An exploratory cross-sectional study of subclinical vascular damage in patients with polymyalgia rheumatica.

Abstract

The aim of the study was to investigate the presence of subclinical vascular damage in polymyalgia rheumatica (PMR). We enrolled PMR patients having major cardiovascular risk factors (MCVRF) and, as controls, patients with MCVRF. All underwent: color Doppler ultrasound to evaluate the common carotid intima-media thickness (IMT), the anterior-posterior abdominal aortic diameter (APAD), and the prevalence of carotid artery stenosis; the cardio-ankle vascular index (CAVI) to measure arterial stiffness together with the ankle-brachial index (ABI) to investigate the presence of lower-extremity peripheral arterial disease. Finally, we measured the serum levels of adipocytokines implicated in vascular dysfunction. As a result, 48 PMR and 56 MCVRF patients were included. An increase of IMT (1.07/0.8-1.2 vs 0.8/0.8-1.05; p = 0.0001), CAVI (8.7/7.8-9.3 vs 7.6/6.9-7.8; p < 0.0001) and APAD values (21.15/18.1-25.6 vs 18/16-22; p = 0.0013) was found in PMR patients with respect to controls. No differences were reported in the prevalence of carotid artery stenosis or ABI values between the two groups. A significant correlation between IMT and CAVI in PMR and MCVRF subjects (r2 = 0.845 and r2 = 0.556, respectively; p < 0.01) was found. Leptin levels (pg/mL; median/25th-75th percentile) were higher in PMR than in MCVRF subjects (145.1/67-398.6 vs 59.5/39.3-194.3; p = 0.04). Serum levels of adiponectin (ng/mL) were higher in PMR patients (15.9/10.65-24.1 vs 6.1/2.8-22.7; p = 0.01), while no difference in serum levels of resistin (ng/mL) was found between PMR and MCVRF subjects (0.37/0.16-0.66 vs 0.26/0.14-1.24). Our study shows an increased subclinical vascular damage in PMR patients compared to those with MCVRF, paving the way for further studies aimed at planning primary cardiovascular prevention in this population.

• Authors: Rossana Scrivo, Valeria Silvestri, Francesco Ciciarello, Paola Sessa, Iolanda Rutigliano, Cristina Sestili, Giuseppe La Torre, Cristiana Barbati, Alessio Altobelli, Cristiano Alessandri, Fulvia Ceccarelli, Manuela Di Franco, Roberta Priori, Valeria Riccieri, Antonio Sili Scavalli, Francesca Romana Spinelli, Luciano Agati, Francesco Fedele, Bruno Gossetti, Fabrizio Conti, Guido Valesini
• Journal: Scientific reports (Sci Rep) Vol. 10 Issue 1 Pg. 11407 (07 09 2020) ISSN: 2045-2322 [Electronic] England
• PMID: 32647217 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• ADIPOQ protein, human
• Adiponectin
• LEP protein, human
• Leptin
• RETN protein, human
• Resistin

Topics

• Adiponectin (blood)
• Aged
• Aged, 80 and over
• Ankle Brachial Index
• Aorta, Abdominal (diagnostic imaging, pathology)
• Cardiovascular Diseases (epidemiology)
• Carotid Artery, Common (diagnostic imaging, pathology)
• Carotid Intima-Media Thickness
• Case-Control Studies
• Comorbidity
• Cross-Sectional Studies
• Diabetes Mellitus (epidemiology)
• Female
• Humans
• Hypercholesterolemia (epidemiology)
• Leptin (blood)
• Male
• Middle Aged
• Overweight (epidemiology)
• Peripheral Arterial Disease (blood, pathology)
• Polymyalgia Rheumatica (blood, epidemiology, pathology)
• Resistin (blood)
• Risk Factors
• Smoking (epidemiology)
• Ultrasonography, Doppler, Color
• Vascular Stiffness