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Evaluation of the Risk of Subclinical Atherosclerosis in Vitiligo Patients by Measuring Carotid Artery Intima Media Thickness via Ultrasonography

Yıl 2025, Cilt: 7 Sayı: 2, 255 - 261, 23.06.2025
https://doi.org/10.52827/hititmedj.1682097

Öz

Objective: Vitiligo is an autoimmune disease characterized by the destruction of melanocytes. It is often associated with other autoimmune diseases and systemic metabolic disorders. This study aimed to evaluate the increased risk of subclinical atherosclerosis in vitiligo patients.
Material and Method: In this prospective study, 70 vitiligo patients and 70 healthy control subjects, who were over the age of 18 years and without cardiovascular disease risk factors, underwent carotid artery ultrasonography, between 2022 and 2023. Carotid artery intima-media thickness which is an indicator of subclinical atherosclerosis was measured bilaterally. Vitiligo patients were grouped according to the presence of vitiligo vulgaris, acrofacial disease, focal vitiligo, family history, duration of disease, and age of the patient at disease onset.
Results: The mean carotid artery intima-media thickness in vitiligo patients was significantly greater than healthy controls (p<0.001). In particular, intima-media thickness was greatest in vitiligo patients with a disease duration less than one year, but this difference was not statistically significant (p>0.05).
Conclusion: This study revealed the risk of subclinical atherosclerosis in vitiligo patients with the carotid artery ultrasonography, which is a radiation free, inexpensive imaging method. There are few studies on the risk of cardiovascular diseases in vitiligo patients. The main difference of our study is that we excluded the subjects with any risk factors for cardiovascular diseases to identify the vitiligo as an independent risk factor for subclinical atherosclerosis and therefore cardiovascular diseases. At this point, we think that our study makes an important contribution to the literature.

Etik Beyan

This study was performed in accordance with the principles outlined in the latest version of Declaration of Helsinki. It was approved by the Non-Interventional Health Research Ethics Committee of Hitit University (Protocol no: 2022-13, approval date: 23 February 2022). Informed consent was obtained from the individuals included in the study.

