Metabolic Syndrome Frequency and Cardiovascular Risk Factors Assessment in Subtypes of Psoriatic Arthritis

Öz

Psoriatic arthritis (PsA) is a chronic inflammatory disease that can involve axial and peripheral joints. It is known that chronic inflammation in PsA plays a role in atherogenesis and peripheric insulin resistance. The aim of this study is to determine the relationship between carotid intima- media thickness (CIMT), which is an indicator of subclinical atherosclerosis, and metabolic syndrome components in patients with PsA according to joint involvement types. In our study, we included 74 PsA, 38 rheumatoid arthritis (RA) patients and 53 healthy people. Patients with PsA was divided into two types as peripheral and axial joint involvement. Age, gender, laboratory values, drugs were obtained from hospital files and waist circle, blood pressure, CIMT were measured in all subject. RA patients had significantly higher CIMT levels than PsA patients and both patient groups compared to the healty control group. (p<0.001). The frequency of metabolic syndrome was higher in patients with PsA than in patients with RA (p=0.036). No difference was found between PsA subtypes in terms of CIMT, presence of metabolic syndrome and Framingham risk score. There was a positive correlation of CIMT with age, sedimentation, CRP, fasting blood glucose, total cholesterol, LDL- cholesterol, triglyceride, uric acid levels, body mass index, systolic/diastolic blood pressure, smoking consumption and Framingham risk score. Multiple linear regression analysis revealed that age and Framingham risk score were the independent predictors of CIMT.In our study, cardiovascular risks and metabolic syndrome were showed often in PsA patients, but there was no difference in subtypes of PsA for atherosclerosis.

Anahtar Kelimeler

• Atherosclerosis
• carotid intima media thickness
• metabolic syndrome
• psoriatic arthritis

Psöriatik Artrit Alt Tiplerinde Metabolik Sendrom Sıklığı ve Kardiyovasküler Risk Faktörlerinin Değerlendirilmesi

Öz

Psöriatik Artrit (PsA), aksiyel ve periferik eklemleri tutabilen kronik inflamatuvar hastalıktır. PsA’daki kronik inflamasyonun ateroskleroz ve periferik insülin direncine yol açtığı öne sürülmektedir. Bu çalışmanın amacı, PsA eklem tutulum tiplerine göre subklinik aterosklerozun göstergesi olan karotis intima media kalınlığı (KİMK) ile metabolik sendrom komponentleri arasındaki ilişkiyi araştırmaktadır. 74 PsA, 38 Romatoid Artrit (RA) ve 53 sağlıklı kişi çalışmaya dahil edildi. PsA’lı hastalar RA benzeri periferik eklem tutulumu ve spondiloartrit benzeri eklem tutulumu olmak üzere iki tipe ayrıldı. Hasta dosyalarından yaş, cinsiyet, laboratuvar verileri, tedavide kullanılan ilaçlar kayıt edildi. Hastaların bel çevresi ve kan basıncı ölçümleri yapıldı. Ultrasonografi ile KİMK’na bakıldı. RA hastaları PsA hastalarına göre ve her iki hasta grubu sağlıklı kontrol grubuna göre önemli ölçüde yüksek KİMK seviyelerine sahipti. (p<0,001). Metabolik sendrom sıklığı PsA’lı hastalarda RA’lı hastalardan daha yüksek idi (p=0,036). PsA subgrupları arasında KİMK, metabolik sendrom varlığı ve Framingham risk skoru açısından farklılık saptanmadı. KİMK’nın yaş, sedimentasyon, C-reaktif protein, açlık kan şekeri, total kolesterol, LDL-kolesterol, trigliserid, ürik asit düzeyleri, vücut kitle indeksi, sistolik ve diyastolik kan basıncı, sigara tüketimi ve Fragminham risk skoru ile pozitif korelasyonu mevcuttu. Çoklu lineer regresyon analizinde yaş ve Fragminham risk skoru KİMK’nda belirleyici olarak saptandı. PsA’lı hastalarda kardiyovasküler risklerin ve metabolik sendromun daha sık görüldüğü, fakat PsA alt gruplarında ateroskleroz açısından bir fark olmadığı tespit edildi.

Anahtar Kelimeler

• Ateroskleroz
• karotis intima media kalınlığı
• metabolik sendrom
• psöriatik artrit

Kaynakça

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