Subclinical atherosclerosis in scleroderma patients.
OBJECTIVE
To investigate subclinical atherosclerosis in patients with systemic sclerosis (SSc).


METHODS
Sixty-six patients with SSc who met the American College of Rheumatology criteria for the disease were included. The serum levels of total cholesterol (TC), triglycerides, high density lipoprotein cholesterol (HDL-C), and low density lipoprotein cholesterol (LDL-C) were determined in all patients. Carotid artery intima-media thickness (IMT) and carotid plaques were measured. Patients with a history of atherosclerosis, hypertension, smokers, or patients suffering from conditions that affect the lipid profile, such as diabetes mellitus, hypothyroidism, liver or kidney diseases, Cushing's syndrome, obesity, and a history of familial dyslipidaemia, were excluded. Patients receiving medication affecting lipid metabolism were also excluded from the study. Fifty-one age- and sex-matched non-smoking volunteers were used as controls.


RESULTS
Sixty patients were investigated. Six were excluded. Of these, two were smokers, two had diabetes mellitus, one hypothyroidism, and one had hypertension treated with diuretics. Patients with SSc exhibited mild dyslipidaemia expressed mainly by low serum levels of HDL-C and high TC (p < 0.001 and p < 0.021, respectively) compared to controls. In addition, the atherogenic ratio LDL-C/HDL-C was significantly higher among SSc patients (p < 0.0001). Common carotid artery IMTs were higher in SSc compared to controls (0.77 +/- 0.2 vs. 0.59 +/- 0.14, p < 0.0001). No correlation between IMTs and any SSc features were found. Logistic regression analysis showed an independent association of scleroderma with IMTs and TC.


CONCLUSIONS
The scleroderma patients exhibited an atherogenic lipid profile and subclinical atherosclerosis and have an increased risk for cardiovascular events.
Tsifetaki
N
N
Department of Internal Medicine, Rheumatology Clinic, Medical School, University of Ioannina, Ioannina, Greece.
Georgiadis
A N
AN
Alamanos
Y
Y
Fanis
S
S
Argyropoulou
M I
MI
Drosos
A A
AA
D000328:Adult; D000368:Aged; D050197:Atherosclerosis / Q000097:blood / Q000150:complications* / Q000000981:diagnostic imaging; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging; D002784:Cholesterol / Q000097:blood; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D012044:Regression Analysis; D012595:Scleroderma, Systemic / Q000097:blood / Q000150:complications* / Q000000981:diagnostic imaging; D012720:Severity of Illness Index; D014280:Triglycerides / Q000097:blood; D014463:Ultrasonography
D014280:Triglycerides; D002784:Cholesterol