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Oh H, Park J, Kim J, Jang S, Ryu Y, Jeong Y, Kwon S, Suh S, Lee H, Choi D, Lee H, Cho G, Seo W. Temporal Changes in Metabolic Syndrome Indices and Factors of Metabolic Syndrome Development in Patients With Rheumatic Disease: A Prospective Cohort Study. Orthop Nurs 2023; 42:251-261. [PMID: 37494906 DOI: 10.1097/nor.0000000000000958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/28/2023] Open
Abstract
Patients with rheumatic disease have a high prevalence of metabolic syndrome. The purpose of this study was to investigate temporal changes in metabolic syndrome indices and to identify factors influencing metabolic syndrome development. A prospective cohort study design was adopted. The study participants were 68 outpatients with a rheumatic disease at an outpatient clinic of a university hospital. Data on demographics, health-related characteristics, steroid use, serum C-reactive protein levels, and metabolic syndrome indices were collected between December 2017 and March 2021. Temporal changes in body mass indices, serum triglyceride, and cholesterol levels were significant. Body mass indices, diastolic blood pressure, serum triglyceride, high-density lipoprotein, and fasting blood glucose levels at time of diagnosis were found to influence metabolic syndrome development. Temporal changes in serum triglyceride, cholesterol, and fasting blood glucose levels were significantly influenced by inflammatory status. The findings demonstrate the importance of controlling inflammatory activities in the context of inhibiting the progression of metabolic syndrome and rheumatic diseases.
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Affiliation(s)
- HyunSoo Oh
- HyunSoo Oh, PhD, RN, Professor, Department of Nursing, Inha University, Incheon, Republic of Korea
- JiSuk Park, PhD, RN, Nurse, Inha University Hospital, Incheon, Republic of Korea
- JiYoung Kim, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- SungKyung Jang, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- Yeona Ryu, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- YeoJu Jeong, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- SuYeon Kwon, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- SoHyun Suh, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- HaYoung Lee, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- DaHee Choi, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- HanNa Lee, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- GaWon Cho, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- WhaSook Seo, PhD, RN, Professor, Department of Nursing, Inha University, Incheon, Republic of Korea
| | - JiSuk Park
- HyunSoo Oh, PhD, RN, Professor, Department of Nursing, Inha University, Incheon, Republic of Korea
- JiSuk Park, PhD, RN, Nurse, Inha University Hospital, Incheon, Republic of Korea
- JiYoung Kim, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- SungKyung Jang, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- Yeona Ryu, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- YeoJu Jeong, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- SuYeon Kwon, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- SoHyun Suh, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- HaYoung Lee, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- DaHee Choi, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- HanNa Lee, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- GaWon Cho, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- WhaSook Seo, PhD, RN, Professor, Department of Nursing, Inha University, Incheon, Republic of Korea
| | - JiYoung Kim
- HyunSoo Oh, PhD, RN, Professor, Department of Nursing, Inha University, Incheon, Republic of Korea
- JiSuk Park, PhD, RN, Nurse, Inha University Hospital, Incheon, Republic of Korea
- JiYoung Kim, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- SungKyung Jang, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- Yeona Ryu, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- YeoJu Jeong, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- SuYeon Kwon, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- SoHyun Suh, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- HaYoung Lee, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- DaHee Choi, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- HanNa Lee, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- GaWon Cho, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- WhaSook Seo, PhD, RN, Professor, Department of Nursing, Inha University, Incheon, Republic of Korea
| | - SungKyung Jang
- HyunSoo Oh, PhD, RN, Professor, Department of Nursing, Inha University, Incheon, Republic of Korea
- JiSuk Park, PhD, RN, Nurse, Inha University Hospital, Incheon, Republic of Korea
- JiYoung Kim, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- SungKyung Jang, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- Yeona Ryu, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- YeoJu Jeong, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- SuYeon Kwon, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- SoHyun Suh, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- HaYoung Lee, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- DaHee Choi, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- HanNa Lee, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- GaWon Cho, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- WhaSook Seo, PhD, RN, Professor, Department of Nursing, Inha University, Incheon, Republic of Korea
| | - Yeona Ryu
- HyunSoo Oh, PhD, RN, Professor, Department of Nursing, Inha University, Incheon, Republic of Korea
- JiSuk Park, PhD, RN, Nurse, Inha University Hospital, Incheon, Republic of Korea
- JiYoung Kim, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- SungKyung Jang, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- Yeona Ryu, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- YeoJu Jeong, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- SuYeon Kwon, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- SoHyun Suh, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- HaYoung Lee, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- DaHee Choi, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- HanNa Lee, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- GaWon Cho, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- WhaSook Seo, PhD, RN, Professor, Department of Nursing, Inha University, Incheon, Republic of Korea
| | - YeoJu Jeong
- HyunSoo Oh, PhD, RN, Professor, Department of Nursing, Inha University, Incheon, Republic of Korea
- JiSuk Park, PhD, RN, Nurse, Inha University Hospital, Incheon, Republic of Korea
- JiYoung Kim, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- SungKyung Jang, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- Yeona Ryu, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- YeoJu Jeong, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- SuYeon Kwon, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- SoHyun Suh, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- HaYoung Lee, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- DaHee Choi, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- HanNa Lee, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- GaWon Cho, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- WhaSook Seo, PhD, RN, Professor, Department of Nursing, Inha University, Incheon, Republic of Korea
| | - SuYeon Kwon
- HyunSoo Oh, PhD, RN, Professor, Department of Nursing, Inha University, Incheon, Republic of Korea
- JiSuk Park, PhD, RN, Nurse, Inha University Hospital, Incheon, Republic of Korea
- JiYoung Kim, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- SungKyung Jang, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- Yeona Ryu, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- YeoJu Jeong, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- SuYeon Kwon, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- SoHyun Suh, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- HaYoung Lee, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- DaHee Choi, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- HanNa Lee, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- GaWon Cho, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- WhaSook Seo, PhD, RN, Professor, Department of Nursing, Inha University, Incheon, Republic of Korea
| | - SoHyun Suh
- HyunSoo Oh, PhD, RN, Professor, Department of Nursing, Inha University, Incheon, Republic of Korea
- JiSuk Park, PhD, RN, Nurse, Inha University Hospital, Incheon, Republic of Korea
- JiYoung Kim, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- SungKyung Jang, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- Yeona Ryu, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- YeoJu Jeong, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- SuYeon Kwon, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- SoHyun Suh, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- HaYoung Lee, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- DaHee Choi, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- HanNa Lee, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- GaWon Cho, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- WhaSook Seo, PhD, RN, Professor, Department of Nursing, Inha University, Incheon, Republic of Korea
| | - HaYoung Lee
- HyunSoo Oh, PhD, RN, Professor, Department of Nursing, Inha University, Incheon, Republic of Korea
- JiSuk Park, PhD, RN, Nurse, Inha University Hospital, Incheon, Republic of Korea
- JiYoung Kim, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- SungKyung Jang, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- Yeona Ryu, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- YeoJu Jeong, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- SuYeon Kwon, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- SoHyun Suh, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- HaYoung Lee, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- DaHee Choi, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- HanNa Lee, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- GaWon Cho, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- WhaSook Seo, PhD, RN, Professor, Department of Nursing, Inha University, Incheon, Republic of Korea
| | - DaHee Choi
- HyunSoo Oh, PhD, RN, Professor, Department of Nursing, Inha University, Incheon, Republic of Korea
- JiSuk Park, PhD, RN, Nurse, Inha University Hospital, Incheon, Republic of Korea
- JiYoung Kim, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- SungKyung Jang, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- Yeona Ryu, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- YeoJu Jeong, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- SuYeon Kwon, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- SoHyun Suh, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- HaYoung Lee, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- DaHee Choi, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- HanNa Lee, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- GaWon Cho, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- WhaSook Seo, PhD, RN, Professor, Department of Nursing, Inha University, Incheon, Republic of Korea
| | - HanNa Lee
- HyunSoo Oh, PhD, RN, Professor, Department of Nursing, Inha University, Incheon, Republic of Korea
- JiSuk Park, PhD, RN, Nurse, Inha University Hospital, Incheon, Republic of Korea
- JiYoung Kim, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- SungKyung Jang, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- Yeona Ryu, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- YeoJu Jeong, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- SuYeon Kwon, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- SoHyun Suh, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- HaYoung Lee, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- DaHee Choi, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- HanNa Lee, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- GaWon Cho, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- WhaSook Seo, PhD, RN, Professor, Department of Nursing, Inha University, Incheon, Republic of Korea
| | - GaWon Cho
- HyunSoo Oh, PhD, RN, Professor, Department of Nursing, Inha University, Incheon, Republic of Korea
- JiSuk Park, PhD, RN, Nurse, Inha University Hospital, Incheon, Republic of Korea
- JiYoung Kim, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- SungKyung Jang, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- Yeona Ryu, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- YeoJu Jeong, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- SuYeon Kwon, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- SoHyun Suh, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- HaYoung Lee, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- DaHee Choi, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- HanNa Lee, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- GaWon Cho, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- WhaSook Seo, PhD, RN, Professor, Department of Nursing, Inha University, Incheon, Republic of Korea
| | - WhaSook Seo
- HyunSoo Oh, PhD, RN, Professor, Department of Nursing, Inha University, Incheon, Republic of Korea
- JiSuk Park, PhD, RN, Nurse, Inha University Hospital, Incheon, Republic of Korea
- JiYoung Kim, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- SungKyung Jang, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- Yeona Ryu, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- YeoJu Jeong, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- SuYeon Kwon, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- SoHyun Suh, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- HaYoung Lee, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- DaHee Choi, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- HanNa Lee, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- GaWon Cho, BSN, RN, Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- WhaSook Seo, PhD, RN, Professor, Department of Nursing, Inha University, Incheon, Republic of Korea
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Madenidou AV, Mavrogeni S, Nikiphorou E. Cardiovascular Disease and Cardiac Imaging in Inflammatory Arthritis. Life (Basel) 2023; 13:life13040909. [PMID: 37109438 PMCID: PMC10143346 DOI: 10.3390/life13040909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 03/23/2023] [Accepted: 03/27/2023] [Indexed: 04/01/2023] Open
Abstract
Cardiovascular morbidity and mortality are more prevalent in inflammatory arthritis (IA) compared to the general population. Recognizing the importance of addressing this issue, the European League Against Rheumatism (EULAR) published guidelines on cardiovascular disease (CVD) risk management in IA in 2016, with plans to update going forward based on the latest emerging evidence. Herein we review the latest evidence on cardiovascular disease in IA, taking a focus on rheumatoid arthritis, psoriatic arthritis, and axial spondylarthritis, reflecting on the scale of the problem and imaging modalities to identify disease. Evidence demonstrates that both traditional CVD factors and inflammation contribute to the higher CVD burden. Whereas CVD has decreased with the newer anti-rheumatic treatments currently available, CVD continues to remain an important comorbidity in IA patients calling for prompt screening and management of CVD and related risk factors. Non-invasive cardiovascular imaging has been attracting much attention in view of the possibility of detecting cardiovascular lesions in IA accurately and promptly, even at the pre-clinical stage. We reflect on imaging modalities to screen for CVD in IA and on the important role of rheumatologists and cardiologists working closely together.
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Mei J, Wei P, Zhang L, Ding H, Zhang W, Tang Y, Fang X. Impact of ankylosing spondylitis on stroke limited to specific subtypes: Evidence from Mendelian randomization study. Front Immunol 2023; 13:1095622. [PMID: 36741373 PMCID: PMC9893629 DOI: 10.3389/fimmu.2022.1095622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 12/27/2022] [Indexed: 01/20/2023] Open
Abstract
Background The relationship between Ankylosing Spondylitis (AS) and the risk of stroke is complex. Therefore, we utilized Two-Sample Mendelian randomization to examine the probable causal link between these two features. Methods The genetic instruments linked to AS were chosen from a summary-level genetic data set from the FinnGen consortium in people of European ancestry (1462 cases and 164,682 controls). Stroke and its subtypes were selected as outcomes, and the MEGASTROKE consortium population was used to identify the genetic associations of AS on stroke (40,585 cases and 406,111 controls), ischemic stroke (IS) (34,217 cases and 406,111 controls), and its subtypes including large artery stroke (LAS) (4373 cases and 146,392 controls), small vessel stroke (SVS) (5386 cases and 192,662 controls), and cardioembolic stroke (CES) (7193 cases and 204,570 controls). Intracerebral hemorrhage (ICH) (1687 cases and 201,146 controls) data set from the FinnGen consortium was also used. To obtain the casual estimates, the inverse variant weighted (IVW) method was mainly used. By examining the heterogeneity and pleiotropy of particular single nucleotide polymorphisms (SNPs), the robustness of the results was also examined. Results There was no evidence found to prove the correlation between genetically predicted AS and stroke (odds ratio [OR] 1.014; 95% confidence interval [CI] 0.999-1.031; P = 0.063), ICH (OR 1.030; 95% CI 0.995-1.067; P = 0.090), and IS (OR 1.013; 95% CI 0. 998-1.030; P = 0.090). In terms of the different subtypes of IS, there was strong evidence of positive causal inferences on CES (OR 1.051; 95% CI 1.022-1.081; P = 0.001), and suggestive evidence of positive causal inferences on LAS (OR 1.042; 95% CI 1.003-1.082; P = 0.033), while it was not significant for SVS (OR 1.010; 95% CI 0.975-1.047; P = 0.563). Conclusion This study suggests that the possible causative impact of genetically predicted AS on stroke may be restricted to the CES and LAS subtypes.
