Sex-specific impact of inflammation on traditional cardiovascular risk factors and atherosclerosis in axial spondyloarthritis. A multicentre study of 913 patients.

IF 5.1 2区 医学 Q1 RHEUMATOLOGY RMD Open Pub Date : 2024-06-28 DOI:10.1136/rmdopen-2024-004187
Ivan Ferraz-Amaro, Fernanda Genre, Ricardo Blanco, Vanesa Calvo-Rio, Cristina Corrales-Selaya, Virginia Portilla, Elena Aurrecoechea, Ricardo Batanero, Vanesa Hernández-Hernández, Juan Carlos Quevedo-Abeledo, Carlos Rodríguez-Lozano, Clementina López-Medina, Lourdes Ladehesa-Pineda, Santos Castañeda, Esther F Vicente-Rabaneda, Cristina Fernández-Carballido, María Paz Martínez Vidal, David Castro Corredor, Joaquín Anino Fernández, Diana Peiteado, Chamaida Plasencia-Rodriguez, Rosa Expósito, Maria Luz Garcia Vivar, Eva Galíndez-Agirregoikoa, Nuria Vegas, Irati Urionagüena, Esther Montes-Perez, Miguel A Gonzalez-Gay, Javier Rueda-Gotor
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Abstract

Introduction: The nature of the relationship between inflammation, cardiovascular (CV) risk factors and atherosclerosis in axial spondyloarthritis (axSpA) remains largely unknown and sex differences in this regard are yet to be assessed.

Methods: Study including 611 men and 302 women from the Spanish multicentre AtheSpAin cohort to assess CV disease in axSpA. Data on CV disease risk factors were collected both at disease diagnosis and at enrolment, and data on disease activity, functional indices and carotid ultrasonography only at enrolment.

Results: After a median disease duration of 9 years, patients of both sexes who at disease diagnosis had elevated acute phase reactants (APRs), more frequently had hypertension and obesity. The same occurred with dyslipidaemia in men and with diabetes mellitus in women. At enrolment, CV risk factors were independently associated with APR and with activity and functional indices, with various sex differences. C reactive protein (CRP) values were inversely associated with HDL-cholesterol in men (β coefficient: -1.2 (95% CI: -0.3 to -0.07) mg/dL, p=0.001), while erythrocyte sedimentation rate values were positively associated with triglycerides in women (β coefficient: 0.6 (95% CI: 0.04 to 1) mg/dL, p=0.035). Furthermore, only women showed an independent relationship between insulin resistance parameters and APR or disease activity. Both men and women with high-very high CV risk according to the Systematic Assessment of Coronary Risk Evaluation 2 and CRP levels higher than 3 mg/L at diagnosis of the disease presented carotid plaques significantly more frequently than those with normal CRP levels at disease diagnosis.

Conclusion: Inflammation is associated with atherosclerosis and CV disease in axSpA. A gender-driven effect is observed in this relationship.

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炎症对轴向脊柱关节炎患者传统心血管风险因素和动脉粥样硬化的性别特异性影响。一项针对913名患者的多中心研究。
导言:轴性脊柱关节炎(axSpA)患者的炎症、心血管(CV)风险因素和动脉粥样硬化之间的关系在很大程度上仍然未知,这方面的性别差异也有待评估:这项研究包括西班牙多中心 AtheSpAin 队列中的 611 名男性和 302 名女性,目的是评估 axSpA 中的心血管疾病。在疾病诊断和入组时均收集了有关心血管疾病风险因素的数据,仅在入组时收集了有关疾病活动性、功能指数和颈动脉超声的数据:中位病程为 9 年的男女患者在确诊时都有急性时相反应物(APRs)升高,更常见的是高血压和肥胖。同样的情况也发生在男性血脂异常和女性糖尿病患者身上。入学时,心血管疾病风险因素与急性时相反应蛋白、活动和功能指数独立相关,并存在不同的性别差异。男性的 C 反应蛋白(CRP)值与高密度脂蛋白胆固醇成反比(β 系数:-1.2 (95% CI: -0.3 to -0.07) mg/dL,p=0.001),而女性的红细胞沉降率值与甘油三酯成正比(β 系数:0.6 (95% CI: 0.04 to 1) mg/dL,p=0.035)。此外,只有女性的胰岛素抵抗参数与 APR 或疾病活动性之间存在独立关系。根据《冠状动脉风险系统评估 2》(Systematic Assessment of Coronary Risk Evaluation 2),冠状动脉风险极高且确诊时 CRP 水平高于 3 毫克/升的男性和女性出现颈动脉斑块的频率明显高于确诊时 CRP 水平正常的男性和女性:炎症与动脉粥样硬化和心血管疾病有关。结论:炎症与 axSpA 患者的动脉粥样硬化和心血管疾病有关,在这种关系中可以观察到性别驱动效应。
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来源期刊
RMD Open
RMD Open RHEUMATOLOGY-
CiteScore
7.30
自引率
6.50%
发文量
205
审稿时长
14 weeks
期刊介绍: RMD Open publishes high quality peer-reviewed original research covering the full spectrum of musculoskeletal disorders, rheumatism and connective tissue diseases, including osteoporosis, spine and rehabilitation. Clinical and epidemiological research, basic and translational medicine, interesting clinical cases, and smaller studies that add to the literature are all considered.
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