MUKOZAL VE KUTANÖZ TUTULUM İLE SEYREDEN LİKEN PLANUS HASTALARINDA SUBKLİNİK KARDİYOVASKÜLER HASTALIK RİSKİNİN DEĞERLENDİRİLMESİ Evaluation of Subclinical Cardiovascular Disease Risk in Lichen Planus Patients with Mucosal and Cutaneous Involvement

Yıl 2021, Cilt: 11 Sayı: 3, 25 - 35, 15.09.2021

Mehmet Erdoğan Ahmet Kasapkara Serdal Baştuğ Yakup Alsancak Akın Aktaş Ayşe Saatcı Yaşar

Öz

ÖZET
Amaç: Liken planus (LP) kronik inflamatuar bir hastalıktır. Karotis intima-medya kalınlığı (KİMK) ölçülmesi
ve lipit profilinin değerlendirilmesi aterosklerotik risk tahmini için kabul görmüş bir metottur. Bu çalışmada
LP hastalarında kardiyovasküler hastalık (KVH) risk faktörlerinin prevalansı ve subklinik ateroskleroz riskinin
değerlendirilmesi amaçlanmıştır.
Gereç ve Yöntemler: Bu olgu-kontrolü çalışmaya LP tanısı alan 60 hasta grubu ile yaş ve demografik özellikler açısından benzer 60 kontrol grubu dahil edildi. Gruplar arasında bazal karakteristik özellikleri, KVH
risk faktörleri, biyokimyasal ve hematolojik parametreleri, konvansiyonel 2-boyutlu ve Doppler transtorasik
ekokardiyografi parametreleri, sol ventrikül kitle indeksi (SoVKİ) ve KİMK karşılaştırıldı.
Bulgular: Çalışmaya yaş ortalaması 46±13 yıl olan, 73’ü kadın (%61), 47’si erkek (%39) olmak üzere toplam
120 hasta alındı. Total kolesterol (TK) seviyeleri LP grubunda kontrol grubuna kıyasla daha yüksek bulundu
(sırasıyla 209, 192, p=0,038). Gruplar arasında SoVKİ ve konvansiyonel ekokardiyografik ölçümler benzer bulundu. LP grubunda KİMK 0,88±0,16 mm iken kontrol grubunda 0,59±0,10 mm olarak ölçüldü (p<0,001). Kutanöz LP ile mukozal LP arasında ise KİMK benzer bulunmuştur. LP grubunda hastalık süresi ile KİMK arasında
anlamlı bir korelasyon izlenmiştir (r=0,61, p<0,001). Hasta grubunda yapılan çok değişkenli doğrusal regresyon analizinde ise yaş, TK seviyesi ve LP hastalık süresinin KİMK’in bağımsız belirleyicileri olduğu gösterildi.
Sonuç: LP hastalık süresi ve TK seviyeleri bağımsız olarak KİMK ile ilişkilidir ve LP hastalarının hem mukozal
hem de kutanöz tutulumunda KİMK ile önemli ölçüde ilişkilidir.
Anahtar Kelimeler: Liken planus; Karotis iç-orta kalınlığı; Ateroskleroz; İnflamasyon; Dislipidemi.
ABSTRACT
Objective: Lichen planus (LP) is a chronic inflammatory disease. Measurement of the carotid intima-media
thickness (CIMT) and lipid profile is an established method for atherosclerotic risk estimation. The aim of
this study was to evaluate the prevalence of cardiovascular disease (CVD) risk factors and the risk of subclinical atherosclerosis in patients with LP.
Material and Methods: In this case-control study included 60 patient group diagnosed with LP and 60 control group similar in terms of age and demographic characteristics. Baseline characteristics, CVD risk factors,
biochemical and haematological parameters, conventional 2-dimensional and Doppler transthoracic echocardiographic parameters, left ventricular mass index (LVMI) and CIMT were compared between the groups.
Results: A total of 120 patients, 73 female (61%) and 47 male (39%), with a mean age of 46 ± 13 years, were
included in the study. Total cholesterol (TC) levels were found to be higher in the LP group compared to the
control group (209, 192, p = 0.038, respectively). The LVMI and conventional echocardiographic measurements were comparable between the groups. CIMT was 0.88 ± 0.16 mm in the LP group and 0.59 ± 0.10 mm
in the control group (p <0.001). CIMT was similar between cutaneous LP and mucosal LP. In the group of LP,
a significant correlation was observed between disease duration and CIMT (r = 0.61, p <0.001). Multivariate
linear regression analysis demonstrated that, age, TC levels and LP disease duration were independent determinants of CIMT in the patients group
Conclusion: LP disease duration and TC levels are independently associated with CIMT and significantly
correlates with CIMT in both mucosal and cutaneous involvement of LP patients.
Keywords: Lichen Planus; Carotid İntima-Media Thickness; Atherosclerosis; İnflammation; Dyslipidemia.