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Affiliation(s)
- Jian Mei
- Department of Orthopaedic Surgery, the First Affiliated Hospital, Fujian Medical University, Fuzhou, China,Department of Orthopaedic Surgery, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China,Department of Orthopedic Surgery, Experimental Orthopedics, Centre for Medical Biotechnology (ZMB), University of Regensburg, Regensburg, Germany
| | - Penghui Wei
- Department of Neurosurgery, Neurosurgery Research Institute, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Linjie Zhang
- Institute for Stroke and Dementia Research, University Hospital, Ludwig Maximilian University, Munich, Germany
| | - Haiqi Ding
- Department of Orthopaedic Surgery, the First Affiliated Hospital, Fujian Medical University, Fuzhou, China,Department of Orthopaedic Surgery, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Wenming Zhang
- Department of Orthopaedic Surgery, the First Affiliated Hospital, Fujian Medical University, Fuzhou, China,Department of Orthopaedic Surgery, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Yusen Tang
- Department of Orthopaedics, The 909th Hospital, School of Medicine, Xiamen University, Zhangzhou, Fujian, China,*Correspondence: Yusen Tang, ; Xinyu Fang,
| | - Xinyu Fang
- Department of Orthopaedic Surgery, the First Affiliated Hospital, Fujian Medical University, Fuzhou, China,Department of Orthopaedic Surgery, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China,*Correspondence: Yusen Tang, ; Xinyu Fang,
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4
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Ben Tekaya A, Boukriba S, Fendri A, Rouached L, Saidane O, Bouden S, Tekaya R, Ben Salem K, Mahmoud I, Habiba M, Abdelmoula L. Endothelial dysfunction and increased carotid intima-media thickness in patients with spondyloarthritis without traditional cardiovascular risk factors. RMD Open 2022; 8:rmdopen-2022-002270. [PMID: 35793876 PMCID: PMC9260841 DOI: 10.1136/rmdopen-2022-002270] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 06/07/2022] [Indexed: 12/13/2022] Open
Abstract
Background The aim of our study was to assess subclinical atherosclerosis in spondyloarthritis (SpA) by combining three ultrasound methods (flow-mediated dilation (FMD), carotid intima–media thickness (cIMT) and Ankle Brachial Index (ABI)) and to determine the predictive factors of theses parameters. Methods This was a case control study conducted over 12 months including 47 patients with SpA-free-cardiovascular (CV) disease in comparison with age and sex matched 47 healthy controls. Sociodemographic, clinical and biological features as well as therapeutic modalities were recorded in our patients. All subjects had Doppler ultrasound with measurement of cIMT, FMD and ABI. Ultrasound measurements were compared between patients and controls. Linear regression was performed and assessed by machine learning to determine the predictive models of markers of subclinical atherosclerosis. Results We found higher cIMT (p<0.0001), lower FMD (p=0.008) and higher left ABI (0.048) in patients with SpA compared with controls. cIMT was positively correlated to patient-related parameters (age, systolic blood pressure) and disease parameters (age at onset of SpA, disease duration and renal involvement). Biologically, cIMT was positively correlated with creatinine, blood-glocose, total cholesterol (CT) and CT/cholesterol-high density lipoprotein ratio. FMD was negatively correlated with male gender, age, systolic blood pressure, creatinine, blood glucose and Left Lequesne Index. ABI was significantly associated with diastolic blood pressure. Multiple regression analysis identified age, CT and creatinine as independents predictive factors for increased cIMT. Regarding endothelial dysfunction, blood glucose and Left Lequesne Index were the independents predictive factors of decreased FMD. Conclusion Our study supported the accelerated subclinical atherosclerosis in patients with SpA. This subclinical atherosclerosis was mainly mediated by traditional CV risk factors.
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Affiliation(s)
- Aicha Ben Tekaya
- Rheumatology Department Charles Nicolle Hospital, Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Seif Boukriba
- Radiology Department, La Rabta Hospital, Faculty of medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Ahmed Fendri
- Radiology Department, La Rabta Hospital, Faculty of medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Leila Rouached
- Rheumatology Department Charles Nicolle Hospital, Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Olfa Saidane
- Rheumatology Department Charles Nicolle Hospital, Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Selma Bouden
- Rheumatology Department Charles Nicolle Hospital, Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Rawdha Tekaya
- Rheumatology Department Charles Nicolle Hospital, Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
| | | | - Ines Mahmoud
- Rheumatology Department Charles Nicolle Hospital, Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Mizouni Habiba
- Radiology Department, La Rabta Hospital, Faculty of medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Leila Abdelmoula
- Rheumatology Department Charles Nicolle Hospital, Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
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Toussirot E. The Risk of Cardiovascular Diseases in Axial Spondyloarthritis. Current Insights. Front Med (Lausanne) 2021; 8:782150. [PMID: 34859023 PMCID: PMC8630576 DOI: 10.3389/fmed.2021.782150] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 10/19/2021] [Indexed: 12/23/2022] Open
Abstract
There is an increased cardiovascular (CV) risk in axial spondyloarthritis (axSpA), leading to increased CV mortality and morbidity in these patients. The factors that may explain this enhanced CV risk in axSpA are multiple, including traditional CV risk factors such as smoking, but also the inflammatory process and probably the use of non-steroidal anti-inflammatory drugs (NSAIDs). The CV involvement of axSpA may be detected at an early and pre-clinical stage, using non-invasive techniques. While NSAIDs play a deleterious role in the CV risk of axSpA, TNF inhibitors seem to have a beneficial impact, but this remains to be demonstrated in specific clinical studies. More data are needed to determine the potential effects of IL-17 inhibitors on the CV risk of axSpA. CV comorbidity has been mainly assessed in the radiographic form of axSpA, while limited data are available in patients with the non-radiographic form. The current management of axSpA must consider this CV comorbidity according to the EULAR recommendations. Rheumatologists play a determinant role in the detection of CV risk and current management of these patients is focused on the control of disease activity, suppression of inflammation, screening for and management of traditional CV risk factors, as well as the restriction of NSAID use.
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Affiliation(s)
- Eric Toussirot
- INSERM CIC-1431 Centre Investigation Clinique, CHU de Besançon, Besançon, France.,Rhumatologie, CHU de Besançon, Besançon, France.,Département de Thérapeutique, Université de Bourgogne Franche-Comté, Besançon, France.,INSERM UMR1098 Relations Hôte Greffon Tumeurs, ingénierie cellulaire et génique, Université de Bourgogne Franche-Comté, Besançon, France
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6
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Patterns of dyslipidemia in young patients with seronegative spondyloarthropathies without cardiovascular diseases. Reumatologia 2021; 59:285-291. [PMID: 34819702 PMCID: PMC8609379 DOI: 10.5114/reum.2021.110610] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 10/01/2021] [Indexed: 11/17/2022] Open
Abstract
Objectives Patients with seronegative spondyloarthritis (SpA) – psoriatic arthritis (PsA) and ankylosing spondylitis (AS) – have a higher risk of cardiovascular morbidity and mortality. The aim of the present study was to evaluate the incidence and type of dyslipidemia, a potent atherosclerosis risk factor, in SpA patients. Material and methods It was a two-center, case-control study. Patients diagnosed with PsA and AS aged 23–60 years, with disease duration < 10 years, were enrolled. The inflammatory activity, serum levels of C-reactive protein (CRP) and lipid profile were evaluated in each patient. In patients > 40 years old, the 10-year risk of fatal cardiovascular disease (CVD), using Systematic Coronary Risk Evaluation (SCORE), was estimated. Results In total 79 patients with SpA were included in the study, with PsA diagnosed, n = 39 (mean age 45.1 ±9.6 years; 21, 53.9%, women), and with AS diagnosed, n = 40 (age 40.3 ±9.5; 12.3%, women), control group (CG): n = 88 (age 42.3 ±8.1; 42, 47.7% women). Based on the interview and laboratory tests, dyslipidemia was diagnosed in 19 (47.5%) patients with AS and in 28 (71.8%) patients with PsA. Most patients had hypercholesterolemia or mixed hyperlipidemia. Types of dyslipidemia were similar. In SpA patients (PsA and AS), the level of triglycerides (TG) and atherogenic index (AI) were significantly higher than in the CG, respectively TG in SpA: 116 (83–156) and in the CG: 91.2 (72.6–134.6) mg/dl, p = 0.0182; AI in SpA: 3.77 ±1.26 and in the CG: 2.58 ±1.27, p < 0.0001. The low-density cholesterol (LDL) level was significantly lower in SpA patients than in the CG, SpA: 109.1 ±29.4 vs. CG: 125.2 ±35.9 mg/dl, p = 0.0023. There was a strong negative correlation between CRP levels and HDL cholesterol levels in patients with PsA, rho = 0.42, p = 0.0132. Mean SCORE values were 2.33% in PsA patients and 2.38% in AS patients, which results in moderate 10-year risk of death from CVD. Conclusions In young patients with spondyloarthropathies, inflammatory factors significantly influence dyslipidemia patterns, which result in higher TG and lower LDL cholesterol levels. In patients with PsA, dyslipidemia was diagnosed more often than in patients with AS.
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Onmaz DE, Isik K, Sivrikaya A, Abusoglu S, Gezer İA, Abusoglu G, Yerlikaya FH, Unlu A. Determination of serum methylarginine levels by tandem mass spectrometric method in patients with ankylosing spondylitis. Amino Acids 2021; 53:1329-1338. [PMID: 34273021 DOI: 10.1007/s00726-021-03046-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 07/05/2021] [Indexed: 10/20/2022]
Abstract
Our aim in this study was to measure serum levels of methylarginines and related metabolites in patients with ankylosing spondylitis (AS), moreover, to investigate the relationship between these parameters and various clinical and laboratory parameters of patients with AS. The study included 60 patients with AS and 60 healthy volunteers. Serum asymmetric dimethylarginine (ADMA), L-N monomethylarginine (L-NMMA), symmetric dimethylarginine (SDMA), arginine (Arg), homoarginine (hArg), ornithine, and citrulline concentrations were measured with tandem mass spectrometry. In addition, participants were divided into three groups according to the treatment regimen: TNF-α inhibitor group (n = 25), conventional therapy group (n = 35), and control group (n = 60). These groups were compared in terms of serum levels of methylarginine pathway metabolites and various biochemical parameters. It was found that total methylated arginine load significantly increased in patients with AS (p < 0.001), and the Arg/ADMA ratio was positively correlated with HDL levels and negatively correlated with glucose, ESR, total cholesterol, triglyceride, and LDL levels. In addition, serum ADMA, SDMA, total methylated arginine load, and CRP levels were lower (p < 0.05) in the TNF-α group compared to the conventional treatment group. To the best of our knowledge, this is the first study to comprehensively investigate serum methylarginine levels in patients with AS. Elevated total methylated arginine load and decreased global arginine bioavailability ratio (GABR) indicate that NO metabolism is impaired in patients with AS. Therefore, the increased cardiovascular risk in patients with AS may be related to the decreased NO production or bioavailability due to the elevated total methylarginine load.
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Affiliation(s)
- Duygu Eryavuz Onmaz
- Department of Biochemistry, Selcuk University Faculty of Medicine Alaaddin Keykubat Campus, 42075, Selcuklu, Konya, Turkey.
| | - Kevser Isik
- Department of Physical Medicine and Rehabilitation, Selcuk University Faculty of Medicine, Konya, Turkey
| | - Abdullah Sivrikaya
- Department of Biochemistry, Selcuk University Faculty of Medicine Alaaddin Keykubat Campus, 42075, Selcuklu, Konya, Turkey
| | - Sedat Abusoglu
- Department of Biochemistry, Selcuk University Faculty of Medicine Alaaddin Keykubat Campus, 42075, Selcuklu, Konya, Turkey
| | - İlknur Albayrak Gezer
- Department of Physical Medicine and Rehabilitation, Selcuk University Faculty of Medicine, Konya, Turkey
| | - Gulsum Abusoglu
- Department of Medical Laboratory Techniques, Selcuk University Vocational School of Health, Konya, Turkey
| | - Fatma Humeyra Yerlikaya
- Department of Biochemistry, Selcuk University Faculty of Medicine Alaaddin Keykubat Campus, 42075, Selcuklu, Konya, Turkey
| | - Ali Unlu
- Department of Biochemistry, Selcuk University Faculty of Medicine Alaaddin Keykubat Campus, 42075, Selcuklu, Konya, Turkey
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8
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AKALTUN MS, ALTINDAĞ Ö, TURAN N, AYDENİZ A, GÜRSOY S, GÜR A. Relationship between metabolic syndrome and vitamin D level in patients with ankylosing spondylitis. CUKUROVA MEDICAL JOURNAL 2021. [DOI: 10.17826/cumj.841343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Cioffi G, Viapiana O, Tarantini L, Orsolini G, Idolazzi L, Sonographer FO, Dalbeni A, Gatti D, Fassio A, Rossini M, Giollo A. Clinical profile and outcome of patients with chronic inflammatory arthritis and metabolic syndrome. Intern Emerg Med 2021; 16:863-874. [PMID: 33083946 PMCID: PMC8195765 DOI: 10.1007/s11739-020-02520-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Accepted: 09/25/2020] [Indexed: 01/28/2023]
Abstract
Systemic chronic inflammation may favor the onset of metabolic syndrome (MetS) which represents a risk factor for CV events. Rheumatoid arthritis (RA), ankylosing spondylitis (AS) and psoriatic arthritis (PsA) are disorders with high prevalence of MetS. We assessed the factors associated with MetS and its prognostic role in non-selected RA/AS/PsA patients. Between March 2014 and April 2016, 458 patients (228 RA, 134 PsA, 96 AS) selected for a primary prevention program for cardiovascular diseases were analyzed. Primary and co-primary end points were a composite of all-cause death/all-cause hospitalization and CV death/CV hospitalization, respectively. MetS was diagnosed according to the IDF Task Force on Epidemiology and Prevention. Patients were divided into MetS + (73 = 16%) and MetS - (385 = 84%). At multivariate logistic analysis, cancer, moderate/high disease activity, higher LV mass (LVM) and degree of LV diastolic dysfunction were independently associated with MetS. At 36-month follow-up, the event rate for primary/co-primary end point was 52/15% in MetS + vs 23/7% in MetS - (both p < 0.001). At multivariate Cox regression analysis, MetS was related to primary end point (HR 1.52 [CI 1.01-2.47], p = 0.04) together with higher LVM, disease duration and higher prevalence of biologic DMARDs refractoriness, and to co-primary end point (HR 2.05 [CI 1.16-3.60], p = 0.01) together with older age and higher LVM. The RA/AS/PsA phenotype MetS + is a subject with moderate/high disease activity, LV structural and functional abnormalities at increased risk for cancer. MetS + identifies RA/AS/PsA patients at higher risk for CV and non-CV events, independently of traditional CV risk factors analyzed individually and traditional indexes of inflammation.
