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Increased carotid intima-media thickness in patients with radiographic axial spondyloarthritis compared to controls and associations with markers of inflammation

Law, Lucy ; Lindqvist, Per ; Liv, Per ; Hellman, Urban ; Lejon, Kristina ; Geijer, Mats LU ; Söderberg, Stefan and Forsblad-d’Elia, Helena (2024) In Clinical Rheumatology
Abstract

Objective: There is an increased risk for cardiovascular disease (CVD) in patients with radiographic axial spondyloarthritis (r-axSpA). In this cross-sectional study, we aimed to, overall and stratified by sex, (i) compare ultrasound derived carotid intima media thickness (cIMT), between patients and controls, and (ii) investigate associations between cIMT, clinical disease activity and inflammation-related laboratory markers in patients with r-axSpA. Method: In total, 155 patients diagnosed with r-axSpA using the modified New York criteria and 400 controls were included. Bilateral carotid ultrasound, laboratory testing, and questionaries were acquired. Disease-specific assessments were carried out for patients. Linear regression... (More)

Objective: There is an increased risk for cardiovascular disease (CVD) in patients with radiographic axial spondyloarthritis (r-axSpA). In this cross-sectional study, we aimed to, overall and stratified by sex, (i) compare ultrasound derived carotid intima media thickness (cIMT), between patients and controls, and (ii) investigate associations between cIMT, clinical disease activity and inflammation-related laboratory markers in patients with r-axSpA. Method: In total, 155 patients diagnosed with r-axSpA using the modified New York criteria and 400 controls were included. Bilateral carotid ultrasound, laboratory testing, and questionaries were acquired. Disease-specific assessments were carried out for patients. Linear regression analysis was used to assess associations. Results: Linear regression analyses showed that patients with r-axSpA had increased mean cIMT compared to controls (mean ± SD, 0.8 ± 0.1 mm vs 0.7± 0.1 mm, respectively, unstandardized β (95% CI) -0.076 (-0.10, -0.052), P < 0.001) adjusted for smoking status and age. Linear regression analyses for patients with r-axSpA showed that only males presented significant associations between cIMT and inflammation-related laboratory markers, white blood cell (WBC) count (mean ± SD, 6.8 ± 1.6 109/L) and monocytes (0.6 ± 0.2 109/L); WBC count (unstandardized β (95% CI) 0.019 (0.0065, 0.031), P = 0.003, R2 = 0.57) and monocytes (0.13 (0.0047, 0.26), P = 0.041, R2 = 0.55), adjusted for age, smoking status, body mass index, hypertension, dyslipidemia, diabetes mellitus, ASDAS-CRP, and treatment with DMARDs and glucocorticoids. No significant association was found between cIMT and clinical disease activity assessed by ASDAS-CRP. Conclusion: Patients with r-axSpA had significantly increased cIMT compared to controls. In male patients, higher WBC and monocyte count were associated with an increase in cIMT suggesting the role of inflammation in the development of atherosclerosis. (Table presented.)

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author
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organization
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
Cardiovascular disease (CVD), Carotid intima-media thickness (cIMT), Radiographic axial spondyloarthritis (r-axSpA), Ultrasound
in
Clinical Rheumatology
publisher
Springer
external identifiers
  • pmid:38443604
  • scopus:85186622797
ISSN
0770-3198
DOI
10.1007/s10067-024-06913-8
language
English
LU publication?
yes
id
6d467972-0c76-45e3-a5b2-cf0859b0502a
date added to LUP
2024-03-22 15:17:05
date last changed
2024-04-19 16:25:37
@article{6d467972-0c76-45e3-a5b2-cf0859b0502a,
  abstract     = {{<p>Objective: There is an increased risk for cardiovascular disease (CVD) in patients with radiographic axial spondyloarthritis (r-axSpA). In this cross-sectional study, we aimed to, overall and stratified by sex, (i) compare ultrasound derived carotid intima media thickness (cIMT), between patients and controls, and (ii) investigate associations between cIMT, clinical disease activity and inflammation-related laboratory markers in patients with r-axSpA. Method: In total, 155 patients diagnosed with r-axSpA using the modified New York criteria and 400 controls were included. Bilateral carotid ultrasound, laboratory testing, and questionaries were acquired. Disease-specific assessments were carried out for patients. Linear regression analysis was used to assess associations. Results: Linear regression analyses showed that patients with r-axSpA had increased mean cIMT compared to controls (mean ± SD, 0.8 ± 0.1 mm vs 0.7± 0.1 mm, respectively, unstandardized β (95% CI) -0.076 (-0.10, -0.052), P &lt; 0.001) adjusted for smoking status and age. Linear regression analyses for patients with r-axSpA showed that only males presented significant associations between cIMT and inflammation-related laboratory markers, white blood cell (WBC) count (mean ± SD, 6.8 ± 1.6 10<sup>9</sup>/L) and monocytes (0.6 ± 0.2 10<sup>9</sup>/L); WBC count (unstandardized β (95% CI) 0.019 (0.0065, 0.031), P = 0.003, R<sup>2</sup> = 0.57) and monocytes (0.13 (0.0047, 0.26), P = 0.041, R<sup>2</sup> = 0.55), adjusted for age, smoking status, body mass index, hypertension, dyslipidemia, diabetes mellitus, ASDAS-CRP, and treatment with DMARDs and glucocorticoids. No significant association was found between cIMT and clinical disease activity assessed by ASDAS-CRP. Conclusion: Patients with r-axSpA had significantly increased cIMT compared to controls. In male patients, higher WBC and monocyte count were associated with an increase in cIMT suggesting the role of inflammation in the development of atherosclerosis. (Table presented.)</p>}},
  author       = {{Law, Lucy and Lindqvist, Per and Liv, Per and Hellman, Urban and Lejon, Kristina and Geijer, Mats and Söderberg, Stefan and Forsblad-d’Elia, Helena}},
  issn         = {{0770-3198}},
  keywords     = {{Cardiovascular disease (CVD); Carotid intima-media thickness (cIMT); Radiographic axial spondyloarthritis (r-axSpA); Ultrasound}},
  language     = {{eng}},
  publisher    = {{Springer}},
  series       = {{Clinical Rheumatology}},
  title        = {{Increased carotid intima-media thickness in patients with radiographic axial spondyloarthritis compared to controls and associations with markers of inflammation}},
  url          = {{http://dx.doi.org/10.1007/s10067-024-06913-8}},
  doi          = {{10.1007/s10067-024-06913-8}},
  year         = {{2024}},
}