Abstract
Objective: To describe the parameters of subclinical vascular changes [Carotid Intima Media Thickness (cIMT), Flow Mediated Dilatation (FMD), Ankle Brachial Pressure Index (ABPI)] in patients with systemic sclerosis and compare them with age and sex matched controls. Methods: 50 patients of systemic sclerosis aged 20-50 years were selected and compared with the same no. of age and sex matched controls. Patients with diabetes, hypertension, dyslipidemia, smoking and thyroid disorders were excluded. cIMT, FMD and ABPI were calculated for all participants. Results: The cases and controls were well matched in terms of age, blood pressure, Body Mass Index, renal and liver functions, and lipid profiles. 34 patients had limited cutaneous SSc while 16 had diffuse cutaneous SSc. cIMT was significantly more in SSc patients as compared to controls (0.585 mm vs. 0.571 mm; p=0.001). FMD measurements in SSc patients were lower when compared to controls, but they did not achieve statistical significance (7.61% vs. 8.03%; p=0.608). ABPI values were similar in SSc patients and controls (1.056 vs. 1.036; p=0.398). cIMT did not show any correlation with age or duration of illness. ABPI showed significant inverse correlation with duration of illness (Rho=-0.385; p=0.006). However, none of these parameters varied as per the pattern of skin involvement (diffuse vs. limited), presence or absence of digital infarcts or pulmonary fibrosis. Conclusion: cIMT is increased in patients with systemic sclerosis as compared to matched controls. cIMT and ABPI may prove useful for assessing the burden of subclinical atherosclerosis and peripheral vascular disease.
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