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Affiliation(s)
- Giovanni Cioffi
- Rheumatology Section, Department of Medicine, University of Verona, Verona, Italy.
| | - Ombretta Viapiana
- Rheumatology Section, Department of Medicine, University of Verona, Verona, Italy
| | - Luigi Tarantini
- Department of Cardiology, Ospedale Civile S. Martino, Belluno, Italy
| | - Giovanni Orsolini
- Rheumatology Section, Department of Medicine, University of Verona, Verona, Italy
| | - Luca Idolazzi
- Rheumatology Section, Department of Medicine, University of Verona, Verona, Italy
| | | | - Andrea Dalbeni
- Department of Medicine, General Medicine and Hypertension Unit, University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - Davide Gatti
- Rheumatology Section, Department of Medicine, University of Verona, Verona, Italy
| | - Angelo Fassio
- Rheumatology Section, Department of Medicine, University of Verona, Verona, Italy
| | - Maurizio Rossini
- Rheumatology Section, Department of Medicine, University of Verona, Verona, Italy
| | - Alessandro Giollo
- Rheumatology Section, Department of Medicine, University of Verona, Verona, Italy
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10
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Petcharat C, Srinonprasert V, Chiowchanwisawakit P. Association between syndesmophyte and metabolic syndrome in patients with psoriatic arthritis or ankylosing spondylitis: a cross-sectional study. BMC Musculoskelet Disord 2021; 22:367. [PMID: 33879097 PMCID: PMC8056532 DOI: 10.1186/s12891-021-04222-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 03/31/2021] [Indexed: 12/20/2022] Open
Abstract
Objective To investigate the prevalence of and factors associated with metabolic syndrome (MetS) in patients with psoriatic arthritis (PsA) or ankylosing spondylitis (AS). Methods This cross-sectional study included PsA or AS patients who attended Siriraj Hospital (Bangkok, Thailand) during March 2014 to October 2017. The Harmonized MetS definition was used to diagnose MetS. Demographic, clinical, and spinal radiographic data were collected. Logistic regression was used to identify factors associated with MetS. Results Among 319 patients, 153 had AS and 166 had PsA. MetS was present in 43% of PsA and 19% of AS (p < 0.001). Multiple regression analysis identified body mass index (BMI) > 23 (odds ratio [OR]: 3.7), female gender (OR range: 3.8–3.9), and the number of syndesmophytes or ankylosis [SynAnk] (OR: 1.1) were associated with MetS among PsA patients. For AS patients, BMI > 23 (OR: 9.1) and age > 40 (OR: 4.3) were associated with MetS. Disease activity index was not associated with MetS. Conclusions MetS was significantly more prevalent in PsA than in AS. Structural change of the spine was associated with MetS in PsA. PsA patients with being female, BMI > 23 or evidence of spinal change should be informed to screen for MetS. AS patients with age > 40 or BMI > 23 should be informed to screen for MetS.
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Affiliation(s)
- Chonachan Petcharat
- Division of Rheumatology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, Bangkok, 10700, Thailand
| | - Varalak Srinonprasert
- Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Praveena Chiowchanwisawakit
- Division of Rheumatology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, Bangkok, 10700, Thailand.
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11
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Li HH, Li XQ, Sai LT, Cui Y, Xu JH, Zhou C, Zheng J, Li XF, Liu HX, Zhao YJ. Association of homocysteine with ankylosing spondylitis: a systematic review and meta-analysis. Adv Rheumatol 2021; 61:17. [PMID: 33691801 PMCID: PMC7944467 DOI: 10.1186/s42358-021-00175-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 03/02/2021] [Indexed: 11/16/2022] Open
Abstract
Background Hyperhomocysteinemia is associated with autoimmune diseases such as ankylosing spondylitis (AS), systemic lupus erythematosus (SLE), and rheumatoid arthritis (RA). Current findings regarding plasma/serum homocysteine (HCY) levels in AS patients are inconsistent. This study aims to systematically evaluate the association between circulating HCY levels and AS. Methods Online electronic databases (PubMed, Web of Science, Embase, ScienceDirect, China National Knowledge Infrastructure (CNKI), and Wanfang data) were used to retrieve all relevant articles published up to May 7, 2020. The pooled standardized mean difference (SMD) with 95% confidence interval (CI) was calculated using the random-effect model, Stata16 software. Results Nine articles containing 778 AS patients and 522 controls were included in this meta-analysis. No significant differences in HCY levels were found between AS and control groups (pooled SMD = 0.46, 95% CI = − 0.30 to 1.23, P = 0.23). However, subgroup analysis suggested that HCY levels were significantly higher (P < 0.05) in the AS group treated with methotrexate (MTX) compared with the control group. In contrast, HCY levels were significantly (P < 0.05) lower in the AS group receiving anti-TNF-α treatment compared with the control group. No significant differences were detected between HCY levels and disease activity scores (Bath AS disease activity index, BASDAI), and methylenetetrahydrofolate reductase (MTHFR) C677T genotype. Conclusion This meta-analysis indicates that HCY levels are similar between AS and controls, and do not correlate with disease activity. However, different medical treatments cause fluctuations of circulating HCY levels in AS patients. Further and larger-scale studies are needed to confirm these findings. Trial registration This study was registered at international prospective register of systematic reviews (PROSPERO), registration number: CRD42020184426.
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Affiliation(s)
- Hui-Hui Li
- Department of Obstetrics and Gynecology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China.,Department of Obstetrics and Gynecology, University of Wisconsin-Madison, Madison, WI, 53715, USA
| | - Xue-Quan Li
- Department of Gastroenterology, Shouguang People's Hospital, Shouguang, 262700, Shandong, China
| | - Lin-Tao Sai
- Department of Infectious Diseases, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China
| | - Yi Cui
- Department of Intensive Care Unit, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China
| | - Jia-Hui Xu
- Shandong First Medical University & Shandong Academic of Medical Sciences, Jinan, 250000, Shandong, China
| | - Chi Zhou
- School of Animal and Comparative Biomedical Sciences, University of Arizona, Tucson, AZ, USA
| | - Jing Zheng
- Department of Obstetrics and Gynecology, University of Wisconsin-Madison, Madison, WI, 53715, USA
| | - Xing-Fu Li
- Department of Rheumatology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China
| | - Hua-Xiang Liu
- Department of Rheumatology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China.
| | - Ying-Jie Zhao
- Department of Obstetrics and Gynecology, University of Wisconsin-Madison, Madison, WI, 53715, USA. .,Department of Rheumatology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China.
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12
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Sarp Ü, ÜstÜner E, Kutlay S, Ataman Ş, Kutlay S. Biomarkers of Cardiovascular Disease in Patients With Ankylosing Spondylitis. Arch Rheumatol 2021; 35:435-439. [PMID: 33458668 PMCID: PMC7788654 DOI: 10.46497/archrheumatol.2020.7868] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Accepted: 12/30/2019] [Indexed: 12/28/2022] Open
Abstract
Objectives
This study aims to evaluate the inflammatory status and clinical and vascular alterations using tonometry and B-mode sonography in patients with ankylosing spondylitis (AS). Patients and methods
The study included 71 AS patients (57 males, 14 females; mean age 40.1±10.8 years; range, 29 to 51 years) without cardiovascular disease and 30 healthy controls (24 males, 6 females; mean age 41.2±9.3 years; range, 32 to 50 years). We evaluated participants’ clinical, biological and functional status along with laboratory data and measured both the arterial stiffness using carotid-femoral pulse wave velocity (PWV) measured by applanation tonometry and carotid intima-media thickness (CIMT) as a preclinical atherosclerosis marker. Results
The mean disease duration of AS patients was 10.6±4.2 years. CIMT (p=0.03) and PWV (p=0.04) data showed significant differences between AS patients and healthy controls. Multiregression analysis showed that PWV correlated with age (r2=0.42; p=0.03) and disease duration (r2=0.31; p=0.04), while CIMT correlated with disease duration (r2=0.37; p=0.03) and Bath Ankylosing Spondylitis Disease Activity Index (r2=0.3; p=0.04). Conclusion This study demonstrated an increase in early preclinical atherosclerosis in AS patients without cardiovascular (CV) disease compared to healthy controls. Therefore, screening AS patients with noninvasive methods for atherosclerosis and subclinical vasculopathy would allow us to take primary prevention measures. We found that the major determinant for increased CV risk was the disease duration, while there was no difference between different treatment modalities.
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Affiliation(s)
- Ümit Sarp
- Department of Physical Medicine and Rehabilitation, Ankara University School of Medicine, Ankara, Turkey
| | - Evren ÜstÜner
- Department of Radiology, Ankara University School of Medicine, Ankara, Turkey
| | - Sehim Kutlay
- Department of Physical Medicine and Rehabilitation, Ankara University School of Medicine, Ankara, Turkey
| | - Şebnem Ataman
- Department of Physical Medicine and Rehabilitation, Ankara University School of Medicine, Ankara, Turkey
| | - Sim Kutlay
- Department of Nephrology, Ankara University School of Medicine, Ankara, Turkey
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Demir K, Avcı A, Ergulu Esmen S, Tuncez A, Yalcın MU, Yılmaz A, Yılmaz S, Altunkeser BB. Assessment of arterial stiffness and epicardial adipose tissue thickness in predicting the subclinical atherosclerosis in patients with ankylosing spondylitis. Clin Exp Hypertens 2020; 43:169-174. [PMID: 33028113 DOI: 10.1080/10641963.2020.1833025] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Atherosclerosis is a chronic, progressive, inflammatory disease. Recognition of subclinical atherosclerotic vascular changes before clinical manifestation in an asymptomatic population is important for risk stratification and optimal management, which finally leads to the prevention of cardiovascular disease. We aimed to determine the risk of premature subclinical atherosclerosis by evaluating epicardial adipose tissue thickness (EATT) and arterial stiffness parameters in patients with ankylosing spondylitis (AS). METHODS We performed a prospective study of 60 consecutive patients meeting modified New York criteria for AS compared to 60 controls matched for age and sex. Patients with traditional cardiovascular risk factors were excluded. Arterial stiffness parameters and EATT (examined via echocardiography) values of all patients and control groups were measured. RESULTS There was no difference between basal characteristic and echocardiographic parameters in patients with AS and in the control group. EATT and pulse wave velocity (PWV) were higher in the AS patients compared to the control group. EATT was 5.74 ± 1.22 mm and 4.91 ± 1.21 mm (p < .001) and PWV was 9.90 ± 0.98 m/s and 6.46 ± 0.83 m/s (p = .009) in the AS and control groups, respectively. Also, PWV was significantly correlated with EATT, age, and central blood pressure in patients with AS. CONCLUSIONS EATT and PWV, markers of atherosclerosis and cardiovascular disease, were significantly higher in patients with AS than the control group. In addition, in this study, it has been shown that there is a significant relationship between PWV and EATT in patients with AS.
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Affiliation(s)
- Kenan Demir
- Faculty of Medicine Cardiology Department, Selcuk University , Konya, Turkey
| | - Ahmet Avcı
- Faculty of Medicine Cardiology Department, Zonguldak Bülent Ecevit University , Zonguldak, Turkey
| | - Serpil Ergulu Esmen
- Department of Rheumatology, Konya Education Research Hospital , Konya, Turkey
| | - Abdullah Tuncez
- Faculty of Medicine Cardiology Department, Selcuk University , Konya, Turkey
| | | | - Ahmet Yılmaz
- , Department of Cardiology, Karaman State Hospital , Karaman, Turkey
| | - Sema Yılmaz
- Faculty of Medicine Rheumatology Department, Selcuk University , Konya, Turkey
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14
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Giraud C, Lambert C, Dutheil F, Pereira B, Soubrier M, Tournadre A. The relationship between weight status and metabolic syndrome in patients with rheumatoid arthritis and spondyloarthritis. Joint Bone Spine 2020; 88:105059. [PMID: 32712331 DOI: 10.1016/j.jbspin.2020.07.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 07/16/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To compare the prevalence and correlates of metabolic syndrome (MetS) stratified by body mass index (BMI) categories in rheumatoid arthritis (RA) and spondyloarthritis (SpA). METHODS The age- and sex-standardized prevalence of MetS was calculated by BMI categories and compared between RA and SpA patients before starting first biologic, and controls. The determinants of metabolic syndrome in patients without obesity were investigated. RESULTS MetS was observed in 28% of RA (21/75), 22.5% of SpA (18/80), 19% of controls (187/998). The age- and sex-standardized prevalence of MetS was not significantly different between RA 19% (95% CI: 11-27%), SpA 26% (95% CI: 16-36%) and controls 16% (95% CI: 14-18%). When stratified by BMI, the standardized prevalence of MetS was less frequent in obese RA patients (15%, 95% CI: 4-27%) compared to obese controls (48%, 95% CI: 40-55%) or to obese SpA (36%, 95% CI: 26-45%). In normal-weight RA patients, MetS standardized prevalence was 16% (95% CI: 7-25%) compared to 5% (95% CI: 0-11%) in SpA, and 6% (95% CI: 4-8%) in controls. In non-obese SpA, MetS was associated with abdominal obesity, visceral fat mass and cardiovascular risk. In non-obese RA patients with metabolic syndrome, body composition did not differ from metabolically healthy RA patients. CONCLUSIONS MetS is not uniform among patients with similar BMI. In RA, MetS was less frequent in obese patients, and unlike SpA, was not associated with body fat composition in non-obese patients. Differences between RA and SpA for metabolic health suggest various pathophysiological mechanisms.