Kaynakça

  • Liang X, Guo F, Zhang M, et al. Risk factors for cardiovascular diseases in patients with vitiligo: an analysis of current evidence. Ann Med 2024;56:2326297.
  • Christian Krüger, Karin Uta Schallreuter. A review of the worldwide prevalence of vitiligo in children/adolescents and adults. Int J Dermatol 2012;51:1206-1212.
  • Mascarenhas MRM, Oliveira MC, Oliveira LF, Magalhães AS, Machado PRL. Clinical profile of vitiligo patients and relationship with immuno-inflammatory markers. An Bras Dermatol 2024;99:196-201.
  • Diotallevi F, Gioacchini H, De Simoni E, et al. Vitiligo, from pathogenesis to therapeutic advances: state of the art. Int J Mol Sci 2023;24:4910.
  • Bergqvist C, Ezzedine K. Vitiligo: a review. Dermatology 2020;236:571-592.
  • Frisoli ML, Essien K, Harris JE. Vitiligo: mechanisms of pathogenesis and treatment. Annu Rev Immunol 2020;38:621-648.
  • Bergqvist C, Ezzedine K. Vitiligo: a focus on pathogenesis and its therapeutic implications. J Dermatol 2021;48:252-270.
  • Bathina N, Ganni S, Kolalapudi SA, Konala S, Dharavath K, Reddy MTK. Prevalence of Metabolic Syndrome in Vitiligo Patients and its Relation to Vitiligo Severity-A Cross-Sectional Study. Indian Dermatol Online J 2024;15:612-615.
  • Azzazi Y, Mostafa WZ, Sayed KS, et al. Support for increased cardiovascular risk in non-segmental vitiligo among Egyptians: A hospital-based, case-control study. Pigment Cell Melanoma Res 2021;34:598-604.
  • Ataş H, Gönül M. Increased risk of metabolic syndrome in patients with vitiligo. Balkan Medical Journal 2017;34:219-225.
  • Bastonini E, Bellei B, Filoni A, Kovacs D, Iacovelli P, Picardo M. Involvement of Non-Melanocytic Skin Cells in Vitiligo. Exp Dermatol 2019;28:667-673.
  • Picardo M, Dell’Anna ML, Ezzedine K, et al. Vitiligo. Nat Rev Dis Primers 2015:1:15011.
  • D’Arino A, Picardo M, Truglio M, Pacifico A, Iacovelli P. Metabolic Comorbidities in Vitiligo: A Brief Review and Report of New Data from a Single-Center Experience. Int J Mol Sci 2021;22:8820.
  • Bao P, Liu G, Wei Y. Association between IL-6 and Related Risk Factors of Metabolic Syndrome and Cardiovascular Disease in Young Rats. Int J Clin Exp Med 2015;8:13491-13499.
  • Gossl M, Lerman LO, Lerman A. Frontiers in nephrology: early atherosclerosis – a view beyond the lümen. J Am Soc Nephrol 2007;18:2836-2842.
  • Weber C, Noels H. Atherosclerosis: current pathogenesis and therapeutic options. Nat Med 2011;17:1410-1422.
  • Hegele RA. The pathogenesis of atherosclerosis. Clin Chim Acta 1996;246:21-38.
  • Katakami N, Matsuoka T, Shimomura I. Clinical utility of carotid ultrasonography: Application for the management of patients with diabetes. Journal of Diabetes Investigation 2019;10:883-889.
  • Kablak-Ziembicka A, Przewlocki T, Tracz W, Pieniazek P, Musialek P, Sokolowski A. Gender differences in carotid intima-media thickness in patients with suspected coronary artery disease. Am J Cardiol 2005;96:1217-1222.
  • Bauer M, Caviezel S, Teynor A, Erbel R, Mahabadi AA, Schmidt-Trucksäss A. Carotid intima-media thickness as a biomarker of subclinical atherosclerosis. Swiss Med Wkly 2012;142:w13705.
  • Namazi N, Amani M, Haghighatkhah HR, Noori E, Abdollahimajd F. Increased risk of subclinical atherosclerosis and metabolic syndrome in patients with vitiligo: a real association or a coincidence? Dermatol Ther 2021;34:e14803.
  • Frączek A, Owczarczyk-Saczonek A, Ludwig RJ, et al. Vitiligo is associated with an increased risk of cardiovascular diseases: a large-scale, propensity-matched, US-based retrospective study. EBioMedicine 2024:109:105423.
  • Mangge H, Becker K, Fuchs D, Gostner JM. Antioxidants, inflammation and cardiovascular disease. World J Cardiol 2014;6:462-477.
  • Karadag AS, Tutal E, Ertugrul DT, Akin KO, Bilgili SG. Serum holotranscobalamine, vitamin B12, folic acid and homocysteine levels in patients with vitiligo. Clin Exp Dermatol 2012;37:62-64.
  • Solak B, Dikicier BS, Cosansu NC, Erdem T. Neutrophil to lymphocyte ratio in patients with vitiligo. Postepy Dermatol Alergol 2017;34:468-470.
  • Seremet S, Gurel MS. Miscellaneous skin disease and the metabolic syndrome. Clin Dermatol 2018;36:94-100.
  • Sharma YK, Bansal P, Menon S, Prakash N. Metabolic syndrome in vitiligo patients among a semi-urban Maharashtrian population: a case-control study. Diabetes Metab Syndr 2017;11:77-80.
  • Tune JD, Goodwill AG, Sassoon DJ, Mather KJ. Cardiovascular consequences of metabolic syndrome. Transl Res 2017;183:57-70.

Vitiligo Hastalarında Ultrasonografi ile Karotis Arter İntima Media Kalınlığının Ölçülerek Subklinik Ateroskleroz Riskinin Değerlendirilmesi

Yıl 2025, Cilt: 7 Sayı: 2, 255 - 261, 23.06.2025
https://doi.org/10.52827/hititmedj.1682097

