Insulin resistance as a risk factor for subclinical atherosclerosis in rheumatoid arthritis

Sayed, Adel Mahmoud El; Bakry, Samah A. El; Mobasher, Sameh; Rahman, Rehab Abd El; Abo-Shady, Rania A.; Abaza, Nouran

doi:10.1016/j.ejr.2013.08.003

Cited by 11 publications

(4 citation statements)

References 34 publications

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“…The role of duplex scanning in the investigation of carotid artery disease is well established, and there is evidence to suggest that it has a predictive role in identifying those patients with a greater than normal risk of stroke [5]. The study of the IMT in other rheumatic diseases on Egyptian patients showed subclinical atherosclerosis in rheumatoid arthritis [9], systemic lupus erythematosus [10], Behc¸ets disease [11] and primary osteoarthritis [12].…”

Section: Introductionmentioning

confidence: 97%

Subclinical atherosclerosis and peripheral vascular disease in systemic sclerosis patients: Relation to potential risk factors

Farag

Serougy

Metawee

et al. 2015

The Egyptian Rheumatologist

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Aim of the work: To measure the extent of subclinical atherosclerosis in patients with systemic sclerosis, and to evaluate any potential vascular risk factors in these patients.Patients and methods: This study included 30 patients with systemic sclerosis diagnosed according to the American college of rheumatology criteria and 20 healthy individuals were also included as a control group. Non-invasive vascular tests including; carotid duplex scanning measuring common carotid arteries (CCA) intima-media thickness (IMT), and ankle brachial pressure index (ABPI) were performed. Traditional vascular risk factors such as blood pressure, blood sugar, lipid profiles, steroid usage and other immunosuppressive medications were assessed.Results: The mean IMT of CCA was higher in systemic sclerosis patients (right 0.67 ± 0.11 mm, left 0.67 ± 0.12 mm) when compared with the control group (right 0.48 ± 0.2 mm, left 0.54 ± 0.13 mm) (p < 0.001). Carotid plaques were found in 4 SSc patients. Mean IMT was correlated with patients' age (p < 0.001), disease duration (p < 0.001), systolic blood pressure (p < 0.05), and dyslipidemia (p < 0.01). Ankle brachial pressure index (ABPI) was significantly lower in SSc patients (0.94 ± 0.13) when compared with controls (1.16 ± 0.12) (p < 0.001). No difference was found between limited (n = 25) and diffuse (n = 5) disease subtypes in mean IMT, nor in mean ABPI. There was no significant correlation between mean IMT and steroid dose or other immunosuppressive intake.Conclusion: There is an increased risk of subclinical atherosclerosis and peripheral arterial disease in SSc patients. Increased systolic blood pressure, dyslipidemia, long disease duration and older age were possible risk factors.

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Section: Introductionmentioning

confidence: 97%

Subclinical atherosclerosis and peripheral vascular disease in systemic sclerosis patients: Relation to potential risk factors

Farag

Serougy

Metawee

et al. 2015

The Egyptian Rheumatologist

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“…The IMT has been found to be increased in many rheumatic diseases such as rheumatoid arthritis [10], SLE [11,12], Behcets disease [13] and osteoarthritis [14]. Together with classical conventional risk factors, other mechanisms (disease-specific factors) promote accelerated atherosclerosis in SLE.…”

Section: Introductionmentioning

confidence: 98%

Intima-media thickness in secondary anti-phospholipid syndrome patients: Impact of disease activity