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Affiliation(s)
- Charlotte Giraud
- Rheumatology department, CHU de Clermont-Ferrand, 63003 Clermont-Ferrand, France; UNH-UMR 1019, INRAe and University of Clermont-Auvergne, 63003 Clermont-Ferrand, France
| | - Céline Lambert
- Biostatistics unit (DRCI), CHU de Clermont-Ferrand, 63003 Clermont-Ferrand, France
| | - Frédéric Dutheil
- Preventive and Occupational Medicine, CHU de Clermont-Ferrand, 63003 Clermont-Ferrand, France
| | - Bruno Pereira
- Biostatistics unit (DRCI), CHU de Clermont-Ferrand, 63003 Clermont-Ferrand, France
| | - Martin Soubrier
- Rheumatology department, CHU de Clermont-Ferrand, 63003 Clermont-Ferrand, France; UNH-UMR 1019, INRAe and University of Clermont-Auvergne, 63003 Clermont-Ferrand, France
| | - Anne Tournadre
- Rheumatology department, CHU de Clermont-Ferrand, 63003 Clermont-Ferrand, France; UNH-UMR 1019, INRAe and University of Clermont-Auvergne, 63003 Clermont-Ferrand, France.
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15
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Genre F, Rueda-Gotor J, Quevedo-Abeledo JC, Corrales A, Hernández-Hernández V, Fañanas-Rodríguez N, Lavín-Gómez B, Delgado-Frías E, de Vera-González A, González-Delgado A, de Armas-Rillo L, García-Unzueta MT, González-Gay MÁ, Ferraz-Amaro I. Insulin resistance in non-diabetes patients with spondyloarthritis. Scand J Rheumatol 2020; 49:476-483. [PMID: 32648492 DOI: 10.1080/03009742.2020.1751272] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Objectives: Insulin resistance (IR) constitutes a major underlying abnormality driving cardiovascular disease in the general population and has been linked to inflammatory diseases. In this study, we aimed to determine the prevalence of IR in patients with spondyloarthritis (SpA) and whether IR can be explained by disease-related features in such cases. Method: The study included 577 subjects: 306 patients diagnosed with SpA according to Assessment of SpondyloArthritis international Society criteria and 271 controls. Insulin and C-peptide serum levels, IR and β-cell function (%B) indices by homoeostatic model assessment (HOMA2), and lipid profiles were assessed in patients and controls. A multivariable regression analysis was performed to evaluate the differences in IR indices between patients and controls and to determine how IR is associated with disease-related characteristics in SpA patients. Results: HOMA2-%B and HOMA2-IR scores, both calculated with insulin or C-peptide, had significantly higher values in SpA patients compared to controls in multivariable analysis adjusted for age, gender, traditional IR-related factors, and glucocorticoid intake. Disease activity, functional status, and metrological SpA indices were positively related to IR, but only in univariable analysis. Disease duration and positivity for human leucocyte antigen-B27 were independently associated with a higher HOMA2-%B after multivariable analysis. Conclusion: Patients with SpA have an increased IR compared to controls. SpA disease-related data are independently associated with β-cell dysfunction.
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Affiliation(s)
- F Genre
- Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Marqués de Valdecilla University Hospital, IDIVAL , Santander, Spain
| | - J Rueda-Gotor
- Division of Rheumatology, Marqués de Valdecilla University Hospital , Santander, Spain
| | - J C Quevedo-Abeledo
- Division of Rheumatology, University Hospital of Gran Canaria Dr Negrin , Las Palmas, Gran Canaria, Spain
| | - A Corrales
- Division of Rheumatology, Marqués de Valdecilla University Hospital , Santander, Spain
| | - V Hernández-Hernández
- Division of Rheumatology, University Hospital of the Canary Islands , Tenerife, Spain
| | - N Fañanas-Rodríguez
- Division of Endocrinology, Marqués de Valdecilla University Hospital , Santander, Spain
| | - B Lavín-Gómez
- Division of Endocrinology, Marqués de Valdecilla University Hospital , Santander, Spain
| | - E Delgado-Frías
- Division of Rheumatology, University Hospital of the Canary Islands , Tenerife, Spain
| | - A de Vera-González
- Central Laboratory Division, University Hospital of the Canary Islands , Tenerife, Spain
| | - A González-Delgado
- Central Laboratory Division, University Hospital of the Canary Islands , Tenerife, Spain
| | - L de Armas-Rillo
- Department of Health Sciences, European University of the Canary Islands , Tenerife, Spain
| | - M T García-Unzueta
- Division of Endocrinology, Marqués de Valdecilla University Hospital , Santander, Spain
| | - M Á González-Gay
- Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Marqués de Valdecilla University Hospital, IDIVAL , Santander, Spain.,Division of Rheumatology, Marqués de Valdecilla University Hospital , Santander, Spain.,School of Medicine, University of Cantabria , Santander, Spain.,Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand , Johannesburg, South Africa
| | - I Ferraz-Amaro
- Division of Rheumatology, University Hospital of the Canary Islands , Tenerife, Spain
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16
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Immunological and oxidative stress biomarkers in Ankylosing Spondylitis patients with or without metabolic syndrome. Cytokine 2020; 128:155002. [DOI: 10.1016/j.cyto.2020.155002] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Revised: 01/15/2020] [Accepted: 01/17/2020] [Indexed: 12/17/2022]
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17
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Atzeni F, Nucera V, Galloway J, Zoltán S, Nurmohamed M. Cardiovascular risk in ankylosing spondylitis and the effect of anti-TNF drugs: a narrative review. Expert Opin Biol Ther 2019; 20:517-524. [PMID: 31847607 DOI: 10.1080/14712598.2020.1704727] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Introduction: Cardiovascular (CV) mortality is increased in patients with ankylosing spondylitis (AS), but little is known about CV morbidity beyond the fact that they have a two-fold higher prevalence of ischemic heart disease than controls due to the inflammatory pattern of the disease itself, and a higher prevalence of traditional CV risk factors than the general population. Anti-TNF drugs reduce inflammation and a number of studies have reported a reduction in sub-clinical atherosclerosis in AS patients treated with anti-TNF drugs, thus suggesting that inflammation contributes to their higher CV risk. Anti-TNF drugs also alter the lipid profiles of AS patients, although these changes may reflect their normalization secondary to inflammation control, and improve their other myocardial alterations.Areas covered: This review concentrates on the risk of cardiovascular morbidity and mortality among AS patients and the effect of anti-TNF drugs on this risk, with particular emphasis on the putative causes involved and the aspects that are relevant in clinical practice.Expert opinion: The growing evidence of CV disease in AS means that all clinicians need to know how to prevent it and treat patients appropriately. It is important to bear in mind the EULAR guidelines, which state that a rheumatologist is responsible for monitoring all AS patients for signs of CV involvement because this is essential in order to ensure that they are treated properly. As there is little clinical evidence concerning the effects of biological drugs other than anti-TNF agents, treatment should be decided on the basis of the clinical aspects of the type of AS and the CV co-morbidity: for example, patients who are hypertensive or dyslipidemic should immediately start treatment with an anti-hypertensive agent and/or a statin. All of the patients should be educated to prevent CV events by keeping to a balanced healthy diet, avoiding tobacco smoking, and maintaining normal blood pressure, LDL-cholesterol and glucose levels. Finally, all clinicians (but particularly rheumatologists) should always bear in mind CV complications in order to guarantee that the quality of life of AS patients is as good as possible.
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Affiliation(s)
- Fabiola Atzeni
- Rheumatology Unit, University of Messina, Messina, Italy
| | - Valeria Nucera
- Rheumatology Unit, University of Messina, Messina, Italy
| | - James Galloway
- Centre for Rheumatic Disease, Kings College London, London, UK
| | - Szekanecz Zoltán
- Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, University of Debrecen, Debrecen, Hungary
| | - Mike Nurmohamed
- Department of Rheumatology Reade, Amsterdam Rheumatology and Immunology Center, Reade & VU University Medical Center, Amsterdam, The Netherlands
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18
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Gonen T, Tiosano S, Comaneshter D, Amital H, Cohen AD, Shovman O. The coexistence of gout in ankylosing spondylitis patients: a case control study. Rheumatol Int 2019; 40:465-470. [PMID: 31630236 DOI: 10.1007/s00296-019-04462-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Accepted: 10/05/2019] [Indexed: 12/14/2022]
Abstract
Ankylosing spondylitis (AS) and gout are common inflammatory arthropathies. It had been claimed previously that the two conditions rarely coexist. The aim of this study was to compare the prevalence of gout in a population of AS patients to its prevalence in the general population. To conduct this population-based case-control study, data of adult patients with a physician diagnosis of AS were retrieved from the database of the largest health-care provider organization in Israel, Clalit Health Services. For each patient with AS, five age- and sex-matched subjects without AS were randomly selected from the same database. Different parameters including the existence of gout, hypertension, body mass index, socioeconomic status, and smoking were evaluated in both the AS and the control groups. The study included 3763 patients with AS and 19,214 controls. The proportion of gout in the AS group was higher than in the control group: 73 subjects in the AS group had gout, while only 107 subjects in the non-AS group had gout (1.94% and 0.56%, respectively, OR 3.53, P < 0.001). Logistic regression adjusting for possible confounding variables found that AS was independently associated with gout (OR 1.41, P = 0.037). Our study suggests that gout is not less common in AS patients in comparison with the general population, and that it might even be more common in AS patients.
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Affiliation(s)
- Tal Gonen
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - Shmuel Tiosano
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel.,Department of Medicine 'B', Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, 5262100, Ramat Gan, Israel
| | | | - Howard Amital
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel.,Department of Medicine 'B', Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, 5262100, Ramat Gan, Israel
| | - Arnon D Cohen
- Clalit Health Services Tel Aviv, Tel Aviv, Israel.,Faculty of Health Sciences, Siaal Research Center for Family Medicine and Primary Care, Ben Gurion University of the Negev, Beersheba, Israel
| | - Ora Shovman
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel. .,Department of Medicine 'B', Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, 5262100, Ramat Gan, Israel.
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19
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Surucu GD, Yildirim A, Yetisgin A, Akturk E. Epicardial adipose tissue thickness as a new risk factor for atherosclerosis in patients with ankylosing spondylitis. J Back Musculoskelet Rehabil 2019; 32:237-243. [PMID: 30248026 DOI: 10.3233/bmr-160650] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
PURPOSE The aim of this study was to compare epicardial adipose tissue thickness (EATT), which is a novel cardiometabolic risk factor in patients with ankylosing spondylitis (AS), and carotid intima media thickness (CIMT) with healthy controls to assess the relationship between these markers and disease activity. MATERIALS AND METHODS This study involved 38 patients with AS and 38 controls with no history of cardiovascular disease. CIMT was measured by Doppler ultrasound, and EATT by echocardiography, in all participants. Total cholesterol (TC), low density lipoprotein (LDL) cholesterol, high density lipoprotein cholesterol, triglycerides, thyroid stimulating hormone, erythrocyte sedimentation rate, C-reactive protein, and hemogram measurements were performed in all subjects after 8 hours of fasting. In addition, the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and the Bath Ankylosing Spondylitis Functional Index (BASFI) scores of the patients with AS were recorded. RESULTS EATT was significantly higher in patients with AS (0.45 ± 0.17 mm) compared with healthy (0.37 ± 0.10 mm) controls (p= 0.01). Significant positive correlations were detected between EAT thickness and BASFI, CIMT, and disease duration in patients with AS (p= 0.008, p= 0.024, and p= 0.012, respectively). Significant negative correlations were observed between EATT and TC and LDL cholesterol concentrations (p= 0.016 and p= 0.009, respectively). No significant difference was detected in CIMT between the patients (0.515 ± 0.08 mm) and the controls (0.517 ± 0.094 mm, p= 0.98). No significant correlation was observed between CIMT of the patients with AS and the BASDAI, BASFI, TC, HDL cholesterol, systolic blood pressure, or diastolic blood pressure values. Significant positive correlations were observed between CIMT and waist circumference, weight, body mass index, and LDL cholesterol in patients with AS and the controls. CONCLUSIONS This study demonstrated increased EATT in patients with AS compared with a healthy population, which was positively correlated with disease duration and BASFI.
