Omima A. Sayed , Rasha A. Abdel-Magied , Hazem M.A. Farrag , Mostafa A. Abu Elela , Abdallah M.M. Safwat , Ahmed M. Abdel-Nasser
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Abstract
Aim of the work
To assess the frequency of subclinical atherosclerosis in Behçet’s disease (BD) and the influence of neutrophil–lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and serum asymmetric dimethylarginine (ADMA) compared to traditional cardiovascular risk factors and their relation to the disease characteristics.
Patients and methods
This study included 60 BD patients and 30 age and sex matched healthy controls. The BD current activity form (BDCAF) was scored. Traditional cardiovascular risk factors were evaluated. Complete blood count was assessed and both NLR and PLR were calculated. Serum ADMA level was measured. Radiological evaluation of carotid intima media thickness (CIMT) was performed.
Results
The mean age of patients was 36.5 ± 10 years and were 48 males and 12 females (M:F 4:1). BD patients had significantly higher CIMT and carotid atherosclerotic plaques compared to the control (0.53 ± 0.14 versus 0.41 ± 0.09, p < 0.001 and 21.7 % versus 0 % respectively) despite similar rate of traditional cardiovascular risk factors. CIMT of BD patients correlated with age (r = 0.38,p = 0.003), disease duration (r = 0.3,p = 0.02), presence of ocular manifestation (r = 0.31,p = 0.02), waist/hip ratio (WHR)(r = 0.29,p = 0.03), NLR (r = 0.42, p = 0.001), PLR (r = 0.27, p = 0.04) and ADMA (r = 0.5,p < 0.001). Only serum ADMA level was found to be a significant determinant of CIMT in BD (p < 0.001), contributing in 37.9 % of the variance of CIMT. NLR, PLR and ADMA can differentiate BD with subclinical atherosclerosis at cut-off values 2.36, 125.51 and 1.27 umol/L respectively.
Conclusion
BD is associated with an increased rate of subclinical atherosclerosis, which is best determined by increased hematological indices and serum ADMA level rather than traditional cardiovascular risk factors.