原发性斯约格伦综合征可独立促进过早出现亚临床动脉粥样硬化

IF 5.1 2区医学 Q1 RHEUMATOLOGY

RMD Open Pub Date : 2024-04-01 DOI:10.1136/rmdopen-2023-003559

N. Zehrfeld, Malin Abelmann, Sabrina Benz, Clara Luisa Zippel, S. Beider, E. Kramer, T. Seeliger, G. Sogkas, V. Gödecke, G. Ahrenstorf, Franz Paul Armbruster, T. Skripuletz, Torsten Witte, A. Derda, Kristina Sonnenschein, Diana Ernst

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Data collection was performed by a standardised questionnaire and Doppler ultrasound to evaluate the plaque extent and carotid intima-media thickness (cIMT). Propensity score matching included all cardiovascular risk (CVR) factors and corresponding laboratory markers. Results Data were available for 299 participants (199 pSS/100 controls), aged 59.4 years (50.6–65.0), 19.1% male. After matching, the pSS cohort had greater cIMT (p<0.001) and plaque extent (OR=1.82; 95% CI 1.14 to 2.95). Subgroup analyses of patients with pSS revealed that OI was associated with increased cIMT (p=0.025) and increased plaque occurrence compared with patients without OI (OR=1.74; 95% CI 1.02 to 3.01). OxLDL ab tended to be lower in patients with plaque (p=0.052). Correlations of higher Oxidized Low Density Lipoprotein (oxLDL) ab with EULAR Sjögren’s Syndrome Disease Activity Index (p<0.001) and anti–Sjögren's-syndrome-related antigen A autoantibodies (SSA/Ro antibodies) (p=0.026) were observed. 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Propensity score matching included all cardiovascular risk (CVR) factors and corresponding laboratory markers. Results Data were available for 299 participants (199 pSS/100 controls), aged 59.4 years (50.6–65.0), 19.1% male. After matching, the pSS cohort had greater cIMT (p<0.001) and plaque extent (OR=1.82; 95% CI 1.14 to 2.95). Subgroup analyses of patients with pSS revealed that OI was associated with increased cIMT (p=0.025) and increased plaque occurrence compared with patients without OI (OR=1.74; 95% CI 1.02 to 3.01). OxLDL ab tended to be lower in patients with plaque (p=0.052). Correlations of higher Oxidized Low Density Lipoprotein (oxLDL) ab with EULAR Sjögren’s Syndrome Disease Activity Index (p<0.001) and anti–Sjögren's-syndrome-related antigen A autoantibodies (SSA/Ro antibodies) (p=0.026) were observed. Conclusions Subclinical atherosclerosis occurs earlier and more severely in patients with pSS. 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引用次数: 0

摘要

目的心血管合并症在自身免疫性疾病患者中很常见。本研究调查了原发性斯约格伦综合征（pSS）患者亚临床动脉粥样硬化的程度。研究分析了亚临床动脉粥样硬化与器官受累（OI）或疾病活动性等临床因素的相关性，并测量了作为血管损伤潜在生物标志物的氧化低密度脂蛋白抗体（oxLDL ab）。方法连续纳入风湿病门诊的 pSS 患者。同时招募年龄和性别匹配的对照组（2:1）。通过标准化问卷和多普勒超声评估斑块范围和颈动脉内膜中层厚度（cIMT）来收集数据。倾向评分匹配包括所有心血管风险（CVR）因素和相应的实验室指标。结果 299 名参与者（199 名 pSS/100 名对照组）的数据可用，年龄为 59.4 岁（50.6-65.0），19.1% 为男性。匹配后，pSS 组群的 cIMT（p<0.001）和斑块范围（OR=1.82；95% CI 1.14 至 2.95）更大。对 pSS 患者进行的亚组分析显示，与没有 OI 的患者相比，OI 与 cIMT 增加（p=0.025）和斑块发生率增加有关（OR=1.74；95% CI 1.02 至 3.01）。斑块患者的 OxLDL ab 往往较低（p=0.052）。氧化低密度脂蛋白（oxLDL）ab较高与EULAR斯约格伦综合征疾病活动指数（p<0.001）和抗斯约格伦综合征相关抗原A自身抗体（SSA/Ro抗体）（p=0.026）相关。结论亚临床动脉粥样硬化在 pSS 患者中发生得更早也更严重。pSS 与对照组之间的 cIMT 差异似乎主要由 OI 患者造成，这表明该亚组患者的风险尤其高。OxLDL ab 可防止 pSS 患者的动脉粥样硬化恶化。应该对CVR分层和预防性药物（如羟甲基戊二酰-CoA（HMG-CoA）还原酶抑制剂）进行讨论，并需要进一步的纵向研究。

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Primary Sjögren’s syndrome independently promotes premature subclinical atherosclerosis

Objectives Cardiovascular comorbidities are common in patients with autoimmune diseases. This study investigates the extent of subclinical atherosclerosis in patients with primary Sjögren’s syndrome (pSS). Correlations with clinical factors such as organ involvement (OI) or disease activity were analysed and oxLDL antibodies (oxLDL ab) were measured as potential biomarkers of vascular damage. Methods Patients with pSS were consecutively included from the rheumatology outpatient clinic. Age- and sex-matched controls were recruited (2:1 ratio). Data collection was performed by a standardised questionnaire and Doppler ultrasound to evaluate the plaque extent and carotid intima-media thickness (cIMT). Propensity score matching included all cardiovascular risk (CVR) factors and corresponding laboratory markers. Results Data were available for 299 participants (199 pSS/100 controls), aged 59.4 years (50.6–65.0), 19.1% male. After matching, the pSS cohort had greater cIMT (p<0.001) and plaque extent (OR=1.82; 95% CI 1.14 to 2.95). Subgroup analyses of patients with pSS revealed that OI was associated with increased cIMT (p=0.025) and increased plaque occurrence compared with patients without OI (OR=1.74; 95% CI 1.02 to 3.01). OxLDL ab tended to be lower in patients with plaque (p=0.052). Correlations of higher Oxidized Low Density Lipoprotein (oxLDL) ab with EULAR Sjögren’s Syndrome Disease Activity Index (p<0.001) and anti–Sjögren's-syndrome-related antigen A autoantibodies (SSA/Ro antibodies) (p=0.026) were observed. Conclusions Subclinical atherosclerosis occurs earlier and more severely in patients with pSS. The difference in cIMT between pSS and controls seems mainly driven by patients with OI, suggesting that this subgroup is particularly at risk. OxLDL ab might protect against atherosclerotic progression in patients with pSS. CVR stratification and preventive medications such as Hydroxymethylglutaryl-CoA (HMG-CoA) reductase inhibitors should be discussed and further longitudinal studies are needed.

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来源期刊

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.