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Affiliation(s)
- Gulseren Dost Surucu
- Department of Physical Medicine and Rehabilitation, Adiyaman University Medical School, Adiyaman, Turkey
| | - Adem Yildirim
- Department of Physical Medicine and Rehabilitation, Adiyaman University Medical School, Adiyaman, Turkey
| | - Alparslan Yetisgin
- Department of Physical Medicine and Rehabilitation, Harran University Medical School, Sanliurfa, Turkey
| | - Erdal Akturk
- Department of Cardiology, Adiyaman University Medical School, Adiyaman, Turkey
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20
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Liu M, Huang Y, Huang Z, Huang Q, Guo X, Wang Y, Deng W, Huang Z, Li T. Prevalence of metabolic syndrome and its associated factors in Chinese patients with ankylosing spondylitis. Diabetes Metab Syndr Obes 2019; 12:477-484. [PMID: 31114277 PMCID: PMC6489596 DOI: 10.2147/dmso.s197745] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 02/28/2019] [Indexed: 12/20/2022] Open
Abstract
Purpose: We assessed the prevalence of metabolic syndrome (MetS) and associated factors in mainland Chinese patients with ankylosing spondylitis (AS). Patients and methods: A retrospective study was conducted in 117 AS patients and 117 age- and sex-matched healthy controls. Parameters of MetS based on the criteria established by the Chinese Diabetes Society in 2013 were tabulated. Demographic features, laboratory data, and clinical characteristics were also collected. Independent factors correlated with MetS in AS patients were identified by backward stepwise multivariate analysis. Results: The prevalence of MetS was higher in AS patients than in healthy controls (P= 0.026). AS patients also had higher blood pressure and fasting serum glucose levels, but generally lower serum lipid levels. AS patients with and without MetS had no distinct differences in disease duration, medication usage, disease activity, or biomarkers of inflammation. Multivariable logistic regression analysis showed that hyperuricemia (odds ratio [OR] = 2.385, 95% confidence interval [95% CI] = 1.019-5.582, P= 0.045) and high body mass index (BMI, OR = 5.165; 95% CI = 1.935-13.787, P=0.001) were independent factors for MetS in AS patients. Conclusion: Chinese AS patients living in the mainland have an increased risk of developing MetS. Hyperuricemia and high BMI are predictors of MetS in AS patients.
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Affiliation(s)
- Meng Liu
- Department of Rheumatology and Immunology, Guangdong Second Provincial General Hospital, Guangzhou, Guangdong, People’s Republic of China
| | - Yukai Huang
- Department of Rheumatology and Immunology, Guangdong Second Provincial General Hospital, Guangzhou, Guangdong, People’s Republic of China
| | - Zhengping Huang
- Department of Rheumatology and Immunology, Guangdong Second Provincial General Hospital, Guangzhou, Guangdong, People’s Republic of China
| | - Qidang Huang
- Department of Rheumatology and Immunology, Guangdong Second Provincial General Hospital, Guangzhou, Guangdong, People’s Republic of China
| | - Xin Guo
- Department of Rheumatology and Immunology, Guangdong Second Provincial General Hospital, Guangzhou, Guangdong, People’s Republic of China
| | - Yunqing Wang
- Department of Rheumatology and Immunology, Guangdong Second Provincial General Hospital, Guangzhou, Guangdong, People’s Republic of China
| | - Weiming Deng
- Department of Rheumatology and Immunology, Guangdong Second Provincial General Hospital, Guangzhou, Guangdong, People’s Republic of China
| | - Zhixiang Huang
- Department of Rheumatology and Immunology, Guangdong Second Provincial General Hospital, Guangzhou, Guangdong, People’s Republic of China
| | - Tianwang Li
- Department of Rheumatology and Immunology, Guangdong Second Provincial General Hospital, Guangzhou, Guangdong, People’s Republic of China
- Correspondence: Tianwang LiDepartment of Rheumatology and Immunology, Guangdong Second Provincial General Hospital, No 466 Xingangzhonglu Road, Haizhu Square, Guangzhou, Guangdong510220, People’s Republic of ChinaTel +86 208 916 9092Fax +86 208 916 9092Email
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21
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Bai R, Zhang Y, Liu W, Ma C, Chen X, Yang J, Sun D. The Relationship of Ankylosing Spondylitis and Subclinical Atherosclerosis: A Systemic Review and Meta-Analysis. Angiology 2018; 70:492-500. [PMID: 30497278 DOI: 10.1177/0003319718814309] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- Ruocen Bai
- Department of Cardiovascular Ultrasound, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Yanfen Zhang
- Department of Cardiovascular Ultrasound, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Wen Liu
- Department of Cardiovascular Ultrasound, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Chunyan Ma
- Department of Cardiovascular Ultrasound, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Xin Chen
- Department of Cardiovascular Ultrasound, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Jun Yang
- Department of Cardiovascular Ultrasound, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Dandan Sun
- Department of Cardiovascular Ultrasound, The First Affiliated Hospital of China Medical University, Shenyang, China
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22
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Park CJ, Choi YJ, Kim JG, Han IB, Do Han K, Choi JM, Sohn S. Association of Acute Myocardial Infarction with ankylosing Spondylitis: A nationwide longitudinal cohort study. J Clin Neurosci 2018; 56:34-37. [DOI: 10.1016/j.jocn.2018.08.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2018] [Revised: 07/27/2018] [Accepted: 08/08/2018] [Indexed: 12/17/2022]
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23
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Genre F, Rueda-Gotor J, Remuzgo-Martínez S, Corrales A, Mijares V, Expósito R, Mata C, Portilla V, Blanco R, Hernández JL, Llorca J, Gualillo O, López-Mejías R, González-Gay MA. Association of circulating calprotectin with lipid profile in axial spondyloarthritis. Sci Rep 2018; 8:13728. [PMID: 30213986 PMCID: PMC6137145 DOI: 10.1038/s41598-018-32199-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 09/04/2018] [Indexed: 02/07/2023] Open
Abstract
Calprotectin (CPT) is released during inflammation, also in the context of atherosclerosis. The link between CPT and the atherosclerotic process was evaluated in several diseases. However, studies in axial spondyloarthritis (axSpA), associated with a high incidence of subclinical atherosclerosis, are scarce. Therefore, we assessed the association of CPT with subclinical atherosclerosis and metabolic risk factors in axSpA. CPT serum levels were measured by enzyme-linked immunosorbent assay in 163 axSpA patients and 63 controls. Subclinical atherosclerosis was determined in patients by carotid ultrasonography (assessing the presence/absence of carotid plaques and carotid intima-media thickness [cIMT]). Data on inflammation, disease activity, lipid profile and treatment were collected to evaluate its relationship with CPT. axSpA patients evidenced lower CPT levels than controls. CPT showed no association with plaques or cIMT in axSpA. CPT and HDL-cholesterol negatively correlated, while a positive association of CPT with the atherogenic index was disclosed. Additionally, axSpA patients with C-reactive protein values at diagnosis higher than 3 mg/L displayed higher CPT levels. Our study shows no relationship between CPT and markers of subclinical atherosclerosis in axSpA. Nevertheless, it demonstrates an association of CPT with adverse lipid profiles and inflammatory biomarkers, which could further influence on the development of atherosclerosis.
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Affiliation(s)
- Fernanda Genre
- Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, IDIVAL, Santander, 39011, Spain
| | - Javier Rueda-Gotor
- Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, IDIVAL, Santander, 39011, Spain
| | - Sara Remuzgo-Martínez
- Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, IDIVAL, Santander, 39011, Spain
| | - Alfonso Corrales
- Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, IDIVAL, Santander, 39011, Spain
| | - Verónica Mijares
- Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, IDIVAL, Santander, 39011, Spain
| | - Rosa Expósito
- Division of Rheumatology, Hospital Comarcal de Laredo, Laredo, 39770, Spain
| | - Cristina Mata
- Division of Rheumatology, Hospital Comarcal de Laredo, Laredo, 39770, Spain
| | - Virginia Portilla
- Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, IDIVAL, Santander, 39011, Spain
| | - Ricardo Blanco
- Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, IDIVAL, Santander, 39011, Spain
| | - José Luis Hernández
- Bone Metabolism Unit, Department of Internal Medicine, Hospital Universitario Marqués de Valdecilla, IDIVAL, University of Cantabria, RETICEF, Santander, 39008, Spain
| | - Javier Llorca
- Department of Epidemiology and Computational Biology, School of Medicine, University of Cantabria, and CIBER Epidemiología y Salud Pública (CIBERESP), IDIVAL, Santander, 39011, Spain
| | - Oreste Gualillo
- SERGAS (Servizo Galego de Saude) and IDIS (Instituto de Investigación Sanitaria de Santiago), The NEIRID Group (Neuroendocrine Interactions in Rheumatology and Inflammatory Diseases), Santiago University Clinical Hospital, Santiago de Compostela, 15706, Spain
| | - Raquel López-Mejías
- Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, IDIVAL, Santander, 39011, Spain.
| | - Miguel A González-Gay
- Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, IDIVAL, Santander, 39011, Spain. .,School of Medicine, University of Cantabria, Santander, 39011, Spain. .,Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, 2000, South Africa.
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24
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Yuan Y, Yang J, Zhang X, Han R, Chen M, Hu X, Ma Y, Wu M, Wang M, Xu S, Pan F. Carotid Intima-Media Thickness in Patients with Ankylosing Spondylitis: A Systematic Review and Updated Meta-Analysis. J Atheroscler Thromb 2018; 26:260-271. [PMID: 30089757 PMCID: PMC6402883 DOI: 10.5551/jat.45294] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Aim: Inflammatory arthritis (IA) diseases are relevant with subclinical atherosclerosis, but the data in ankylosing spondylitis (AS) were inconsistent. Therefore, we performed this meta-analysis to explore the relationship between the marker of subclinical atherosclerosis (carotid intima-media thickness (IMT)) and AS. Methods: We performed a systematic literature review using PubMed, Web of Science, Chinese National Knowledge Infrastructure (CNKI) and Chinese Biomedical Database (CBM) databases up to March 2018. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated to assess the association between carotid IMT and AS. Subgroup analysis, sensitivity analysis, and meta-regression were applied to explore the sources of heterogeneity, and publication bias was calculated to access the quality of pooled studies. Results: A total of 24 articles were collected. The carotid IMT was significantly increased in AS compared with healthy controls (SMD = 0.725, 95% CI = 0.443–1.008, p < 0.001). Subgroup analyses showed the Bath Ankylosing Spondylitis Activity Index (BASDAI) was the source of heterogeneity. Notably, IMT was not significantly increased in those studies that included > 50% patients treated with anti-TNF. Meta-regression revealed severe inflammation status (BASDAI and C-reactive protein (CRP)) could significantly impact carotid IMT in AS. Conclusions: Carotid IMT was significantly increased in patients with AS compared with healthy controls, which suggested subclinical atherosclerosis is related to AS.
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Affiliation(s)
- Yaping Yuan
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University.,The Key Laboratory of Major Autoimmune Diseases, Anhui Medical University
| | - Jiajia Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University.,The Key Laboratory of Major Autoimmune Diseases, Anhui Medical University
| | - Xu Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University.,The Key Laboratory of Major Autoimmune Diseases, Anhui Medical University
| | - Renfang Han
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University.,The Key Laboratory of Major Autoimmune Diseases, Anhui Medical University
| | - Mengya Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University.,The Key Laboratory of Major Autoimmune Diseases, Anhui Medical University
| | - Xingxing Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University.,The Key Laboratory of Major Autoimmune Diseases, Anhui Medical University
| | - Yubo Ma
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University.,The Key Laboratory of Major Autoimmune Diseases, Anhui Medical University
| | - Meng Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University.,The Key Laboratory of Major Autoimmune Diseases, Anhui Medical University
| | - Mengmeng Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University.,The Key Laboratory of Major Autoimmune Diseases, Anhui Medical University
| | - Shengqian Xu
- Department of Rheumatism and Immunity, the First Affiliated Hospital of Anhui Medical University
| | - Faming Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University.,The Key Laboratory of Major Autoimmune Diseases, Anhui Medical University
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Kesikburun B, Ekşioğlu E, Çakcı A. Metabolic Syndrome in Rheumatoid Arthritis and Ankylosing Spondylitis. ANKARA MEDICAL JOURNAL 2018. [DOI: 10.17098/amj.435258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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26
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Cure E, Icli A, Uslu AU, Sakiz D, Cure MC, Baykara RA, Yavuz F, Arslan S, Kucuk A. Atherogenic index of plasma: a useful marker for subclinical atherosclerosis in ankylosing spondylitis : AIP associate with cIMT in AS. Clin Rheumatol 2018; 37:1273-1280. [PMID: 29435680 DOI: 10.1007/s10067-018-4027-0] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 01/27/2018] [Accepted: 02/06/2018] [Indexed: 02/07/2023]
Abstract
Ankylosing spondylitis (AS) is associated with an increased risk of atherosclerotic cardiovascular disease (ACD). The atherogenic index of plasma (AIP), which is the logarithmic transformation of the plasma triglyceride (TG) level to the high-density lipoprotein level (HDL) ratio, has been suggested to be a novel marker in the identification of atherosclerosis risk. Therefore, this study aims to determine if the AIP can act as an accurate marker for the detection of subclinical atherosclerosis. Fifty-two male patients with AS and 52 age-, gender-, and body mass index (BMI)-matched healthy control subjects were included in the study. For each patient, AIP and total cholesterol (TC)/HDL values were calculated and carotid artery intima-media thickness (cIMT) was measured. The mean (SD) cIMT and median (range) AIP values for AS patients were higher than that of the healthy control subjects (0.60 ± 0.18 vs. 0.51 ± 0.10, p = 0.003 and 0.23 [- 0.32 to 0.85] vs. 0.09 [- 0.53 to 0.49], p = 0.007, respectively). A positive correlation was found between the patients' cIMT and AIP values (r = 0.307, p = 0.002) and TC/HDL values (r = 0.241, p = 0.014). Regression analysis revealed an independent association between the subclinical atherosclerosis and AIP (beta [β] = 0.309, p = 0.002). There were no independent correlations between subclinical atherosclerosis and TC (β = 0.245, p = 0.065), TG (β = 0.185, p = 0.515), HDL (β = 0.198, p = 0.231), TC/HDL (β = 0.032, p = 0.862), and low-density lipoprotein (LDL) (β = 0.151, p = 0.246). A strong and independent correlation exists between AIP and cIMT values. Therefore, the AIP could serve as a better marker than the TC/HDL ratio for the detection of subclinical atherosclerosis in AS patients.
