title: Premature atherosclerosis in systemic sclerosis patients: Its relation to disease parameters and to traditional risk factors.
abstract: OBJECTIVE
  To detect premature atherosclerosis in systemic sclerosis (SSc) patients and its relation to disease parameters and traditional risk factors.
  
  
  METHODS
  This study included 40 SSc patients and 40 healthy age and sex matched controls. All patients were subjected to full history taking, clinical examination, relevant laboratory and radiological investigations. Doppler ultrasonography (US) of the common carotid was performed to measure intima-media thickness (ccIMT) and Doppler US of the brachial artery was performed to measure flow mediated dilatation (FMD).
  
  
  RESULTS
  The mean value of ccIMT was 0.59 ± 0.2 mm in SSc patients and 0.51 ± 0.09 mm in controls and the difference was significant (P = 0.03). A statistically significant difference was found in mean brachial artery diameter before and after hyperemia, in flow change and in FMD between SSc patients and controls. ccIMT showed significant positive correlation with age, C-reactive protein (CRP), cholesterol, triglycerides and low density lipoprotein (P < 0.05). FMD showed significant positive correlation with daily dose of steroids (P = 0.04). Brachial artery diameter after hyperemia showed significant negative correlation with erythrocyte sedimentation rate (ESR). Peak systolic velocity before ischemia showed significant positive correlation with body mass index (BMI) and significant negative correlation with insulin level.
  
  
  CONCLUSIONS
  Our findings confirm the presence of premature atherosclerosis in SSc patients assessed by significant impairment of FMD, flow change and ccIMT, and it is associated with traditional cardiovascular risk factors such as age, dyslipidemia and obesity (BMI) as well as with the use of steroids and markers of inflammation such as CRP and ESR.
authors.affiliation: Rheumatology and Rehabilitation Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
authors.forename: Manal M
authors.initials: MM
authors.lastname: Sedky Abdou
authors.affiliation: Rheumatology and Rehabilitation Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
authors.forename: Soha M
authors.initials: SM
authors.lastname: El Desouky
authors.affiliation: Radiodiagnosis Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
authors.forename: Khaled M
authors.initials: KM
authors.lastname: Helmy El Kaffas
authors.affiliation: Rheumatology and Rehabilitation Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
authors.forename: Abeer M
authors.initials: AM
authors.lastname: Ahmed Hassan
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000368:Aged; D050197:Atherosclerosis / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000503:physiopathology; D001916:Brachial Artery / Q000000981:diagnostic imaging* / Q000503:physiopathology; D002339:Carotid Arteries / Q000000981:diagnostic imaging*; D059168:Carotid Intima-Media Thickness; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012039:Regional Blood Flow; D012307:Risk Factors; D012595:Scleroderma, Systemic / Q000097:blood / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D018608:Ultrasonography, Doppler; D014664:Vasodilation; D055815:Young Adult
keywords: arterial wall stiffness; atherosclerosis; systemic sclerosis