kerekes, Gyoergy;Szanto, Sandor
Objective.研究表明，强直性脊柱炎（AS），以及类风湿性关节炎，可能与加速动脉粥样硬化和血管疾病。我们评估了血管内皮功能障碍、颈动脉粥样硬化和主动脉硬化的临床和实验室测量。研究了43名AS患者和40名匹配的健康对照者。我们评估了颈总动脉内膜中层厚度（ccIMT）、血流介导的血管舒张（FMD）和脉搏波速度（PWV）与年龄、疾病持续时间、吸烟习惯、体重指数、患者疼痛和疾病活动评估、巴斯AS疾病活动指数、巴斯AS功能指数（BASFI）、度量测量、红细胞沉降率、C反应蛋白和HLA-B27状态的关系。我们发现了受损的口蹄疫（6.85 +/- 2.98% vs 8.30 +/- 3.96%; p = 0.005），ccIMT增加（0.65 +/- 0.15 vs 0.54 +/- 0.15 mm; p = 0.01）和较高的PWV（8.64 +/- 2.44 vs 8.00 +/- 1.46 m/s; p = 0.03）。我们还发现ccIMT与FMD呈负相关（r = -0.563; p = 0.0001），与PWV呈正相关（r = 0.374; p = 0.018）。ccIMT和PWV均与病程相关（分别为r = 0.559; p = 0.013和r = 0.520; p = 0.022），BASH（r = 0.691; p = 0.003和r = 0.654; p = 0.006），腰椎活动度降低（r = -0.656; p = 0.006和r = -0.604; p = 0.013），胸部扩张（r = -0.502; p = 0.047和r = -0.613：p = 0.012），以及增加的壁枕距离（r = 0.509; p = 0.044和r = 0.614; p = 0.011）。在这一充分表征的AS人群中，FMD受损和ccIMT和PWV增加分别表明内皮功能异常和动脉粥样硬化和主动脉僵硬度增加。非侵入性诊断工具的价值需要进一步表征。（2011年1月15日首次发布; J Rheumol 2011;38：723-9; doi：10.3899/jrheum.100668）
Objective. Studies indicate that ankylosing spondylitis (AS), as well as rheumatoid arthritis, may be associated with accelerated atherosclerosis and vascular disease. We assessed endothelial dysfunction, carotid atherosclerosis, and aortic stiffness in AS in context with clinical and laboratory measurements.Methods. Forty-three patients with AS and 40 matched healthy controls were studied. We assessed common carotid intima-media thickness (ccIMT), flow-mediated vasodilation (FMD), and pulse-wave velocity (PWV) in association with age, disease duration, smoking habits, body mass index, patient's assessment of pain and disease activity, Bath AS Disease Activity Index, Bath AS Functional Index (BASFI), metric measurements, erythrocyte sedimentation rate, C-reactive protein, and HLA-B27 status.Results. We found impaired FMD (6.85 +/- 2.98% vs 8.30 +/- 3.96%; p = 0.005), increased ccIMT (0.65 +/- 0.15 vs 0.54 +/- 0.15 mm; p = 0.01), and higher PWV (8.64 +/- 2.44 vs 8.00 +/- 1.46 m/s; p = 0.03) in patients with AS compared to controls, respectively. We also found that ccIMT negatively correlated with FMD (r = -0.563; p = 0.0001) and positively correlated with PWV (r = 0.374; p = 0.018). Both ccIMT and PWV correlated with disease duration (r = 0.559; p = 0.013 and r = 0.520; p = 0.022, respectively), BASH (r = 0.691; p = 0.003 and r = 0.654; p = 0.006), decreased lumbar spine mobility (r = -0.656; p = 0.006 and r = -0.604; p = 0.013), chest expansion (r = -0.502; p = 0.047 and r = -0.613: p = 0.012), and increased wall-occiput distance (r = 0.509; p = 0.044 and r = 0.614; p = 0.011).Conclusion. In this well characterized AS population, impaired FMD and increased ccIMT and PWV indicate abnormal endothelial function and increased atherosclerosis and aortic stiffness, respectively. The value of noninvasive diagnostic tools needs to be further characterized. (First Release Jan 15 2011; J Rheumatol 2011;38:723-9; doi:10.3899/jrheum.100668)