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Affiliation(s)
- Erkan Cure
- Department of Internal Medicine, Camlica Erdem Hospital, Istanbul, Turkey.
| | - Abdullah Icli
- Department of Cardiology, Necmettin Erbakan University, Konya, Turkey
| | - Ali Ugur Uslu
- Department of Internal Medicine, Yunus Emre State Hospital, Eskisehir, Turkey
| | - Davut Sakiz
- Department of Endocrinology and Metabolism, Diskapi Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Medine Cumhur Cure
- Department of Biochemistry, Istanbul Laboratory, Mecidiyekoy, Istanbul, Turkey
| | - Rabia Aydogan Baykara
- Department of Physical Medicine and Rehabilitation, Malatya Training and Research Hospital, Malatya, Turkey
| | - Fatma Yavuz
- Department of Internal Medicine, Dogubeyazit Doc. Dr. Yasar Eryilmaz State Hospital, Agri, Turkey
| | - Sevket Arslan
- Division of Allergy and Clinical Immunology, Konya Training and Research Hospital, Konya, Turkey
| | - Adem Kucuk
- Division of Rheumatology, Department of Internal Medicine, Necmettin Erbakan University, Konya, Turkey
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Vinker Shuster M, Gendelman O, Tiosano S, Comaneshter D, Cohen AD, Amital H. Ischemic heart disease and ankylosing spondylitis—assessing the role of inflammation. Clin Rheumatol 2018; 37:1053-1058. [DOI: 10.1007/s10067-018-4037-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Revised: 02/03/2018] [Accepted: 02/13/2018] [Indexed: 12/17/2022]
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28
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Factors associated with accelerated subclinical atherosclerosis in patients with spondyloarthritis without overt cardiovascular disease. Clin Rheumatol 2017; 36:2487-2495. [DOI: 10.1007/s10067-017-3786-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Revised: 07/19/2017] [Accepted: 08/07/2017] [Indexed: 12/14/2022]
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29
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Neve A, Maruotti N, Corrado A, Cantatore FP. Pathogenesis of ligaments ossification in spondyloarthritis: insights and doubts. Ann Med 2017; 49:196-205. [PMID: 27685190 DOI: 10.1080/07853890.2016.1243802] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Despite intensive research in spondyloarthritis pathogenesis, some important questions still remain unanswered, particularly concerning enthesis new bone formation. Several evidences suggest that it prevalently occurs by endochondral ossification, however it remains to identify factors that can induce and influence its initiation and progression. Recent progress, achieved in animal models and in vitro and genetic association studies, has led us to hypothesize that several systemic factors (adipokines and gut hormones) and local factors (BMP and Wnt signaling) as well as angiogenesis and mechanical stress are involved. We critically review and summarize the available data and delineate the possible mechanisms involved in enthesis ossification, particularly at spinal ligament level. KEY MESSAGES Complete understanding of spondyloarthritis pathophysiology requires insights into inflammation, bone destruction and bone formation, which are all located in entheses and lead all together to ankylosis and functional disability. Several factors probably play a role in the pathogenesis of bone formation in entheses including not only cytokines but also several systemic factors such as adipokines and gut hormones, and local factors, such as BMP and Wnt signaling, as well as angiogenesis and mechanical stress. Data available about pathophysiology of new bone formation in spondyloarthritis are limited and often conflicting and future studies are needed to better delineate it and to develop new therapeutic approaches.
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Affiliation(s)
- Anna Neve
- a Rheumatology Clinic, Department of Medical and Surgical Sciences , University of Foggia Medical School , Foggia , Italy
| | - Nicola Maruotti
- a Rheumatology Clinic, Department of Medical and Surgical Sciences , University of Foggia Medical School , Foggia , Italy
| | - Addolorata Corrado
- a Rheumatology Clinic, Department of Medical and Surgical Sciences , University of Foggia Medical School , Foggia , Italy
| | - Francesco Paolo Cantatore
- a Rheumatology Clinic, Department of Medical and Surgical Sciences , University of Foggia Medical School , Foggia , Italy
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30
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Metabolic syndrome in patients with ankylosing spondylitis receiving anti-TNFα therapy: association with predictors of cardiovascular risk. Clin Rheumatol 2017; 36:2371-2376. [PMID: 28391592 DOI: 10.1007/s10067-017-3623-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Revised: 03/26/2017] [Accepted: 03/31/2017] [Indexed: 01/21/2023]
Abstract
The purposes of this study were to determine the prevalence of metabolic syndrome (MetS) in patients with ankylosing spondylitis (AS) receiving anti-TNFα therapy and evaluate the association of the two conditions with clinical and laboratory findings and predictors of cardiovascular risk. In this cross-sectional study, 63 patients diagnosed with AS according to the modified New York criteria and treated with TNFα blockers and 33 healthy controls were submitted to clinical examination and anthropometric measurements. Glucose levels, lipid profile, and inflammatory markers were registered. The Framingham score (FS), atherogenic index of plasma (AIP), and waist-to-height ratio (WHtR) were calculated. MetS was diagnosed according to the revised National Cholesterol Education Program - Adult Treatment Panel III guidelines. The prevalence of MetS was higher among AS patients than controls (27 vs. 9.1%, p = 0.04). AS patients also had greater body mass index (27.6 kg/m2 ± 4.5 vs. 24.5 kg/m2 ± 2.7; p = 0.001) and WHtR (0.59 ± 0.08 vs. 0.49 ± 0.05; p < 0.01). Patients with MetS had higher FS (9.66 (4.08-20.5) vs. 2.54 (1.56-6.75); p < 0.001), WHtR (0.6444 ± 0.0706 vs. 0.5729 ± 0.0759; p = 0.001), and AIP (0.68 ± 0.46 vs. 0.34 ± 0.24; p = 0.02) than patients without MetS. When stratifying patients with and without MetS according to disease activity, the former had stronger predictors of cardiovascular risk than the latter, regardless of disease activity. MetS was more prevalent in AS patients than in controls. Predictors of cardiovascular risk were stronger in MetS patients than in non-MetS patients.
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31
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Tournadre A, Mathieu S, Soubrier M. Managing cardiovascular risk in patients with inflammatory arthritis: practical considerations. Ther Adv Musculoskelet Dis 2016; 8:180-191. [PMID: 27721904 DOI: 10.1177/1759720x16664306] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Patients with inflammatory arthritis, such as rheumatoid arthritis, psoriatic arthritis, or ankylosing spondylitis, have higher rates of cardiovascular mortality. While the increased cardiovascular risk is only explained to some extent, a lot of research is currently conducted to improve our understanding of its pathogenesis, risk stratification, and optimal cardiovascular risk management. This review sought to report epidemiological data pertaining to the cardiovascular disease burden in patients with inflammatory arthritis, underlying mechanisms accounting for excessive cardiovascular risk, along with recommendations regarding risk assessment and management in this patient population.
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Affiliation(s)
- Anne Tournadre
- Rheumatology Department, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Sylvain Mathieu
- Rheumatology Department, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Martin Soubrier
- Rheumatology Department, CHU Gabriel Montpied, 58 Rue Montalembert, F-63000 Clermont-Ferrand, France
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Przepiera-Będzak H, Fischer K, Brzosko M. Serum Interleukin-18, Fetuin-A, Soluble Intercellular Adhesion Molecule-1, and Endothelin-1 in Ankylosing Spondylitis, Psoriatic Arthritis, and SAPHO Syndrome. Int J Mol Sci 2016; 17:ijms17081255. [PMID: 27527149 PMCID: PMC5000653 DOI: 10.3390/ijms17081255] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 07/27/2016] [Accepted: 07/27/2016] [Indexed: 01/05/2023] Open
Abstract
To examine serum interleukin 18 (IL-18), fetuin-A, soluble intercellular adhesion molecule-1 (sICAM-1), and endothelin-1 (ET-1) levels in ankylosing spondylitis (AS), psoriatic arthritis (PsA), and Synovitis Acne Pustulosis Hyperostosis Osteitis syndrome (SAPHO). We studied 81 AS, 76 PsA, and 34 SAPHO patients. We measured serum IL-18, fetuin-A, sICAM-1, ET-1, IL-6, IL-23, vascular endothelial growth factor (VEGF), and epidermal growth factor (EGF). IL-18 levels were higher in AS (p = 0.001), PsA (p = 0.0003), and SAPHO (p = 0.01) than in controls, and were positively correlated with CRP (p = 0.03), VEGF (p = 0.03), and total cholesterol (TC, p = 0.006) in AS and with IL-6 (p = 0.03) in PsA. Serum fetuin-A levels were lower in AS (p = 0.001) and PsA (p = 0.001) than in controls, and negatively correlated with C-reactive protein (CRP) in AS (p = 0.04) and SAPHO (p = 0.03). sICAM-1 positively correlated with CRP (p = 0.01), erythrocyte sedimentation rate (ESR, p = 0.01), and IL-6 (p = 0.008) in AS, and with IL-6 (p = 0.001) in SAPHO. Serum ET-1 levels were lower in AS (p = 0.0005) than in controls. ET-1 positively correlated with ESR (p = 0.04) and Disease Activity Score 28 (DAS28, p = 0.003) in PsA. In spondyloarthritis, markers of endothelial function correlated with disease activity and TC.
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Affiliation(s)
- Hanna Przepiera-Będzak
- Department of Rheumatology, Internal Medicine and Geriatrics, Pomeranian Medical University in Szczecin, Unii Lubelskiej 1, Szczecin 71-252, Poland.
| | - Katarzyna Fischer
- Independent Laboratory of Rheumatic Diagnostics, Pomeranian Medical University in Szczecin, Unii Lubelskiej 1, Szczecin 71-252, Poland.
| | - Marek Brzosko
- Department of Rheumatology, Internal Medicine and Geriatrics, Pomeranian Medical University in Szczecin, Unii Lubelskiej 1, Szczecin 71-252, Poland.
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33
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Lazzerini P, Capecchi P, Selvi E, Lorenzini S, Bisogno S, Galeazzi M, Laghi Pasini F. Hyperhomocysteinemia: a cardiovascular risk factor in autoimmune diseases? Lupus 2016; 16:852-62. [DOI: 10.1177/0961203307084176] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Epidemiological studies conducted over the past 25 years have provided ample support for the association of mild hyperhomocysteinemia (HHcy) with an elevated risk of atherothrombosis. Since autoimmune disorders (AD) are frequently associated with relevant and early signs of atherothrombotic damage not adequately explained by the traditional risk factors involved in the onset of cardiovascular disease (CVD), a large interest has been shown to the putative role of mild HHcy in this setting. On the basis of such considerations, we focused the attention on the relationship between homocysteine (Hcy) and CVD in patients affected with autoimmune diseases, reviewing the most recent literature data and also providing our original experience. Although the large amount of available studies clearly shows that HHcy represents a common finding in patients affected with several autoimmune diseases, the actual role of Hcy in the development of CVD in the course of AD is not clear yet, perhaps, with the only exception of the systemic lupus erythematosus. In the other conditions, the role of Hcy in the pathogenesis of vascular complications is still a matter of debate, as the result of conflicting reports and/or lack of an adequate body of investigation. Lupus (2007) 16, 852—862.
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Affiliation(s)
- P.E. Lazzerini
- Divisions of Clinical Immunology, University of Siena, Siena, Italy
| | - P.L. Capecchi
- Divisions of Clinical Immunology, University of Siena, Siena, Italy
| | - E. Selvi
- Rheumatology, Department of Clinical Medicine and Immunological Sciences, University of Siena, Siena, Italy
| | - S. Lorenzini
- Rheumatology, Department of Clinical Medicine and Immunological Sciences, University of Siena, Siena, Italy
| | - S. Bisogno
- Rheumatology, Department of Clinical Medicine and Immunological Sciences, University of Siena, Siena, Italy
| | - M. Galeazzi
- Rheumatology, Department of Clinical Medicine and Immunological Sciences, University of Siena, Siena, Italy
| | - F. Laghi Pasini
- Divisions of Clinical Immunology, University of Siena, Siena, Italy
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34
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Shen J, Shang Q, Tam LS. Targeting inflammation in the prevention of cardiovascular disease in patients with inflammatory arthritis. Transl Res 2016; 167:138-51. [PMID: 26051628 DOI: 10.1016/j.trsl.2015.05.006] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Revised: 05/11/2015] [Accepted: 05/12/2015] [Indexed: 12/15/2022]
Abstract
Patients with inflammatory arthritis have increased risk of cardiovascular diseases (CVDs) compared with the general population. Subclinical carotid atherosclerosis and increased arterial stiffness are also common in these patients, which may serve as surrogate end points for cardiovascular (CV) events in clinical trials. Although exact mechanisms are still unclear, persistent systemic inflammation in patients with inflammatory arthritis may contribute to the development of CVD. Dysregulated innate immunity pathways in these patients may also play a role in accelerating atherosclerosis. During the last decade, effective suppression of inflammation by biological disease-modifying antirheumatic drugs has improved the disease outcome dramatically in patients with inflammatory arthritis. Growing evidence suggests that antitumor necrosis factor (TNF) therapy may prevent CVD in patients with rheumatoid arthritis. Nonetheless, data on non-TNF biologics are limited. Whether anti-TNF therapy may prevent CVD in patients with spondyloarthritis also remained unclear. In this review, we summarized the effect of both anti-TNF and non-TNF biologics on the CV system, including traditional CVD risk factors, endothelial function, arterial stiffness, subclinical atherosclerosis, and clinical CVD in patients with inflammatory arthritis.
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Affiliation(s)
- Jiayun Shen
- Department of Medicine and Therapeutics, The Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - Qing Shang
- Department of Medicine and Therapeutics, The Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - Lai-Shan Tam
- Department of Medicine and Therapeutics, The Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China.
