类风湿关节炎女性患者的心血管疾病预测。

IF 0.5 4区 医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Kardiologiya Pub Date : 2024-01-31 DOI:10.18087/cardio.2024.1.n2616
I V Osipova, Y N Starodubova
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引用次数: 0

摘要

目的:在研究类风湿性关节炎(RA)女性患者的传统和疾病介导风险因素(RFs)的整体性和重要性的基础上,建立动脉高血压(AH)和动脉粥样硬化的预后模型。材料与方法:2016-2019年,在古拉市第四医院综合诊所(巴尔瑙尔)、"健康中心"、综合诊所市风湿病科和医院部对223名年龄为(54.9±2.1)岁的女性RA患者进行了评估。统计分析使用 Excel Microsoft Office 2007、Statistica 6.0 和 10.0 以及 SigmaPlot 12.5 软件包进行。多变量回归分析用于研究影响RA发生AH和动脉粥样硬化的属性,并构建预测模型。ROC分析用于确定所建模型的质量。结果显示,P<0.05时差异具有统计学意义:结果:确定了以下在发病中占主导地位的RF因素:传统因素(高血糖、肥胖、舒张压(DBP)升高、心动过速、血脂异常);疾病介导因素(血沉、纤维蛋白原、C反应蛋白(CRP)、类风湿因子、环瓜氨酸肽抗体、中度和高度DAS-28活性)和社会心理因素(压力、焦虑、抑郁、睡眠障碍)。在类风湿持续时间超过一年的情况下,RF 发生率最高的因素及其组合是:传统因素(肥胖、高血糖、收缩压(SBP)升高)和肾小球滤过率降低;疾病介导因素(泼尼松龙治疗)。为 AH 筛查建立了一个高灵敏度模型,该模型包括以下 RFs 组合:疾病介导(RA 持续时间、CRP);传统(饮食不当、体力活动少、早期心血管疾病史、SBP 和 DBP 升高、子痫前期和/或子痫、更年期提前、年龄偏大、血脂异常);社会心理(焦虑、抑郁)和高盐味阈值。为预测女性 RA 多灶性动脉粥样硬化建立了一个高度敏感的模型。该模型包括一系列风险因素:疾病介导因素(通过 DAS-28、CRP、纤维蛋白原、血沉、剂量依赖性泼尼松龙治疗得出的 RA 活性);传统因素(AH、SBP、腰围、心率、早期绝经、先兆子痫和/或子痫、55 岁及以上、血脂异常);以及社会心理因素(睡眠障碍、抑郁):考虑到已确定的预测因素和针对 RA 女性提出的预测模型,制定了早期预防 AH 和动脉粥样硬化的方案。
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Prediction of Cardiovascular Diseases in Women With Rheumatoid Arthritis.

Aim: To develop prognostic models for arterial hypertension (AH) and atherosclerosis based on studying the totality and significance of traditional and disease-mediated risk factors (RFs) in women with rheumatoid arthritis (RA).

Material and methods: 223 female patients with RA aged 54.9±2.1 years were evaluated at the premises of the polyclinic of the Gulla Municipal Hospital #4 (Barnaul), the "Health Center", the City Rheumatology Department of the polyclinic, and the Hospital Department in 2016-2019. Statistical analysis was performed using Excel Microsoft Office 2007, Statistica 6.0 and 10.0, and SigmaPlot 12.5 software packages. Multivariate regression analysis was used for studying the attributes influencing the development of AH and atherosclerosis in RA and for constructing predictive models. ROC analysis was used to determine the quality of the developed models. Differences were considered statistically significant at p<0.05.

Results: The following RFs predominating in the onset of disease were identified: traditional (hyperglycemia, obesity, increased diastolic BP (DBP), tachycardia, dyslipidemia); disease-mediated (ESR, fibrinogen, C-reactive protein (CRP), rheumatoid factor, cyclic citrullinated peptide antibodies, moderate and high DAS-28 activity), and psychosocial (stress, anxiety, depression, sleep disorders). The highest RF incidence and their combinations were determined with a RA duration of more than a year: traditional (obesity, hyperglycemia, increased systolic BP (SBP)), and decreased glomerular filtration rate; and disease-mediated (prednisolone treatment). A highly sensitive model for AH screening was developed that included a combination of RFs: disease-mediated (RA duration, CRP); traditional (improper diet, low physical activity, history of early cardiovascular diseases, increased SBP and DBP, preeclampsia and/or eclampsia, early menopause, older age, dyslipidemia); psychosocial (anxiety, depression), and a high salt-taste threshold. A highly sensitive model was developed for probable prediction of multifocal atherosclerosis in RA in women. The model includes a complex of risk factors: disease-mediated (RA activity by DAS-28, CRP, fibrinogen, ESR, dose-dependent prednisolone treatment); traditional (AH, SBP, waist circumference, heart rate, early menopause, preeclampsia and/or eclampsia, age 55 years and older, dyslipidemia); and psychosocial (sleep disorders, depression).

Conclusion: Algorithms for early prevention of AH and atherosclerosis were developed with consideration of identified predictors and proposed prediction models for women with RA.

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来源期刊
Kardiologiya
Kardiologiya 医学-心血管系统
CiteScore
1.70
自引率
20.00%
发文量
94
审稿时长
3-8 weeks
期刊介绍: “Kardiologiya” (Cardiology) is a monthly scientific, peer-reviewed journal committed to both basic cardiovascular medicine and practical aspects of cardiology. As the leader in its field, “Kardiologiya” provides original coverage of recent progress in cardiovascular medicine. We publish state-of-the-art articles integrating clinical and research activities in the fields of basic cardiovascular science and clinical cardiology, with a focus on emerging issues in cardiovascular disease. Our target audience spans a diversity of health care professionals and medical researchers working in cardiovascular medicine and related fields. The principal language of the Journal is Russian, an additional language – English (title, authors’ information, abstract, keywords). “Kardiologiya” is a peer-reviewed scientific journal. All articles are reviewed by scientists, who gained high international prestige in cardiovascular science and clinical cardiology. The Journal is currently cited and indexed in major Abstracting & Indexing databases: Web of Science, Medline and Scopus. The Journal''s primary objectives Contribute to raising the professional level of medical researchers, physicians and academic teachers. Present the results of current research and clinical observations, explore the effectiveness of drug and non-drug treatments of heart disease, inform about new diagnostic techniques; discuss current trends and new advancements in clinical cardiology, contribute to continuing medical education, inform readers about results of Russian and international scientific forums; Further improve the general quality of reviewing and editing of manuscripts submitted for publication; Provide the widest possible dissemination of the published articles, among the global scientific community; Extend distribution and indexing of scientific publications in major Abstracting & Indexing databases.
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