Romatoid Artritli Hastalarda Lipid Parametrelerinin Değerlendirilmesi

Year 2009, Volume: 1 Issue: 1, 2 - 6, 01.04.2009

Yazıcı S

Abstract

Amaç: Bu çalýºmada romatoid artritli hastalarda serum lipid parametrelerinin düzeyi ve bunlarýn hastalýk aktivitesi ile iliºkisi araºtýrýldý. Materyal ve Metot: Çalýºmamýza 46 RA hastasý ve 31 saðlýklý birey dahil edildi. Hastalýk süresi 0 ile 12 yýl arasýnda (ortalama 4.2± 4.3 yýl) idi. Her iki grupta da plazma trigliserid (TG), total kolesterol (TK), LDL kolesterol (LDL-K), HDL kolesterol (HDL-K) ölçümleri yapýldý. Ayrýca RA grubundaki hastalarda serum yüksek duyarlýklý CRP, CRP, eritrosit sedimentasyon hýzý (ESH) ve romatoid faktör ölçümleri yapýldý. Bulgular: RA grubu ile kontrol grubu karºýlaºtýrýldýðýnda, serum TG seviyeleri sýrasýyla 134±76 mg/dl ve 179±113mg/dl (p=0.310), serum TK seviyeleri 176±36 mg/dl ve 195±49 mg/dl (p=0.320), serum LDLK seviyeleri 103±33mg/dl ve 116±41mg/dl (p=0.420), serum HDL-K seviyeleri 50±15mg/dl ve 47±12mg/dl (p=0.570) olarak bulundu. Yapýlan korelasyon analizinde herhangi bir lipit parametresi ile CRP ve ESH arasýnda anlamlý bir iliºki saptanmadý. Sonuç: RA hastalarý ile saðlýklý bireyler karºýlaºtýrýldýðýnda lipit parametreleri benzer bulundu. Ayrýca hastalýðýn aktivitesi ile lipid parametreleri arasýnda da anlamlý bir iliºki bulunamadý

