The evaluation of comorbid diseases in patients with ankylosing spondylitis

Year 2014, Volume: 41 Issue: 4, 662 - 666, 01.12.2014

Serda Em Mehtap Bozkurt Mehmet Çağlayan Pelin Oktayoğlu Mehmet Karakoç Kemal Nas

https://doi.org/10.5798/diclemedj.0921.2014.04.0495

Abstract

Objective: To evaluate comorbid diseases and existing rates of their in the patients with ankylosing spondylitis (AS). Methods: Totally 70 patients with AS, 70 patients with rheumatoid arthritis (RA) and 70 healthy controls were included in this study. Demographic and clinical features were recorded. Study groups were questioned in terms of comorbid disease including hypertension, atherosclerotic heart disease (ASHD), heart failure, thyroid disease, lung disease, Type 2 diabetes, cerebrovascular events and the patients records were analyzed retrospectively to obtain more comprehensive information. Results: The patient and control groups were similar in terms of age, height and weight. The prevalence of hypertension in the patients with AS were significantly higher than those in controls (p0.05). The incidence of ASHD and cardiac failure in AS and RA were similar and no significant difference was observed in comparison with the positive and negative controls. The prevalence for thyroid diseases was 12.8% and the prevalence for Type 2 diabetes mellitus was 11.6% in the patients with AS. This difference between the two groups was significant compared to healthy controls (p

Keywords

Ankylosing spondylitis, hypertension, diabetes mellitus, thyroid disease, comorbidity

Ankilozan spondilitli hastalarda komorbit hastalıkların değerlendirmesi

Abstract

Amaç: Bu çalışmanın amacı ankilozan spondilit (AS) hastalarında komorbit hastalıkları ve bulunma oranlarını belirlemektir. Yöntemler: Bu çalışmaya 70 AS\'li hasta, 70 romatoid artritli (RA) hasta ve 70 sağlıklı kontrol alındı. Demografik ve klinik özellikler kaydedildi. Tüm gruplar hipertansiyon, Aterosklerotik Kalp Hastalığı (ASKH), kalp yetmezliği, tiroid hastalıkları, akciğer hastalıkları, Tip2 diyabet ve serebrovasküler olay (SVO) açısından sorgulandı ve daha kapsamlı bilgi elde etmek için hasta kayıtları retrospektif olarak incelendi. Bulgular: Hasta ve kontrol grupları yaş, boy ve kilo bakımından benzerdi. AS\'li hastalarda hipertansiyon görülme sıklığı, sağlıklı kontrollerden anlamlı olarak yüksekti (p0.05). AS ve RA\'lı hastalarda ASKH ve kalp yetmezliği görülme sıklığı benzerdi ve AS hastaları kontrol grupları ile karşılaştırıldığında anlamlı farklılık yoktu. AS\'li hastalarda tiroid hastalıkları %12.8 olarak görülürken, Tip2 diyabet sıklığı %11.4 idi ve sağlıklı kontrollerle AS hastaları karşılaştırıldığında bu iki hastalık açısından iki grup arasındaki fark anlamlıydı (p