Raafat

Fawzy

Fishawy

2015

The Egyptian Rheumatologist

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Aim of the work: To assess the carotid intima-media thickness (IMT) and plaque formation in systemic lupus erythematosus (SLE) patients with and without antiphospholipid syndrome (APS) by doppler ultrasonography and to correlate it with the clinical features, disease activity and damage.Patients and methods: Thirty-six female SLE patients with secondary APS and another 36 without were included. Thirty-six matching healthy volunteers were included as control. In patients, the disease activity and damage were assessed using the SLE Disease Activity Index (SLEDAI) and Systemic Lupus International Collaborating Clinics (SLICC) index, respectively. Doppler ultrasound was carried out for patients and control and the IMT was measured.Results: The demographic and clinical characteristics of patients are presented. The disease activity was significantly higher in SLE patients with APS (19.7 ± 7.9) compared to SLE only patients (15.1 ± 9.2) (p = 0.03). The low density lipoprotein (LDL) was significantly increased in APS patients (p = 0.04). The IMT was comparable between both groups (0.83 ± 0.15 mm) vs (0.86 ± 0.2 mm) (p = 0.55) and both were significantly increased compared to the control (0.61 ± 0.11 mm) (p < 0.0001). The dyslipidemia present in the patients showed a significant difference in the measured lipid profile parameters (p < 0.0001). The IMT significantly correlated with the SLEDAI in both groups (p < 0.002 and <0.001 respectively).Conclusion: The increased IMT as a marker of atherosclerosis is confirmed in SLE patients with no obvious difference in those with secondary APS. The link between the increased IMT and disease activity favors the role of disease-specific potential risk factors, in addition to the traditional conventional ones, in the development of atherosclerosis.

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“…High-resolution ultrasound is a non-invasive and practical method to examine peripheral arteries and carotid lesions, including increased intima-media thickness and atherosclerotic plaques [9]. The studies of the IMT in Egyptian patients with other rheumatic diseases documented subclinical atherosclerosis in rheumatoid arthritis [10], systemic lupus erythematosus [11], and primary osteoarthritis [12].…”

Section: Introductionmentioning

confidence: 99%

Study of MRI brain findings and carotid US features in systemic sclerosis patients, relationship with disease parameters

et al. 2019

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Background/objectives Systemic sclerosis (SSc) is an autoimmune disease associated with immune abnormalities and widespread vascular lesions, including increased intimal and medial thickness. These changes may be reflected in early atherosclerosis and cardiovascular risks. We aimed in this study to examine the carotid artery intima-media thickness and MRI brain findings in SSc patients and compared them to a group of normal controls. A relationship between these parameters and clinical measures in SSc was also sought. Methods Seventy-two SSc patients with no central nervous system (CNS) symptoms and 42 healthy controls were included. Clinical and laboratory measures, Medsger’s severity scale, and Doppler ultrasound common carotid artery intima-media thickness (CCA-IMT) were measured. Brain fluid-attenuated inversion recovery (FLAIR)-MRI and diffusion-weighted MRI (DWI) were also done. Results SSc patients had more CCA-IMT, higher CRP, and more brain MRI hyperintense lesions than controls ( P < 0.05). Significant positive correlations existed between CCA-IMT and Medsger vascular ( r = 0.7, P = 0.02). The FLAIR-MRI showed multiple hyperintense lesions in 24 patients (33%), ranging 0–36 lesions. SSc patients with more lesions (positive MRI) had longer disease duration ( P = 0.001) and left and right carotid artery atheromata ( P = 0.001, and 0.013, respectively) than SSc patients with negative MRIs; Medsger vascular score did not separate the SSc groups ( P = 0.08). Conclusions In systemic sclerosis patients without central nervous system symptoms, MRI lesion numbers correlated with CCA-IMT. MRI abnormalities were found more frequently if CRP was elevated, if the Medsger SSc Severity Scale was increased, or if there was thickened carotid IMT.

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Insulin resistance as a risk factor for subclinical atherosclerosis in rheumatoid arthritis

Cited by 11 publications

References 34 publications

Subclinical atherosclerosis and peripheral vascular disease in systemic sclerosis patients: Relation to potential risk factors

Subclinical atherosclerosis and peripheral vascular disease in systemic sclerosis patients: Relation to potential risk factors

Intima-media thickness in secondary anti-phospholipid syndrome patients: Impact of disease activity

Study of MRI brain findings and carotid US features in systemic sclerosis patients, relationship with disease parameters

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