Sistemik lupus eritematozuslu hastalarda ateroskleroz ve ilişkili faktörlerin değerlendirilmesi
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Tarih
2010
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Yayıncı
Trakya Üniversitesi Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Çalışmamızda, öncelikle Sistemik lupus eritematozus tanısı ile izlenen hastaların genel özelliklerini, organ ve sistem tutulumlarını, ilaç kullanımını, kardiyovasküler risk faktörlerini saptamayı amaçladık. Bununla birlikte kronik inflamasyona maruz kalan bu hasta grubunda ateroskleroz ile inflamasyon arasındaki ilişkiyi tespit etmek için önemli inflamasyon ve ateroskleroz parametreleri olan migrasyon inhibe edici faktör, LIGHT, endotelyal lipaz'ın değerlendirilmesi amaçlandı. Subklinik aterosklerozun değerlendirilmesi amacı ile karotis arter intima-media kalınlığının ultrasonografi ile değerlendirilmesi amaçlandı. Trakya Üniversitesi Tıp Fakültesi, İç Hastalıkları Anabilim Dalı, Romatoloji Bilim Dalı'ında yürütülen çalışmaya, Sistemik lupus eritematozus tanısı ile izlenen 87 hasta ve kontrol grubu olarak 84 sağlıklı birey alındı. Sistemik lupus eritematozuslu hastaların klinik özellikleri, poliklinik kontrolleri sırasında değerlendirilen lipid düzeyleri ve insülin direncine ilişkin veriler kaydedildi. Tüm hastalarda ve kontrol grubunda enzyme-linked immunosorbent assay yöntemi ile migrasyon inhibe edici faktör, LIGHT ve endotelyal lipaz düzeyleri bakıldı. Tüm hastalara ve kontrol grubundan 30 bireye karotis arter intima-media kalınlık değerlendirilmesi yapıldı ve Framingham risk skorları değerlendirildi. Çalışmamızda Sistemik lupus eritematozuslu olgularımızda Framingham 10 yıllık kardiyovasküler risk skoru ortalama %2,67 bulundu. Hastalarımızda subklinik ateroskleroz sıklığını ise %12,6 olarak saptadık. Karotis intima-media kalınlığı ile Framingham risk skoru ve faktörleri arasında anlamlı ilişki bulunmadı. Aynı şekilde subklinik ateroskleroz ile hastalık genel özellikleri arasında ilişki saptanmadı. Antifosfolipid antikor pozitifliği ile subklinik ateroskleroz arasında anlamlı ilişki gözlendi (p<0001). Tedavi parametrelerinde steroid, siklofosfamid ve antimalaryal ilaçlar ile karotis intima-media kalınlığı arasında ilişki gözlenmez iken, azatiopirin ile karotis intima-media kalınlığı arasında ilişki gözlendi (p=0,05). Bunun yanında, hasta ve kontrol grupları arasında migrasyon inhibe edici faktör, LIGHT ve endotelyal lipaz değerlendirilmesi ile karotis intima-media kalınlığı arasında anlamlı farklılık gözlenmedi.
Abstract
In our study, we first aimed to evaluate the general features, organ and system involvements, drug usage and cardiovascular risk factors in patients with Systemic Lupus Erythematosus. Moreover, in such a group of patients who are exposed to chronic inflammation, we aimed to evaluate certain important markers of inflammation and atherosclerosis, migrasyon inhibiting factor, LIGHT and endothelial lipase to assess the relation between atherosclerosis and inflammation. To determine the subclinical atherosclerosis, we aimed to evaluate the carotid artery intima-media thickness with ultrasonography. Eighty-seven patients with the diagnosis of Systemic Lupus Erythematosus who are followed up by the Division of Rheumatology of the Department of Internal Medicine, Trakya University Faculty of Medicine and 84 healthy controls were enrolled in the study. The clinical features, lipid profiles and data regarding the insulin resistance from their medical files were recorded. Serum values of migration inhibiting factor, LIGHT and endothelial lipase were evaluated in all patients and controls by enzyme-linked immunosorbent assay method. Carotid artery intima-media thickness was evaluated in all patients and 30 of the healthy controls as well as their Framingham cardiovascular risk scores were calculated. The mean ten years? Framingham cardiovascular risk score was calculated as 2,67%. The frequency of subclinical atherosclerosis was observed to be 12,6%. No relation was observed between the Framingham risk scores and factors with carotid intima-media thickness. Likewise, the general features of the patients were observed to be non-related with subclinical atherosclerosis. Antiphospholipid antibody positivity was related with subclinical atherosclerosis (p<0,001). As treatment parameters, use of steroids, cyclophosphomide and antimalarials were observed to be non-related with carotid intima-media thickness while azathiopurine use was related with carotid intima-media thickness (p=0,05). Moreover, no significant relation was found within patient and control groups regarding carotid intimamedia thickness and serum values of migration inhibiting factor, LIGHT and endothelial lipase.
Abstract
In our study, we first aimed to evaluate the general features, organ and system involvements, drug usage and cardiovascular risk factors in patients with Systemic Lupus Erythematosus. Moreover, in such a group of patients who are exposed to chronic inflammation, we aimed to evaluate certain important markers of inflammation and atherosclerosis, migrasyon inhibiting factor, LIGHT and endothelial lipase to assess the relation between atherosclerosis and inflammation. To determine the subclinical atherosclerosis, we aimed to evaluate the carotid artery intima-media thickness with ultrasonography. Eighty-seven patients with the diagnosis of Systemic Lupus Erythematosus who are followed up by the Division of Rheumatology of the Department of Internal Medicine, Trakya University Faculty of Medicine and 84 healthy controls were enrolled in the study. The clinical features, lipid profiles and data regarding the insulin resistance from their medical files were recorded. Serum values of migration inhibiting factor, LIGHT and endothelial lipase were evaluated in all patients and controls by enzyme-linked immunosorbent assay method. Carotid artery intima-media thickness was evaluated in all patients and 30 of the healthy controls as well as their Framingham cardiovascular risk scores were calculated. The mean ten years? Framingham cardiovascular risk score was calculated as 2,67%. The frequency of subclinical atherosclerosis was observed to be 12,6%. No relation was observed between the Framingham risk scores and factors with carotid intima-media thickness. Likewise, the general features of the patients were observed to be non-related with subclinical atherosclerosis. Antiphospholipid antibody positivity was related with subclinical atherosclerosis (p<0,001). As treatment parameters, use of steroids, cyclophosphomide and antimalarials were observed to be non-related with carotid intima-media thickness while azathiopurine use was related with carotid intima-media thickness (p=0,05). Moreover, no significant relation was found within patient and control groups regarding carotid intimamedia thickness and serum values of migration inhibiting factor, LIGHT and endothelial lipase.
Açıklama
Tıpta Uzmanlık Tezi
Anahtar Kelimeler
Romatoloji, Rheumatology, Hastalıklar, İç Hastalıkları, Sistemik Lupus Eritematozus, Ateroskleroz, Migrasyon İnhibe Edici Faktör, Systemic Lupus Erythematosus