Keywords

Anahtar Ateroskleroz Kelimeler: Romatoid Artrit, Lipit Parametreleri

References

• Bacon PA, Moots RJ. Extra-articular rheumatoid arthritis. In: Kopman WJ (Ed). Arthritis and Allied Conditions. 13 th Ed, Pennsylvania: Williams and Wilkins, 1997; 71, 1088.
• Dedhia HV, DiBartolomeo A. Rheumatoid arthritis. Review.Crit Care Clin 2002;18:841-854.
• Sattar N, McCarey WD, Capell H et al. Explaining how "high-grade" systemic inflammation accelerates vascular risk in rheumatoid arthritis. Circulation 2003;108: 2957- 2963.
• Mutru O, Laakso M, Isomaki H, Koota K. Cardiovascular mortality in patients with rheumatoid arthritis. Cardiology 1989;76: 71ñ77.
• Del Rincon I, Oíleary DH, Freeman GL, Escalante A. Acceleration of atherosclerosis during the course of rheumatoid arthritis. Atherosclerosis 2007;195:354-360.
• Gonzalez-Gay MA, Gonzalez-Juanatey C, Martin J. Rheumatoid arthritis: a disease associated with accelerated atherogenesis. Semin Arthritis Rheum 2005;35:8-17.
• del Rincon ID, Williams K, Stern MP, Freeman GL, Escalante A. High incidence of cardiovascular events in a rheumatoid arthritis cohort not explained by traditional cardiac risk factors. Arthritis Rheum 2001;44:2737-2745.
• Dessein PH, Joffe BI, Veller MG et al. Traditional and nontraditional cardiovascular risk factors are associated with atherosclerosis in rheumatoid arthritis. J Rheumatol 2005;32:435-442.
• Nurmohamed MT. Atherogenic lipid profiles and its management in patients with rheumatoid arthritis. Vasc Health Risk Manag 2007;3:845-852.
• Dursunoðlu D, Evreng¸l E, Polat B ve ark. Romatoid artritli hastalarda lipoprotein (a) ve lipidler: serum d¸zeyleri ve inflamasyonla iliºkisi. MN-Kardiyoloji Dergisi 2003;10:277-282.
• G¸r A, Nas K, «olpan L, «evik R, Erdoðan F, SaraÁ A. Romatoid Artritli Hastalarda Kardiyak Mortaliteden Sorumlu Faktˆr Serum Lipid Profilindeki Deðiºimler midir? T¸rkiye Fiziksel T˝p ve Rehabilitasyon Dergisi 1999;2:18-26.
• Rexhepaj N, Bajraktari G, Berisha I et al. Left and right ventricular diastolic functions in patients with rheumatoid arthritis without clinically evident cardiovascular disease. Int J Clin Pract 2006;60:683-688.
• Wislowska M, Jaszczyk B, KochmaÒski M, Sypu˘a S, Sztechman M. Diastolic heart function in RA patients. Rheumatol Int 2008;28: 513-519.
• McMahon M, Grossman J, FitzGerald J et al. Proinflammatory high-density lipoprotein as a biomarker for atherosclerosis in patients with systemic lupus erythematosus and rheumatoid arthritis. Arthritis Rheum 2006;54:2541-2549.
• Park YB, Lee SK, Lee WK et al. Lipid profiles in untreated patients with rheumatoid arthritis. J Rheumatol 1999;26:1701-1704.
• White D, Fayez S, Doube A. Atherogenic lipid profiles in rheumatoid arthritis. NZ Med J 2006;119:U21-25
• Manzi S, Wasko MC. Inflammation-mediated rheumatic diseases and atherosclerosis. Ann Rheum Dis 2000;59:321-325.
• van Halm VP, Nielen MM, Nurmohamed MT et al. Lipids and inflammation: serial measurements of the lipid profile of blood donors who later developed rheumatoid arthritis. Ann Rheum Dis 2007;66:184-188.
• Gonzalez-Gay MA, Gonzalez-Juanatey C, Pineiro A, Garcia-Porrua C, Testa A, Llorca J. High-grade C-reactive protein elevation correlates with accelerated atherogenesis in patients with rheumatoid arthritis. J Rheumatol 2005;32:1219-1223.
• Arnett FC, Edworthy SM, Bloch DA et al. The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 1988;31:315-324.
• Boers M, Nurmohammed MT, Doelman CJ et al. Influence of glucocorticoids and disease activity on total and high density lipoprotein cholesterol in patients with rheumatoid arthritis. Ann Rheum Dis 2003;62: 842ñ845.
• Shoenfeld Y, Gerli R, Doria A et al. Accelerated atherosclerosis in autoimmune rheumatic diseases. Circulation 2005;112: 3337ñ3347.
• Snow MH, Mikuls TR. Rheumatoid arthritis and cardiovascular disease: the role of systemic inflammation and evolving strategies of prevention. Curr Opin Rheumatol 2005;17: 234ñ241.
• Popa C, van den Hoogen FH, Radstake TR et al. Modulation of lipoprotein plasma concentrations during long-term anti-TNF therapy in patients with active rheumatoid arthritis. Ann Rheum Dis 2007;66:1503ñ1507.
• James RW. A long and winding road: defining the biological role and clinical importance of paraoxonases. Clin Chem Lab Med 2006;44:1052-1059.
• Park YB, Ahn CW, Choi HK et al. Atherosclerosis in rheumatoid arthritis: morphologic evidence obtained by carotid ultrasound. Arthritis Rheum 2002;46:1714-1719.
• Sherer Y. Shoenfeld Y. Mechanisms of disease: atherosclerosis in autoimmune diseases. Nat Clin Pract Rheumatol 2006;2:99-106.
• Van Doornum S, Mc Coll G, Wicks IP. Accelerated atherosclerosis: an extraarticular feature of rheumatoid arthritis? Arthritis Rheum 2002;46:862ñ873.