Session Information
Date: Wednesday, October 24, 2018
Title: 6W025 ACR Abstract: Vasculitis–Non-ANCA-Assocd & Rel D/Os III: Clinical Subtype & Outcome(2988–2993)
Session Type: ACR Concurrent Abstract Session
Session Time: 11:00AM-12:30PM
Background/Purpose: Behçet’s Syndrome (BS) is a vasculitic process which is characterized by recurrent oral and genital aphthous ulcerations, ocular, vascular, neurological, and gastrointestinal involvement . Although the exact pathogenic mechanism for vascular lesions in BS patients is still unclear, endothelial dysfunction may be important in the development of these lesions . Endothelial dysfunction is accepted as the initial lesion in atherogenesis and recent studies have shown that the increase in carotid intima media thickness (cIMT) is significantly associated with endothelial dysfunction. In this study, it was aimed to determine the frequency of subclinical atherosclerosis (ATS) according to vascular involvement in BS patients.
Methods: A hundred patients with BS and 30 healthy controls (HC) were included in this study. Participants with a history of cardiovascular (CV) events, type 1 or 2 diabetes mellitus, chronic kidney disease, and malignancy were excluded. Bilateral cIMTs were evaluated by using B-mode ultrasonography (US) in BS patients and compared with those in controls. Subclinical atherosclerosis was defined by CIMT≥0.9 mm or ≥1 carotid plaque which accepted as US positive group.
Results: The demographic characteristics, cardiovascular risk factors and US findings of patients with BS and HC are listed in table 1. cIMT in BS patients was higher compared to HC (0.78±0.21 mm versus 0.69±0.13 mm; p=0.006). Thirty two (32%) BS patients, and two (6,7%) HC had subclinical atherosclerosis (BS versus HC: p=0.006).cIMT in BS patients with vascular involvement was higher than nonvascular group (0.83±0.21 versus 0.75±0.21; p=0.072). Comparison of disease characteristics and traditional CV risk factors of US positive and US negative BS patients are shown in Table 2. In regression analysis, older age and having vascular disease were independently associated with subclinical ATS (Table 3).
Conclusion: This study showed that cIMT measurements were higher in BS patients than HC and also significantly higher in BS patients with vascular group than nonvascular group. Vascular involvement in BS patients is an independent risk factor for the development of ATS. Therefore, BS patients with vascular involvement should be carefully monitored for the development of CV disease.
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Table 1. The demographic characteristics, CV risk factors, and carotid US findings of patients with Behçet’s syndrome and healthy controls
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BS (n=100)
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HC (n=30)
|
p value
|
|
|
Age, years
|
45.9 ± 12.0 |
41.8 ± 12.2 |
0.097
|
|
Female, n. (%) |
62 (62) |
18 (60) |
0.834 |
|
Hypertension, n. (%) |
17 (17) |
7 (23.3) |
0.433 |
|
Ever smoked, n. (%)
|
42 (42) |
10 (33.3) |
0.395 |
|
ESR, mm/hour
|
14.45 ± 12.74 |
10.93 ± 7.33 |
0.152 |
|
CRP, mg/liter
|
7.03 ± 14.39 |
3.40 ± 4.63 |
0.031
|
|
LDL cholesterol*, mg/dl
|
120.7 ± 34.1 |
116.0 ± 22.6 |
0.433 |
|
Low HDL cholesterol*, n. (%)
|
39 (52.7) |
11 (47.8) |
0.683 |
|
Total cholesterol*, mg/dl
|
195.4 ± 42.1 |
184.9 ± 23.8 |
0.137 |
|
Total cholesterol/HDL cholesterol*
|
4.29 ± 1.02 |
3.97 ± 0.88 |
0.176 |
|
Triglicerides >150 mg/dl*, n. (%)
|
25 (33.8) |
4 (16) |
0.091
|
|
Right CIMT |
0.79 ± 0.25 |
0.70 ± 0.14 |
0.011
|
|
Left CIMT |
0.77 ± 0.21 |
0.68 ± 0.14 |
0.029
|
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Mean CIMT |
0.78 ± 0.21 |
0.69 ± 0.13 |
0.006
|
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CIMT ≥ 0.90 mm, no. (%) |
29 (29) |
1 (3.3) |
0.003
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CIMT ≥ 0.90 mm and/or carotid plaque, n. (%)
|
32 (32) |
2 (6.7) |
0.006
|
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Carotis plaques, no. (%)
|
8 (8) |
1 (3.3) |
0.684 |
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*Lipid profile was available for 99 patients
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Table 2. Characteristics of US positive and US negative BS patients
