Determinants of atherosclerosis in an Egyptian cohort of systemic sclerosis: Relation to disease activity and severity

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• 作者：Amina Bader El-Din^a ; Samah A. El-Bakry^a ; ^{samahmn72@yahoo.com" class="auth_mail" title="E-mail the corresponding author} ; Amr Abdel Zaher^a ; Khaled F. Alhassanein^a ; Al-Hussein M. El-Dakrony^b ; Safaa Sayed^b ; Rehab Abdel Rahman^c ; Ahmed Yousry^d
• 关键词：Systemic sclerosis ; Modified Rodnan skin score (mRss) ; Medsger severity score ; Intima-media thickness (IMT) ; Flow mediated vasodilatation (FMD) ; Atherosclerosis
• 刊名：The Egyptian Rheumatologist
• 出版年：2016
• 出版时间：July 2016
• 年：2016
• 卷：38
• 期：3
• 页码：195-201
• 全文大小：735 K

文摘

Systemic sclerosis (SSc) is a rare multi-system autoimmune disease characterized by vascular abnormalities with an increased prevalence of macrovascular disease.

Aim of the work

To evaluate macro-vascular disease (atherosclerosis) in SSc patients and determine its relation to the disease activity and severity.

Patients and methods

Twenty-five SSc patients and 20 matched controls were included. The modified Rodnan skin score (mRss) and disease severity by Medsger’s severity score were assessed. Carotid intima-media thickness (IMT) and flow mediated vasodilatation (FMD) of the brachial artery were measured. Traditional vascular risk factors were assessed by thorough history taking and laboratory investigations.

Results

The age of the patients ranged from 15 to 60 years and they were 22 females and 3 males. 15 had limited and 10 diffuse cutaneous SSc. All SSc patients had an increased IMT (1.24 ± 0.29 mm) which was normal in the control subjects (0.77 ± 0.09 mm) (p < 0.0001). SSc patients had significantly lower HDL, thickened IMT and lower FMD than controls (p = 0.005, p < 0.0001 and p < 0.0001 respectively). The younger age of disease onset was significantly associated with more FMD impairment (r = −0.4, p = 0.04) and Medsger’s severity score (r = 0.5, p = 0.009). The mRss and Medsger’s severity score significantly correlated with the IMT (r = 0.84, p = 0.01 and r = 0.56, p = 0.003 respectively). A significant negative correlation was found between FMD and IMT (r = −0.77, p < 0.0001). Medsger’s severity score significantly correlated with FMD (r = −0.44, p = 0.02).

Conclusion

SSc is associated with an increased risk of atherosclerosis when compared to age and sex-matched controls. Determinants of this include; younger age of disease onset and more sever disease and low levels of HDL.