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35
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Arida A, Protogerou AD, Konstantonis G, Konsta M, Delicha EM, Kitas GD, Sfikakis PP. Subclinical Atherosclerosis Is Not Accelerated in Patients with Ankylosing Spondylitis with Low Disease Activity: New Data and Metaanalysis of Published Studies. J Rheumatol 2015; 42:2098-105. [PMID: 26428207 DOI: 10.3899/jrheum.150316] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2015] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Chronic inflammatory rheumatic diseases are associated with accelerated atherosclerosis, but data in ankylosing spondylitis (AS) are limited and the relative contribution of inflammation versus classical cardiovascular (CV) risk factors remains a matter of controversy. We addressed this in an original study and a metaanalysis of previous studies. METHODS Atheromatic plaques in carotid and femoral arteries, carotid hypertrophy [intima-media thickness (IMT), cross-sectional area], and carotid stiffness by ultrasound, as well as aortic stiffness by pulse wave velocity, were examined in consecutive nondiabetic, CV disease (CVD)-free patients with AS. Healthy individuals carefully matched 1:1 with patients for age, sex, smoking habits, hyperlipidemia, and hypertension served as controls. A metaanalysis of original studies that examined subclinical atherosclerosis in patients with AS versus controls with comparable CVD risk factors was also performed. RESULTS Carotid and femoral atheromatic plaques were slightly less prevalent compared with controls in a contemporary cohort consisting of 67 patients with AS (82% men), aged 47.5 ± 12.5 years (mean ± SD), with a median disease duration of 12 years and a Bath AS Disease Activity Index (BASDAI) of 1.8 (interquartile range 0.4-3.6), of whom 66% were receiving anti-tumor necrosis factor (TNF) treatment. Carotid hypertrophy and stiffness, as well as aortic stiffness, were similar between patients and their matched controls. Metaanalysis of all published studies revealed a significantly increased carotid IMT, but not plaque burden, in AS versus controls. Notably, however, increased IMT was not evident in studies involving patients with low disease activity (mean BASDAI < 4) or in those studies that included > 50% of patients treated with anti-TNF. CONCLUSION Low AS disease activity is not associated with accelerated atherosclerosis.
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Affiliation(s)
- Aikaterini Arida
- From the Rheumatology Unit, First Department of Propaedeutic Internal Medicine, Laikon Hospital; Joint Academic Rheumatology Programme, National Kapodistrian University of Athens Medical School, Athens, Greece.A. Arida, MSc, Rheumatology Unit, First Department of Propaedeutic Internal Medicine, Laikon Hospital, and Joint Academic Rheumatology Programme, National Kapodistrian University of Athens Medical School; A.D. Protogerou, PhD, Rheumatology Unit, First Department of Propaedeutic Internal Medicine, Laikon Hospital, and Joint Academic Rheumatology Programme, National Kapodistrian University of Athens Medical School; G. Konstantonis, MSc, Rheumatology Unit, First Department of Propaedeutic Internal Medicine, Laikon Hospital, and Joint Academic Rheumatology Programme, National Kapodistrian University of Athens Medical School; M. Konsta, MD, Rheumatology Unit, First Department of Propaedeutic Internal Medicine, Laikon Hospital, and Joint Academic Rheumatology Programme, National Kapodistrian University of Athens Medical School; E.M. Delicha, PhD, Rheumatology Unit, First Department of Propaedeutic Internal Medicine, Laikon Hospital, and Joint Academic Rheumatology Programme, National Kapodistrian University of Athens Medical School; G.D. Kitas, Professor, Rheumatology Unit, First Department of Propaedeutic Internal Medicine, Laikon Hospital, and Joint Academic Rheumatology Programme, National Kapodistrian University of Athens Medical School; P.P. Sfikakis, Professor, Rheumatology Unit, First Department of Propaedeutic Internal Medicine, Laikon Hospital, and Joint Academic Rheumatology Programme, National Kapodistrian University of Athens Medical School
| | - Athanasios D Protogerou
- From the Rheumatology Unit, First Department of Propaedeutic Internal Medicine, Laikon Hospital; Joint Academic Rheumatology Programme, National Kapodistrian University of Athens Medical School, Athens, Greece.A. Arida, MSc, Rheumatology Unit, First Department of Propaedeutic Internal Medicine, Laikon Hospital, and Joint Academic Rheumatology Programme, National Kapodistrian University of Athens Medical School; A.D. Protogerou, PhD, Rheumatology Unit, First Department of Propaedeutic Internal Medicine, Laikon Hospital, and Joint Academic Rheumatology Programme, National Kapodistrian University of Athens Medical School; G. Konstantonis, MSc, Rheumatology Unit, First Department of Propaedeutic Internal Medicine, Laikon Hospital, and Joint Academic Rheumatology Programme, National Kapodistrian University of Athens Medical School; M. Konsta, MD, Rheumatology Unit, First Department of Propaedeutic Internal Medicine, Laikon Hospital, and Joint Academic Rheumatology Programme, National Kapodistrian University of Athens Medical School; E.M. Delicha, PhD, Rheumatology Unit, First Department of Propaedeutic Internal Medicine, Laikon Hospital, and Joint Academic Rheumatology Programme, National Kapodistrian University of Athens Medical School; G.D. Kitas, Professor, Rheumatology Unit, First Department of Propaedeutic Internal Medicine, Laikon Hospital, and Joint Academic Rheumatology Programme, National Kapodistrian University of Athens Medical School; P.P. Sfikakis, Professor, Rheumatology Unit, First Department of Propaedeutic Internal Medicine, Laikon Hospital, and Joint Academic Rheumatology Programme, National Kapodistrian University of Athens Medical School
| | - George Konstantonis
- From the Rheumatology Unit, First Department of Propaedeutic Internal Medicine, Laikon Hospital; Joint Academic Rheumatology Programme, National Kapodistrian University of Athens Medical School, Athens, Greece.A. Arida, MSc, Rheumatology Unit, First Department of Propaedeutic Internal Medicine, Laikon Hospital, and Joint Academic Rheumatology Programme, National Kapodistrian University of Athens Medical School; A.D. Protogerou, PhD, Rheumatology Unit, First Department of Propaedeutic Internal Medicine, Laikon Hospital, and Joint Academic Rheumatology Programme, National Kapodistrian University of Athens Medical School; G. Konstantonis, MSc, Rheumatology Unit, First Department of Propaedeutic Internal Medicine, Laikon Hospital, and Joint Academic Rheumatology Programme, National Kapodistrian University of Athens Medical School; M. Konsta, MD, Rheumatology Unit, First Department of Propaedeutic Internal Medicine, Laikon Hospital, and Joint Academic Rheumatology Programme, National Kapodistrian University of Athens Medical School; E.M. Delicha, PhD, Rheumatology Unit, First Department of Propaedeutic Internal Medicine, Laikon Hospital, and Joint Academic Rheumatology Programme, National Kapodistrian University of Athens Medical School; G.D. Kitas, Professor, Rheumatology Unit, First Department of Propaedeutic Internal Medicine, Laikon Hospital, and Joint Academic Rheumatology Programme, National Kapodistrian University of Athens Medical School; P.P. Sfikakis, Professor, Rheumatology Unit, First Department of Propaedeutic Internal Medicine, Laikon Hospital, and Joint Academic Rheumatology Programme, National Kapodistrian University of Athens Medical School
| | - Maria Konsta
- From the Rheumatology Unit, First Department of Propaedeutic Internal Medicine, Laikon Hospital; Joint Academic Rheumatology Programme, National Kapodistrian University of Athens Medical School, Athens, Greece.A. Arida, MSc, Rheumatology Unit, First Department of Propaedeutic Internal Medicine, Laikon Hospital, and Joint Academic Rheumatology Programme, National Kapodistrian University of Athens Medical School; A.D. Protogerou, PhD, Rheumatology Unit, First Department of Propaedeutic Internal Medicine, Laikon Hospital, and Joint Academic Rheumatology Programme, National Kapodistrian University of Athens Medical School; G. Konstantonis, MSc, Rheumatology Unit, First Department of Propaedeutic Internal Medicine, Laikon Hospital, and Joint Academic Rheumatology Programme, National Kapodistrian University of Athens Medical School; M. Konsta, MD, Rheumatology Unit, First Department of Propaedeutic Internal Medicine, Laikon Hospital, and Joint Academic Rheumatology Programme, National Kapodistrian University of Athens Medical School; E.M. Delicha, PhD, Rheumatology Unit, First Department of Propaedeutic Internal Medicine, Laikon Hospital, and Joint Academic Rheumatology Programme, National Kapodistrian University of Athens Medical School; G.D. Kitas, Professor, Rheumatology Unit, First Department of Propaedeutic Internal Medicine, Laikon Hospital, and Joint Academic Rheumatology Programme, National Kapodistrian University of Athens Medical School; P.P. Sfikakis, Professor, Rheumatology Unit, First Department of Propaedeutic Internal Medicine, Laikon Hospital, and Joint Academic Rheumatology Programme, National Kapodistrian University of Athens Medical School
| | - Evi M Delicha
- From the Rheumatology Unit, First Department of Propaedeutic Internal Medicine, Laikon Hospital; Joint Academic Rheumatology Programme, National Kapodistrian University of Athens Medical School, Athens, Greece.A. Arida, MSc, Rheumatology Unit, First Department of Propaedeutic Internal Medicine, Laikon Hospital, and Joint Academic Rheumatology Programme, National Kapodistrian University of Athens Medical School; A.D. Protogerou, PhD, Rheumatology Unit, First Department of Propaedeutic Internal Medicine, Laikon Hospital, and Joint Academic Rheumatology Programme, National Kapodistrian University of Athens Medical School; G. Konstantonis, MSc, Rheumatology Unit, First Department of Propaedeutic Internal Medicine, Laikon Hospital, and Joint Academic Rheumatology Programme, National Kapodistrian University of Athens Medical School; M. Konsta, MD, Rheumatology Unit, First Department of Propaedeutic Internal Medicine, Laikon Hospital, and Joint Academic Rheumatology Programme, National Kapodistrian University of Athens Medical School; E.M. Delicha, PhD, Rheumatology Unit, First Department of Propaedeutic Internal Medicine, Laikon Hospital, and Joint Academic Rheumatology Programme, National Kapodistrian University of Athens Medical School; G.D. Kitas, Professor, Rheumatology Unit, First Department of Propaedeutic Internal Medicine, Laikon Hospital, and Joint Academic Rheumatology Programme, National Kapodistrian University of Athens Medical School; P.P. Sfikakis, Professor, Rheumatology Unit, First Department of Propaedeutic Internal Medicine, Laikon Hospital, and Joint Academic Rheumatology Programme, National Kapodistrian University of Athens Medical School
| | - George D Kitas
- From the Rheumatology Unit, First Department of Propaedeutic Internal Medicine, Laikon Hospital; Joint Academic Rheumatology Programme, National Kapodistrian University of Athens Medical School, Athens, Greece.A. Arida, MSc, Rheumatology Unit, First Department of Propaedeutic Internal Medicine, Laikon Hospital, and Joint Academic Rheumatology Programme, National Kapodistrian University of Athens Medical School; A.D. Protogerou, PhD, Rheumatology Unit, First Department of Propaedeutic Internal Medicine, Laikon Hospital, and Joint Academic Rheumatology Programme, National Kapodistrian University of Athens Medical School; G. Konstantonis, MSc, Rheumatology Unit, First Department of Propaedeutic Internal Medicine, Laikon Hospital, and Joint Academic Rheumatology Programme, National Kapodistrian University of Athens Medical School; M. Konsta, MD, Rheumatology Unit, First Department of Propaedeutic Internal Medicine, Laikon Hospital, and Joint Academic Rheumatology Programme, National Kapodistrian University of Athens Medical School; E.M. Delicha, PhD, Rheumatology Unit, First Department of Propaedeutic Internal Medicine, Laikon Hospital, and Joint Academic Rheumatology Programme, National Kapodistrian University of Athens Medical School; G.D. Kitas, Professor, Rheumatology Unit, First Department of Propaedeutic Internal Medicine, Laikon Hospital, and Joint Academic Rheumatology Programme, National Kapodistrian University of Athens Medical School; P.P. Sfikakis, Professor, Rheumatology Unit, First Department of Propaedeutic Internal Medicine, Laikon Hospital, and Joint Academic Rheumatology Programme, National Kapodistrian University of Athens Medical School
| | - Petros P Sfikakis
- From the Rheumatology Unit, First Department of Propaedeutic Internal Medicine, Laikon Hospital; Joint Academic Rheumatology Programme, National Kapodistrian University of Athens Medical School, Athens, Greece.A. Arida, MSc, Rheumatology Unit, First Department of Propaedeutic Internal Medicine, Laikon Hospital, and Joint Academic Rheumatology Programme, National Kapodistrian University of Athens Medical School; A.D. Protogerou, PhD, Rheumatology Unit, First Department of Propaedeutic Internal Medicine, Laikon Hospital, and Joint Academic Rheumatology Programme, National Kapodistrian University of Athens Medical School; G. Konstantonis, MSc, Rheumatology Unit, First Department of Propaedeutic Internal Medicine, Laikon Hospital, and Joint Academic Rheumatology Programme, National Kapodistrian University of Athens Medical School; M. Konsta, MD, Rheumatology Unit, First Department of Propaedeutic Internal Medicine, Laikon Hospital, and Joint Academic Rheumatology Programme, National Kapodistrian University of Athens Medical School; E.M. Delicha, PhD, Rheumatology Unit, First Department of Propaedeutic Internal Medicine, Laikon Hospital, and Joint Academic Rheumatology Programme, National Kapodistrian University of Athens Medical School; G.D. Kitas, Professor, Rheumatology Unit, First Department of Propaedeutic Internal Medicine, Laikon Hospital, and Joint Academic Rheumatology Programme, National Kapodistrian University of Athens Medical School; P.P. Sfikakis, Professor, Rheumatology Unit, First Department of Propaedeutic Internal Medicine, Laikon Hospital, and Joint Academic Rheumatology Programme, National Kapodistrian University of Athens Medical School.