Öz

Amaç: Vitiligo, melanositlerin yıkımı ile karakterize otoimmün bir hastalıktır. Genellikle diğer otoimmün hastalıklar ve sistemik metabolik bozukluklarla birlikte görülür. Bu çalışmada vitiligoda artmış subklinik ateroskleroz riskinin değerlendirilmesi amaçlanmıştır.
Gereç ve Yöntem: Bu prospektif çalışmada, 18 yaş üstü, kardiyovasküler hastalık risk faktörü olmayan 70 vitiligo hastası ve 70 sağlıklı kontrole 2022-2023 yılları arasında karotis arter ultrasonografisi uygulandı. Subklinik aterosklerozun bir göstergesi olan karotis arter intima-media kalınlığı bilateral olarak ölçüldü. Vitiligo hastaları vitiligo vulgaris varlığı, akrofasiyal hastalık, fokal vitiligo, aile öyküsü, hastalık süresi ve hastalığın başlangıç yaşına göre gruplandırıldı.
Bulgular: Vitiligo hastalarında ortalama karotis arter intima-media kalınlığı sağlıklı kontrol grubu ile karşılaştırıldığında istatistiksel olarak anlamlı derecede yüksekti (p<0.001). Özellikle hastalık süresi bir yıldan az olan vitiligo hastalarında intima-media kalınlığı en yüksekti, ancak istatistiksel olarak anlamlı değildi (p>0.05).
Sonuç: Bu çalışma, radyasyon içermeyen düşük maliyetli bir görüntüleme yöntemi olan karotis arter ultrasonografisi ile vitiligo hastalarında subklinik ateroskleroz riskini ortaya koymaktadır. Vitiligoda kardiyovasküler hastalık riski ile ilgili az sayıda çalışma bulunmaktadır. Çalışmamızın temel farkı ise kardiyovasküler hastalıklar için risk faktörleri olan bireylerin çalışmaya dahil edilmeyerek, subklinik ateroskleroz ve dolayısıyla kardiyovasküler hastalıklar için vitiligonun bağımsız bir risk faktörü olarak ortaya konmasıdır. Bu noktada çalışmamızın literatüre önemli katkı sağladığını düşünmekteyiz.