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US positive (n=32)
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US negative (n=68)
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p value
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|
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Age, years
|
53.2 ± 9.6 |
42.5 ± 11.5 |
< 0.001
|
|
Female, no. (%) |
18 (56.3) |
44 (64.7) |
0.416 |
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Disease duration, years
|
14.9 ± 10.9 |
12.9 ± 9.5 |
0.367 |
|
BSAS |
14.8 ± 9.8 |
14.3 ± 9.2 |
0.792 |
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Vascular Behçet disease, no. (%)
|
15 (46.9) |
18 (26.5) |
0.043
|
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Posterior uveitis and retinal vasculitis ever,no. (%)
|
6 (18.8) |
13 (19.1) |
0.965 |
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Major organ involvement, no. (%)
|
20 (62.5) |
28 (41.2) |
0.046
|
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Glucocorticoid usage ever, no. (%)
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10 (34.5) |
28 (39.4) |
0.643 |
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Immunosuppresive theraphy, no. (%)
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14 (43.8) |
25 (36.8) |
0.504 |
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Hypertension, no. (%) |
8 (25) |
9 (13.2) |
0.144 |
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Ever smoked, no. (%)
|
10 (31.3) |
32 (47.1) |
0.135 |
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ESR, mm/hour
|
17.6 ± 18.2 |
13.0 ± 8.9 |
0.177 |
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CRP, mg/liter
|
7.27 ± 12.84 |
6.92 ± 15.15 |
0.912 |
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LDL cholesterol*, mg/dl
|
121.2 ± 34.8 |
120.5 ± 34.1 |
0.934 |
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Low HDL cholesterol*, no. (%)
|
15 (57.7) |
24 (50) |
0.527 |
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Total cholesterol*, mg/dl
|
196.8 ± 36.7 |
194.7 ± 43.7 |
0.836 |
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Total cholesterol/HDL cholesterol*
|
4.5 ± 1.0 |
4.2 ±1.0 |
0.174 |
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Triglicerides >150 mg/dl*, no. (%)
|
10 (38.5) |
15 (31.3) |
0.531 |
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*Lipid profile was available for 99 patients
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Table 3. Multiple logistic regression analysis for the co–factors that affect subclinical atherosclerosis
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Univariate
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Multivariate
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p |
OR |
95% CI |
B |
SE |
p |
OR |
95 % CI |
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Hypertension |
0.150 |
2.185 |
0.754-6.333 |
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Triglyceride |
0.057 |
1.008 |
1.000-1.016 |
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Total cholesterol/HDL
|
0.174 |
1.405 |
0.860-2.295 |
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Major organ involvement
|
0.014 |
3.367 |
1.285-8.827 |
|||||
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ESR |
0.107 |
1.028 |
0.994-1.063 |
0.032 |
0.019 |
0.100 |
2.708 |
0.994-1.072 |
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Age |
< 0.001 |
1.096 |
1.045-1.149 |
0.096 |
0.030 |
0.001
|
1.101
|
1.038-1.167 |
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Vascular Behçet disease
|
0.046 |
2.451 |
1.018-5.902 |
1.125 |
0.610 |
0.040
|
3.491
|
1.056-11.537 |
To cite this abstract in AMA style:
USLU YURTERI E, ÜSTÜNER E, TORGUTALP M, YAYLA ME, OKATAN IE, KELESOGLU DINCER AB, SEZER S, AYDEMIR GULOKSUZ EG, TURGAY TM, KINIKLI G, Ateş A. Vascular Involvement in Behcet’s Syndrome May be Associated with Subclinical Atherosclerosis [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 9). https://acrabstracts.org/abstract/vascular-involvement-in-behcets-syndrome-may-be-associated-with-subclinical-atherosclerosis/. Accessed .« Back to 2018 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/vascular-involvement-in-behcets-syndrome-may-be-associated-with-subclinical-atherosclerosis/