Novel markers of endothelial dysfunction and inflammation in Behçet's disease patients with ocular involvement: epicardial fat thickness, carotid intima media thickness, serum ADMA level, and neutrophil-to-lymphocyte ratio.
The etiology of Behçet's disease (BD) has not been fully elucidated. However, immunological and environmental factors, endothelial dysfunction (ED), and genetic susceptibility have been proposed to play a role. In this study, we aimed to evaluate epicardial fat thickness (EFT) together with serum asymmetric dimethylarginine (ADMA), carotid intima media thickness (CIMT), and neutrophil-to-lymphocyte ratio (NLR) in BD patients with ocular involvement. Thirty-six ocular BD patients (17 active and 19 inactive ocular involvement), and 35 age and sex-matched healthy controls were enrolled to this cross-sectional study. All patients underwent examinations with transthoracic echocardiography and carotid Doppler ultrasound. Serum ADMA levels, CIMT, EFT, and NLR were compared between groups, and their association with disease activity was evaluated. Behçet's disease patients had higher WBC counts, neutrophil counts, NLR, CIMT, EFT values, and serum ADMA levels than do healthy controls. The other biochemical, hematological, and echocardiographic parameters were comparable between the two groups. Behçet's disease duration was positively correlated with EFT and CIMT. Multivariate logistic regression analysis revealed that increased serum ADMA concentration and CIMT are independently associated with BD. Neutrophil counts, NLR, and serum ADMA level were higher, and lymphocyte count was lower in patients with active ocular BD compared to those of inactive ocular BD group. Carotid intima media thickness, serum ADMA level, EFT, and NLR were increased in ocular BD patients compared to healthy subjects. In addition, both serum ADMA level and NLR were associated with disease activity of ocular involvement. Increase in disease duration was associated with increase in CIMT and EFT which suggests that anatomical changes occur in time during the disease course. Increased CIMT, serum ADMA level, EFT, and NLR may provide new clues about the role of ED and inflammation in the etiopathogenesis of BD.
Department of Cardiology, Dicle University School of Medicine, Diyarbakir, Turkey. yukselmurat@yahoo.com.|Dicle Universitesi Kalp Hastanesi, Kardiyoloji klinigi, Sur, 21280, Diyarbakir, Turkey. yukselmurat@yahoo.com.
Murat
M
Yuksel
Department of Cardiology, Dicle University School of Medicine, Diyarbakir, Turkey.
Abdulkadir
A
Yildiz
Department of Cardiology, Dicle University School of Medicine, Diyarbakir, Turkey.
Mustafa
M
Oylumlu
Department of Ophthalmology, Dicle University School of Medicine, Diyarbakir, Turkey.
Fatih Mehmet
FM
Turkcu
Department of Cardiology, Dicle University School of Medicine, Diyarbakir, Turkey.
Mehmet Zihni
MZ
Bilik
Department of Biochemistry, Dicle University School of Medicine, Diyarbakir, Turkey.
Aysun
A
Ekinci
Department of Immunology, Dicle University School of Medicine, Diyarbakir, Turkey.
Bilal
B
Elbey
Department of Cardiology, Dicle University School of Medicine, Diyarbakir, Turkey.
Ebru
E
Tekbas
Department of Cardiology, Dicle University School of Medicine, Diyarbakir, Turkey.
Sait
S
Alan
D000273:Adipose Tissue / Q000000981:diagnostic imaging*; D000328:Adult; D001120:Arginine / Q000031:analogs & derivatives* / Q000097:blood; D001528:Behcet Syndrome / Q000097:blood / Q000000981:diagnostic imaging / Q000503:physiopathology*; D015415:Biomarkers; D059168:Carotid Intima-Media Thickness; D003430:Cross-Sectional Studies; D004452:Echocardiography; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005123:Eye / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000000981:diagnostic imaging / Q000503:physiopathology*; D007958:Leukocyte Count; D008214:Lymphocytes; D008297:Male; D009504:Neutrophils; D010496:Pericardium / Q000000981:diagnostic imaging
D015415:Biomarkers; C018524:N,N-dimethylarginine; D001120:Arginine
ADMA; Asymmetric dimethylarginine; Behçet’s disease; Carotid intima media thickness; Neutrophil to lymphocyte ratio; Rheumatic diseases