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Sharma SK, Prasad K, Handa R, Sharma SK. Increased prevalence of subclinical atherosclerosis in ankylosing spondylitis. INDIAN JOURNAL OF RHEUMATOLOGY 2015. [DOI: 10.1016/j.injr.2015.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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TOUSSIROT ÉRIC, DUMOULIN GILLES. Effects of TNF-α Inhibitors on Abdominal Adiposity in Patients with Inflammatory Rheumatic Diseases. J Rheumatol 2014; 41:2491. [DOI: 10.3899/jrheum.140912] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Tam LS, Kitas GD, González-Gay MA. Can suppression of inflammation by anti-TNF prevent progression of subclinical atherosclerosis in inflammatory arthritis? Rheumatology (Oxford) 2014; 53:1108-19. [PMID: 24501245 DOI: 10.1093/rheumatology/ket454] [Citation(s) in RCA: 86] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE It remains a matter of debate whether TNF-a antagonists have favourable effects on the cardiovascular (CV) system. This systematic review evaluates the effect of TNF-a blockers on the progression of subclinical atherosclerosis and arterial stiffness in patients with inflammatory arthritis. METHODS A search of the MEDLINE and Web of Knowledge databases was conducted to identify studies into the effect of TNF-a antagonists on subclinical atherosclerosis and arterial stiffness in patients with RA, AS and PsA. Carotid intimamedia thickness (cIMT) was used to assess subclinical atherosclerosis. Two methods were used to assess arterial stiffness: pulse wave velocity (PWV) and aortic augmentation index (AIx). Twenty-three studies matching the search criteria were included for analysis. RESULTS TNF-a blockers probably are effective in preventing (7/13 studies) or even reversing (5/13 studies) the progression of IMT in patients with RA, AS and PsA who are responding to treatment. With regard to arterial stiffness, PWV was either significantly reduced (7/13 studies) or remained unchanged (6/13 studies) following TNF-a antagonist treatment. Nonetheless, most studies in RA (7/10) reported significant improvement of PWV. AIx remained unchanged in 10 of 13 studies. CONCLUSION The balance of evidence suggests that TNF-a antagonists may have a beneficial effect on preventing the progression of subclinical atherosclerosis and arterial stiffness. It remains unknown whether this effect is specific to TNF-a antagonists or relates to better control of inflammation irrespective of the disease modification strategy by which this is achieved.
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Hmamouchi I, Roux C, Paternotte S, Kolta S, Dougados M, Briot K. Early Increase of Abdominal Adiposity in Patients with Spondyloarthritis Receiving Anti-tumor Necrosis Factor-α Treatment. J Rheumatol 2014; 41:1112-7. [DOI: 10.3899/jrheum.131150] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Objective.Patients with spondyloarthritis (SpA) receiving anti-TNF-α treatment have an increase in fat mass. This may be relevant to cardiovascular risk. The aim of this study was to estimate visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) changes by dual-energy x-ray absorptiometry (DEXA) in patients with SpA under anti-TNF-α therapy.Methods.We used an ancillary protocol to an open, prospective 2-year followup study of patients with SpA. Waist circumference (WC), body weight, body mass index, VAT, and SAT were measured at baseline, 6 months, and 1 and 2 years. Univariate and multivariate analyses were performed to assess variables associated with VAT and SAT changes.Results.A total of 85 patients were analyzed. Patients were 39.3 ± 11.4 years old and mean baseline Bath Ankylosing Spondylitis Disease Activity Index was 55.0 ± 20.2. Treatment was effective according to clinical and biological variables, and body weight increased by 0.9 ± 1.7 kg over 2 years. There was a significant gain in VAT after 6 months (13.7 ± 20.6 cm2, p < 0.0001), 1 year (21.0 ± 26.6 cm2, p < 0.0001), and after 2 years (29.1 ± 33.4 cm2, p < 0.0001); and in SAT after 6 months (12.5 ± 27.4 cm2, p < 0.0001), 1 year (27.1 ± 38.2 cm2, p < 0.0001), and after 2 years (31.9 ± 53.2 cm2, p < 0.0001). We could not find any determinant of these changes by multivariate analysis.Conclusion.In patients with SpA receiving anti-TNF-α therapy, there is an early significant increase in abdominal obesity with significant increase in both VAT and SAT after 1 and 2 years of treatment. Prospective studies are required to investigate the relationship between these changes and cardiovascular risk.
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Carotid intima media thickness as a marker of atherosclerosis in ankylosing spondylitis. Int J Rheumatol 2014; 2014:839135. [PMID: 24803936 PMCID: PMC3997910 DOI: 10.1155/2014/839135] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Revised: 03/13/2014] [Accepted: 03/13/2014] [Indexed: 11/17/2022] Open
Abstract
Aim. Increased cardiovascular morbidity and mortality have been observed in ankylosing spondylitis because of accelerated atherosclerosis. We measured carotid intima media thickness (CIMT) as a surrogate marker of atherosclerosis in this study. Methods. In this study 37 cases of AS and the same number of matched individuals were recruited. CIMT measurements were done using B-mode ultrasound. Disease activity was assessed using Bath ankylosing spondylitis disease activity index (BASDAI), Bath ankylosing spondylitis functional index (BASFI), and Bath ankylosing spondylitis metrological index (BASMI) scores and C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) levels. Results. Mean age of the study groups was 29.43 ± 9.00 years. Average disease duration was 65.62 ± 54.92 months. Twenty-eight (75.68%) of cases were HLA B-27 positive. A significantly increased CIMT was observed in cases as compared to control group (0.62 ± 0.12 versus 0.54 ± 0.04; P < 0.001). CIMT in the cases group positively correlated with age (r = 0.357; P < 0.05), duration of disease (r = 0.549; P < 0.01), and BASMI (r = 0.337; P < 0.05) and negatively correlated with ESR (r = -0.295; P < 0.05). Conclusions. Patients of AS had a higher CIMT than those of the control group. CIMT correlated with disease chronicity.
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Epicardial adipose tissue thickness in patients with ankylosing spondylitis. Clin Rheumatol 2014; 34:295-9. [DOI: 10.1007/s10067-014-2568-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Revised: 02/26/2014] [Accepted: 02/28/2014] [Indexed: 11/26/2022]
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Abella V, Scotece M, Conde J, López V, Lazzaro V, Pino J, Gómez-Reino JJ, Gualillo O. Adipokines, metabolic syndrome and rheumatic diseases. J Immunol Res 2014; 2014:343746. [PMID: 24741591 PMCID: PMC3987880 DOI: 10.1155/2014/343746] [Citation(s) in RCA: 103] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Revised: 01/10/2014] [Accepted: 01/10/2014] [Indexed: 02/06/2023] Open
Abstract
The metabolic syndrome (MetS) is a cluster of cardiometabolic disorders that result from the increasing prevalence of obesity. The major components of MetS include insulin resistance, central obesity, dyslipidemia, and hypertension. MetS identifies the central obesity with increased risk for cardiovascular diseases (CVDs) and type-2 diabetes mellitus (T2DM). Patients with rheumatic diseases, such as rheumatoid arthritis, osteoarthritis, systemic lupus erythematosus, and ankylosing spondylitis, have increased prevalence of CVDs. Moreover, CVD risk is increased when obesity is present in these patients. However, traditional cardiovascular risk factors do not completely explain the enhanced cardiovascular risk in this population. Thus, MetS and the altered secretion patterns of proinflammatory adipokines present in obesity could be the link between CVDs and rheumatic diseases. Furthermore, adipokines have been linked to the pathogenesis of MetS and its comorbidities through their effects on vascular function and inflammation. In the present paper, we review recent evidence of the role played by adipokines in the modulation of MetS in the general population, and in patients with rheumatic diseases.
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Affiliation(s)
- Vanessa Abella
- SERGAS, Research Laboratory 9, NEIRID Lab (Neuroendocrine Interactions in Rheumatology and Inflammatory Diseases), Institute of Medical Research (IDIS), Santiago University Clinical Hospital, 15706 Santiago de Compostela, Spain ; Department of Molecular and Cellular Biology, University of Coruña (UDC), 15071 A Coruña, Spain
| | - Morena Scotece
- SERGAS, Research Laboratory 9, NEIRID Lab (Neuroendocrine Interactions in Rheumatology and Inflammatory Diseases), Institute of Medical Research (IDIS), Santiago University Clinical Hospital, 15706 Santiago de Compostela, Spain
| | - Javier Conde
- SERGAS, Research Laboratory 9, NEIRID Lab (Neuroendocrine Interactions in Rheumatology and Inflammatory Diseases), Institute of Medical Research (IDIS), Santiago University Clinical Hospital, 15706 Santiago de Compostela, Spain
| | - Verónica López
- SERGAS, Research Laboratory 9, NEIRID Lab (Neuroendocrine Interactions in Rheumatology and Inflammatory Diseases), Institute of Medical Research (IDIS), Santiago University Clinical Hospital, 15706 Santiago de Compostela, Spain
| | - Verónica Lazzaro
- SERGAS, Research Laboratory 9, NEIRID Lab (Neuroendocrine Interactions in Rheumatology and Inflammatory Diseases), Institute of Medical Research (IDIS), Santiago University Clinical Hospital, 15706 Santiago de Compostela, Spain ; University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy
| | - Jesús Pino
- SERGAS, Division of Orthopaedics Surgery and Traumatology, Santiago University Clinical Hospital, 15706 Santiago de Compostela, Spain
| | - Juan J Gómez-Reino
- SERGAS, Research Laboratory 9, NEIRID Lab (Neuroendocrine Interactions in Rheumatology and Inflammatory Diseases), Institute of Medical Research (IDIS), Santiago University Clinical Hospital, 15706 Santiago de Compostela, Spain
| | - Oreste Gualillo
- SERGAS, Research Laboratory 9, NEIRID Lab (Neuroendocrine Interactions in Rheumatology and Inflammatory Diseases), Institute of Medical Research (IDIS), Santiago University Clinical Hospital, 15706 Santiago de Compostela, Spain
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Tam LS, Shang Q, Kun EW, Lee KL, Yip ML, Li M, Li TK, Zhu TY, Pui MO, Li EK, Yu CM. The effects of golimumab on subclinical atherosclerosis and arterial stiffness in ankylosing spondylitis--a randomized, placebo-controlled pilot trial. Rheumatology (Oxford) 2014; 53:1065-74. [DOI: 10.1093/rheumatology/ket469] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
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Ercan S, Goktepe F, Kisacik B, Pehlivan Y, Onat AM, Yavuz F, Alici H, Davutoğlu V. Subclinical cardiovascular target organ damage manifestations of ankylosing spondylitis in young adult patients. Mod Rheumatol 2014. [DOI: 10.3109/s10165-012-0791-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Hussein DA, Farouk HM, Mobasher SA, El-Azizi NO, Thabet RN, Elia RZ. Atherosclerosis in Egyptian patients with ankylosing spondylitis. EGYPTIAN RHEUMATOLOGY AND REHABILITATION 2014. [DOI: 10.4103/1110-161x.128127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Mattar Valente RL, Mattar Valente J, Werner de Castro GR, Fontes Zimmermann A, de Magalhães Souza Fialho SC, Alves Pereira I. Aterosclerose subclínica em pacientes com espondilite anquilosante: há um papel para a inflamação? REVISTA BRASILEIRA DE REUMATOLOGIA 2013. [DOI: 10.1590/s0482-50042013000500002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
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Ankylosing Spondylitis: Chinese Perspective, Clinical Phenotypes, and Associated Extra-articular Systemic Features. Curr Rheumatol Rep 2013; 15:344. [DOI: 10.1007/s11926-013-0344-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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de Moraes MT, de Souza FHC, de Barros TBM, Shinjo SK. Analysis of Metabolic Syndrome in Adult Dermatomyositis With a Focus on Cardiovascular Disease. Arthritis Care Res (Hoboken) 2013; 65:793-9. [DOI: 10.1002/acr.21879] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2012] [Accepted: 10/05/2012] [Indexed: 11/06/2022]
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Peluso R, Di Minno MND, Iervolino S, Manguso F, Tramontano G, Ambrosino P, Esposito C, Scalera A, Castiglione F, Scarpa R. Enteropathic spondyloarthritis: from diagnosis to treatment. Clin Dev Immunol 2013; 2013:631408. [PMID: 23690825 PMCID: PMC3649644 DOI: 10.1155/2013/631408] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2012] [Accepted: 03/25/2013] [Indexed: 02/08/2023]
Abstract
Enteropathic arthritis (EA) is a spondyloarthritis (SpA) which occurs in patients with inflammatory bowel diseases (IBDs) and other gastrointestinal diseases. Diagnosis is generally established on the medical history and physical examination. It was, generally, made according to the European Spondyloarthropathy Study Group (ESSG) criteria. Rheumatic manifestations are the most frequent extraintestinal findings of IBD with a prevalence between 17% and 39%, and IBD is associated, less frequently, with other rheumatic disease such as rheumatoid arthritis, Sjogren syndrome, Takayasu arteritis, and fibromyalgia. Although the pathogenesis of EA has not been plainly clarified, the most popular theory supposes that joint inflammation occurs in genetically predisposed subjects with bacterial gut infections, provided an important evidence for a possible relationship between inflammation of the gut mucosa and arthritis. The management of patients with EA requires an active cooperation between the gastroenterologist and rheumatologist.
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Affiliation(s)
- Rosario Peluso
- Rheumatology Research Unit, University Federico II, 80131 Naples, Italy.
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Atherosclerosis in male patients with ankylosing spondylitis: the relation with methylenetetrahydrofolate reductase (C677T) gene polymorphism and plasma homocysteine levels. Rheumatol Int 2012; 33:1519-24. [DOI: 10.1007/s00296-012-2552-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2012] [Accepted: 10/21/2012] [Indexed: 10/27/2022]
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