Keywords

Ankilozan spondilit, hipertansiyon, diyabet, tiroid hastalıkları, komorbidite

References

• Arasıl T. Ankilozan spondilit. In: Beyazova M, Gökçe Kutsal Y, edt. Fiziksel Tıp ve Rehabilitasyon. Güneş Kitabevi, An- kara, 2000:1577-1591.
• Stolwijk C, Essers I, van Tubergen A, et al. The epidemiol- ogy of extra-articular manifestations in ankylosing spondy- litis: a population-based matched cohort study. Ann Rheum Dis 2014;3:21.
• van der Horst-Bruinsma IE, Nurmohamed MT, Landewé RB. Comorbidities in patients with spondyloarthritis. Rheum Dis Clin North Am 2012;38:523-538.
• Schneider S, Schmitt G, Richter W. Prevalence and correlates of inflammatory arthritis in Germany: data from the First National Health Survey. Rheumatol Int 2006;27:29-38.
• Mercieca C, van der Horst-Bruinsma IE, Borg AA. Pulmo- nary, renal and neurological comorbidities in patients with ankylosing spondylitis; implications for clinical practice. Curr Rheumatol Rep 2014;16:434-437.
• Maghraoui AE. Extra-articular manifestations of ankylosing spondylitis: Prevalence, characteristics and therapeutic im- plications. Eur J Intern Med 2011;22:554-560.
• Elewaut D, Matucci-Cerinic M. Treatment of ankylosing spondylitis and extraarticular manifestations in everyday rheumatology practice. Rheumatology 2009;48:1029-1035.
• Libby P. Role of inflammation in atherosclerosis associated with rheumatoid arthritis. Am J Med 2008;121:21-31.
• Cevik R, Em S, Gur A, et al. Sex and thyroid hormone status in women with rheumatoid arthritis: are there any effects of menopausal state and disease activity on these hormones? Int J Clin Pract 2004;58:327-332.
• Harrison DG, Guzik TJ, Lob HE, et al. Inflammation, im- munity, and hypertension. Hypertension 2011;57:132-140.
• Xing T, Wang F, Li J, Wang N. Hypertension: an immuno- logic disease? J Hypertens 2012;30:2440-2441.
• Han C, Robinson DW, Jr, Hackett MV, et al. Cardiovascular disease and risk factors in patients with rheumatoid arthri- tis, psoriatic arthritis, and ankylosing spondylitis. J Rheu- matol 2006;33:2167-2172.
• Acay A, Ulu MS, Ahsen A, et al. Assessment of Thyroid Disorders and Autoimmunity in Patients with Rheumatic Diseases. Endocr Metab Immune Disord Drug Targets. 2014;6:26-30.
• Lu MC, Yin WY, Tsai TY, et al. Increased risk of primary Sjögren’s syndrome in female patients with thyroid dis- orders: a longitudinal population-based study in Taiwan. PLoS One 2013;18:e77210.
• Robazzi TC, Adan LF. Autoimmune thyroid disease in patients with rheumatic diseases. Rev Bras Reumatol 2012;52:417-430.
• Peters MJ, van der Horst-Bruinsma IE, Dijkmans BA, et al. Cardiovascular risk profile of patients with spondylarthrop- athies, particularly ankylosing spondylitis and psoriatic ar- thritis. Semin Arthritis Rheum 2004;34:585-592.
• Libby P. Role of inflammation in atherosclerosis associated with rheumatoid arthritis. Am J Med 2008;121:21-31.
• Hollan I, Saatvedt K, Almdahl SM, et al. Spondyloarthritis: a strong predictor of early coronary artery bypass grafting. Scand J Rheumatol 2008;37:18-22.
• Lange U, Boss B, Teichmann J, et al. Thyroid disorders in female patients with ankylosing spondylitis. Eur J Med Res 1999;4:468-474.
• Emmungil H, Erdogan M, Kalfa M, et al. G. Autoimmune thyroid disease in ankylosing spondylitis.Clin Rheumatol 2014;33:955-961.
• Pérez-Fernández OM, Mantilla RD, Cruz-Tapias P, et al. Spondyloarthropathies in autoimmune diseases and vice versa. Autoimmune Dis 2012;2:1-7.
• Tarhan F, Oruk G, Niflioglu O, et al. Thyroid involvement in ankylosing spondylitis and relationship of thyroid dysfunc- tion with anti-TNF treatment. Rheumatol Int 2013;33:853- 857.
• Peluso R, Lupoli GA, Del Puente A, et al Prevalence of thy- roid autoimmunity in patients with spondyloarthropathies. J Rheumatol 38;2011:1-7.
• Chen HH, Su YY, Chen HY, et al. Ankylosing spondylitis and other inflammatory spondyloarthritis increase the risk of developing type 2 diabetes in an Asian population. Rheu- matol Int 2014; 34:265-270.
• Hotamisligil GS, Shargill NS, Spiegelman BM. Adipose expression of tumor necrosis factor-alpha: direct role in obesity-linked insulin resistance. Science 1993;259:87-91
• Gimeno RE, Klaman LD. Adipose tissue as an active en- docrine organ: recent advances. Curr Opin Pharmacol 2005;5:122-128.
• Hotamisligil GS, Spiegelman BM. () Tumor necrosis factor alpha: a key component of the obesity-diabetes link. Diabe- tes 1994;43:1271-1278.
• Brophy S, Cooksey R, Atkinson M, et al. No increased rate of acute myocardial infarction or stroke among patients with ankylosing spondylitis-a retrospective cohort study using routine data. Semin Arthritis Rheum 2012;42:140- 145.
• van der Horst-Bruinsma IE, Nurmohamed MT, Landewé RB. Comorbidities in patients with spondyloarthritis. Rheum Dis Clin North Am 2012;38:523-538.