Assessment of Serum ADMA Levels and Aortic Elastic Properties in Patients with Ankylosing Spondylitis

Öz

Introduction: Ankylosing spondylitis is a chronic infl ammatory disease which may be associated with cardiovascular complications. The aim of the study was to investigate aortic elastic properties and serum asymetric dimethylarginine (ADMA) levels in patients with ankylosing spondylitis without any cardiac involvement. Patients and Methods: Fifty-fi ve ankylosing spondylitis patients and 30 age/gender matched healthy subjects were enrolled into this study. Fasting glucose, serum lipids, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and ADMA were studied. Aortic strain, distensibility and stiffness index were calculated from aortic diameters measured by transthoracic echocardiography and simultaneous blood pressure measurements. Results: ESR and CRP were higher in patients group. Serum ADMA levels were also higher in ankylosing spondylitis than in controls (0.76 ± 0.19 vs. 0.55 ± 0.12, p< 0.001). In subgroup analysis, ADMA was signifi cantly lower in anti-TNF-alfa treatment group than conventional treatment group (0.68 ± 0.15 vs. 0.87 ± 0.18, p< 0.001). Mean aortic strain and distensibility were lower and stiffness index was higher in ankylosing spondylitis group than controls. No correlation between ADMA and aortic elastic properties was observed. In ankylosing spondylitis group, a negative signifi cant correlation was found between duration of ankylosing spondylitis and aortic strain and distensibility. Conclusion: Our study suggest that patients with ankylosing spondylitis without cardiac involvement, aortic elasticity was impaired and ADMA levels were increased, while there was no signifi cant correlation between aortic elastic properties and ADMA levels.

Anahtar Kelimeler

• Spondylitis, ankylosing; dimethylarginine; echocardiography; aorta; elastic modulus

Ankilozan Spondilit Hastalarında Serum ADMA Düzeyleri ve Aortun Elastik Özelliklerinin Değerlendirilmesi

Öz

Giriş: Ankilozan spondilit kronik infl amatuvar bir hastalık olup, kardiyovasküler komplikasyonlarla ilişkili olabilmektedir. Bu çalışmada amacımız, kardiyak tutulum olmayan ankilozan spondilit hastalarında aortun elastik özellikleri ile serum asimetrik dimetilarjinin (ADMA) düzeylerinin araştırılmasıdır. Hastalar ve Yöntem: Elli beş ankilozan spondilit hastasıyla benzer yaş ve cinsiyette 30 sağlıklı birey çalışmaya alındı. Açlık glukoz, serum lipidleri, C-reaktif protein (CRP), eritrosit sedimentasyon hızı (ESH) ve ADMA düzeyleri çalışıldı. Aortik strain, distensibilite ve sertlik indeksi transtorasik ekokardiyografi de aort çapı ölçümleri ve eş zamanlı kan basıncı ölçümleriyle hesaplandı. Bulgular: Ankilozan spondilit grubunda ESH ve CRP düzeyleri yüksekti. Serum ADMA düzeyleri ankilozan spondilit grubunda kontrol grubuna göre anlamlı olarak yüksekti (0.76 ± 0.19 ve 0.55 ± 0.12, p< 0.001). Alt grup analizinde, anti-TNF-alfa tedavisi alan grupta konvansiyonel tedavi grubuna göre daha düşük ADMA düzeyi ölçüldü (0.68 ± 0.15 ve 0.87 ± 0.18, p< 0.001). Ortalama aortik strain ve distensibilite değerleri ankilozan spondilit grubunda daha düşük iken, sertlik indeksi daha yüksek saptandı. Korelasyon analizinde ADMA düzeyleri ile aortun elastik özellikleri arasında ilişki izlenmezken, ankilozan spondilit grubunda hastalık süresi ile aortik strain ve distensibilite arasında ters yönde anlamlı korelasyon izlendi. Sonuç: Çalışmamızda elde ettiğimiz sonuçlar kardiyak tutulumun olmadığı ankilozan spondilit hastalarında aortik elastisitenin bozulduğunu ve ADMA düzeylerinin arttığını göstermektedir. Ayrıca, aortun elastik özellikleri ile ADMA düzeyleri arasında anlamlı ilişki saptanamamıştır.

Anahtar Kelimeler

• Spondilit, ankilozan; dimetilarjinin; ekokardiyografi; aort; elastik modülü.

Kaynakça

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