Carotid intima-media thickness and paraoxonase activity in patients with ankylosing spondylitis

Abstract

Purpose: e risk of atherosclerosis is increased in several rheumatological disorders, but any such risk remains unproven for ankylosing spondylitis. Since carotid intima-media thickness is an indicator of early atherosclerosis, and the paraoxonase (PON1) enzyme has antioxidant activity to prevent LDL oxidation, we aimed to identify: 1) the relationship between carotid intima-media thickness (CIMT) and serum paraoxonase (PON1) activity in ankylosing spondylitis (AS) patients; and 2) the possible di erences in CIMT in AS patients versus age-matched, healthy controls.Methods: Forty-ve AS patients (36.8±9.8 years, 36 males, 9 females) and 30 controls (35.9±10.2 years, 23 males, 7 females) were recruited consecutively. Serum PON1 activity and CIMT were measured. e Bath Ankylosing Spondylitis Metrology Index (BASMI), Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Radiologic Index (BASRI) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) were used to identify relationships between these clinical indices and levels of CIMT and PON1.Results: Mean CIMT was signi cantly increased in AS patients relative to controls (0.49±0.06 mm vs. 0.59±0.07 mm; p < 0.0001). Conversely, serum PON1 activity was decreased (199.1±60.3 U/L vs. 96.7±29 U/L; p < 0.0001). PON1 activity was negatively correlated with CIMT (r = -0.557, p = 0.0001). Disease duration was positively correlated with CIMT (r = 0.542, p = 0.0001) and negatively correlated with PON1 (r = -0.649, p = 0.0001). On multivariate analysis, disease duration and serum PON1 activity were found to be independent predictors of CIMT (R 2 = 0.687, p = 0.0001). Conclusions:In conclusion, signi cantly increased CIMT and decreased PON1 activity suggest a relationship between atherosclerosis and AS: a relationship that is strongly correlated with disease duration.

Evaluation of Atrial Conduction Times, Epicardial Fat Thickness and Carotid Intima-Media Thickness in Patients With Ankylosing Spondylitis

“…35 Nakanishi et al 36 used computed tomography to measure EFT levels and reported that patients with high levels had more coronary artery calcification. In studies by Cece et al 12 and Resorlu et al, 37 CIMT values in AS patients were found to be higher than those of the control group. In our study, AS patients had increased EFT thickness with high CIMT values.…”

“…All participants were selected from the Departments of Physical Medicine and Rehabilitation and Cardiology of Abant Izzet Baysal University. They were diagnosed as AS on the basis of Assessment of SpondyloArthritis International Society criteria 5,12 between December 2014 and April 2015. This study was approved by our Institutional Ethics Committee.…”

“…14 However, there appears to be no clear data in terms of atherosclerosis development related to EFT. 12,15 Accordingly, in this study, we aimed to determine the relationship between atrial EMD, CIMT, and EFT in AS, which has a complicated inflammatory nature.…”

“…11 Due to its easy application and non-invasive nature, carotid intima-media thickness (CIMT) is widely used with the aim of identifying subclinical atherosclerosis. 12 Epicardial fat thickness (EFT), forming as a result of visceral fat tissue accumulating around the heart, is a new cardiometabolic risk predictor. 13 In close contact with the myocardium, EFT works like a type of endocrine organ.…”

Moyamoya disease associated with ankylosing spondylitis in a 9-year-old child: a case report

“…Lange U et al had found that, AS patients' blood inflammatory markers were much higher compared with patients without AS, such as interleukin 6, tumor necrosis factor alpha, and Creactive protein [9]. In addition, in other literatures, AS patients were more likely to associated with early features of atherosclerosis, such as the thickness of intima media of the carotid arteries increased and flow-mediated dilatation of the brachial arteries impaired [10,11]. Therefore, the atherogenesis and plaque formation caused by systemic inflammation may be the reason for higher risk of ischemic stroke in the AS patients.…”