Anahtar Kelimeler

MUKOZAL VE KUTANÖZ TUTULUM İLE SEYREDEN LİKEN PLANUS HASTALARINDA SUBKLİNİK KARDİYOVASKÜLER, HASTALIK RİSKİNİN DEĞERLENDİRİLMESİ, Evaluation of Subclinical Cardiovascular Disease Risk in Lichen Planus Patients with Mucosal and Cutaneous Involvement

Kaynakça

• 1. Ikonomidis I, Stamatelopoulos K, Lekakis J, Vamvakou GD, Kremastinos DT. Inflammatory and non-invasive vascular markers: the multimarker approach for risk stratification in coronary artery disease. Atherosclerosis. 2008 Jul;199(1):3-11.
• 2. Arias-Santiago S, Buendia-Eisman A, Aneiros-Fernandez J, GironPrieto MS, Gutierrez-Salmeron MT, Garcia Mellado V, et al. Lipid levels in patients with lichen planus: a case-control study. Journal of the European Academy of Dermatology and Venereology : JEADV. 2011;25(12):1398- 401.
• 3. McCartan BE, Healy CM. The reported prevalence of oral lichen planus: a review and critique. J Oral Pathol Med. 2008 Sep;37(8):447-53.
• 4. Alaizari NA, Al-Maweri SA, Al-Shamiri HM, Tarakji B, Shugaa-Addin B. Hepatitis C virus infections in oral lichen planus: a systematic review and meta-analysis. Aust Dent J. 2016 Sep;61(3):282-87.
• 5. Barbosa NG, Silveira ÉJ, Lima EN, Oliveira PT, Soares MS, de Medeiros AM. Factors associated with clinical characteristics and symptoms in a case series of oral lichen planus. Int J Dermatol. 2015 Jan;54(1):e1-e6.
• 6. Chung PI, Hwang CY, Chen YJ, Lin MW, Chen TJ, Hua TC, et al. Autoimmune comorbid diseases associated with lichen planus: a nationwide case-control study. J Eur Acad Dermatol Venereol. 2015 Aug;29(8):1570-5.
• 7. Likar-Manookin K, Stewart C, Al-Hashimi I, Curtis W, Berg K, Cherian K, et al. Prevalence of oral lesions of autoimmune etiology in patients with primary Sjogren's syndrome. Oral Dis. 2013 Sep;19(6):598-603.
• 8. Robledo-Sierra J, Landin-Wilhelmsen K, Filipsson Nyström H, Eggertsen R, Larsson L, Dafar A, et al. A mechanistic linkage between oral lichen planus and autoimmune thyroid disease. Oral Dis. 2018 Sep;24(6):1001-11.
• 9. Gullu H, Caliskan M, Dursun R, Ciftci O, Guven A, Muderrisoglu H. Impaired coronary microvascular function and its association with disease duration and inflammation in patients with psoriasis. Echocardiography. 2013 Sep;30(8):912-18.
• 10. Mancini GB. The fire within psoriatic patients: overlap between inflammatory and cardiovascular diseases. Can J Cardiol. 2015 Mar;31(3):242-43.