Kaynakça

  • Liang X, Guo F, Zhang M, et al. Risk factors for cardiovascular diseases in patients with vitiligo: an analysis of current evidence. Ann Med 2024;56:2326297.
  • Christian Krüger, Karin Uta Schallreuter. A review of the worldwide prevalence of vitiligo in children/adolescents and adults. Int J Dermatol 2012;51:1206-1212.
  • Mascarenhas MRM, Oliveira MC, Oliveira LF, Magalhães AS, Machado PRL. Clinical profile of vitiligo patients and relationship with immuno-inflammatory markers. An Bras Dermatol 2024;99:196-201.
  • Diotallevi F, Gioacchini H, De Simoni E, et al. Vitiligo, from pathogenesis to therapeutic advances: state of the art. Int J Mol Sci 2023;24:4910.
  • Bergqvist C, Ezzedine K. Vitiligo: a review. Dermatology 2020;236:571-592.
  • Frisoli ML, Essien K, Harris JE. Vitiligo: mechanisms of pathogenesis and treatment. Annu Rev Immunol 2020;38:621-648.
  • Bergqvist C, Ezzedine K. Vitiligo: a focus on pathogenesis and its therapeutic implications. J Dermatol 2021;48:252-270.
  • Bathina N, Ganni S, Kolalapudi SA, Konala S, Dharavath K, Reddy MTK. Prevalence of Metabolic Syndrome in Vitiligo Patients and its Relation to Vitiligo Severity-A Cross-Sectional Study. Indian Dermatol Online J 2024;15:612-615.
  • Azzazi Y, Mostafa WZ, Sayed KS, et al. Support for increased cardiovascular risk in non-segmental vitiligo among Egyptians: A hospital-based, case-control study. Pigment Cell Melanoma Res 2021;34:598-604.
  • Ataş H, Gönül M. Increased risk of metabolic syndrome in patients with vitiligo. Balkan Medical Journal 2017;34:219-225.
  • Bastonini E, Bellei B, Filoni A, Kovacs D, Iacovelli P, Picardo M. Involvement of Non-Melanocytic Skin Cells in Vitiligo. Exp Dermatol 2019;28:667-673.
  • Picardo M, Dell’Anna ML, Ezzedine K, et al. Vitiligo. Nat Rev Dis Primers 2015:1:15011.
  • D’Arino A, Picardo M, Truglio M, Pacifico A, Iacovelli P. Metabolic Comorbidities in Vitiligo: A Brief Review and Report of New Data from a Single-Center Experience. Int J Mol Sci 2021;22:8820.
  • Bao P, Liu G, Wei Y. Association between IL-6 and Related Risk Factors of Metabolic Syndrome and Cardiovascular Disease in Young Rats. Int J Clin Exp Med 2015;8:13491-13499.
  • Gossl M, Lerman LO, Lerman A. Frontiers in nephrology: early atherosclerosis – a view beyond the lümen. J Am Soc Nephrol 2007;18:2836-2842.
  • Weber C, Noels H. Atherosclerosis: current pathogenesis and therapeutic options. Nat Med 2011;17:1410-1422.
  • Hegele RA. The pathogenesis of atherosclerosis. Clin Chim Acta 1996;246:21-38.
  • Katakami N, Matsuoka T, Shimomura I. Clinical utility of carotid ultrasonography: Application for the management of patients with diabetes. Journal of Diabetes Investigation 2019;10:883-889.
  • Kablak-Ziembicka A, Przewlocki T, Tracz W, Pieniazek P, Musialek P, Sokolowski A. Gender differences in carotid intima-media thickness in patients with suspected coronary artery disease. Am J Cardiol 2005;96:1217-1222.
  • Bauer M, Caviezel S, Teynor A, Erbel R, Mahabadi AA, Schmidt-Trucksäss A. Carotid intima-media thickness as a biomarker of subclinical atherosclerosis. Swiss Med Wkly 2012;142:w13705.
  • Namazi N, Amani M, Haghighatkhah HR, Noori E, Abdollahimajd F. Increased risk of subclinical atherosclerosis and metabolic syndrome in patients with vitiligo: a real association or a coincidence? Dermatol Ther 2021;34:e14803.
  • Frączek A, Owczarczyk-Saczonek A, Ludwig RJ, et al. Vitiligo is associated with an increased risk of cardiovascular diseases: a large-scale, propensity-matched, US-based retrospective study. EBioMedicine 2024:109:105423.
  • Mangge H, Becker K, Fuchs D, Gostner JM. Antioxidants, inflammation and cardiovascular disease. World J Cardiol 2014;6:462-477.
  • Karadag AS, Tutal E, Ertugrul DT, Akin KO, Bilgili SG. Serum holotranscobalamine, vitamin B12, folic acid and homocysteine levels in patients with vitiligo. Clin Exp Dermatol 2012;37:62-64.
  • Solak B, Dikicier BS, Cosansu NC, Erdem T. Neutrophil to lymphocyte ratio in patients with vitiligo. Postepy Dermatol Alergol 2017;34:468-470.
  • Seremet S, Gurel MS. Miscellaneous skin disease and the metabolic syndrome. Clin Dermatol 2018;36:94-100.
  • Sharma YK, Bansal P, Menon S, Prakash N. Metabolic syndrome in vitiligo patients among a semi-urban Maharashtrian population: a case-control study. Diabetes Metab Syndr 2017;11:77-80.
  • Tune JD, Goodwill AG, Sassoon DJ, Mather KJ. Cardiovascular consequences of metabolic syndrome. Transl Res 2017;183:57-70.
Toplam 28 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Dermatoloji, Radyoloji ve Organ Görüntüleme
Bölüm Araştırma Makaleleri
Yazarlar

Zeynep Banu Aydın 0000-0002-8021-3801

Aynure Öztekin 0000-0002-3669-6631

Yayımlanma Tarihi 23 Haziran 2025
Gönderilme Tarihi 23 Nisan 2025
Kabul Tarihi 29 Mayıs 2025
Yayımlandığı Sayı Yıl 2025 Cilt: 7 Sayı: 2

Kaynak Göster

AMA Aydın ZB, Öztekin A. Evaluation of the Risk of Subclinical Atherosclerosis in Vitiligo Patients by Measuring Carotid Artery Intima Media Thickness via Ultrasonography. Hitit Medical Journal. Haziran 2025;7(2):255-261. doi:10.52827/hititmedj.1682097