PP.41.15

Abstract

Objective: The uric acid /UA/ is a product of purine metabolism, which may act as an antioxidant, but also as a mediator of the endothelial dysfunction, smooth muscle cell proliferation and inflammation. Recently a great amount of evidence for the correlation between serum UA and cardio-vascular diseases /CVD/ has been found in the general population. And surprisingly, such correlation was discovered not only in patients with hyperuricemia, but also in people with UA levels considered to be normal. Nevertheless, the role of the UA as an independent cardiovascular risk factor is still controversial. Usually the autoimmune inflammatory rheumatic diseases are not associated with hyperuricemia. That is why only few studies had analyzed the correlation between UA and atherosclerosis in this specific group of patients Design and method: The aim of our study was to search for correlation between subclinical atherosclerosis /defined as carotid intima-media -IMT-thicker than 0.9 mm or presence of plaque/ and traditional cardiovascular risk factors /hypertension, diabetes, dyslipidemia and smoking/ and some unconventional risk factors such as serum uric acid and markers of inflammation /CRP and SR/. 105 patients with inflammatory rheumatic diseases were studied.. They were compared to 72 hypertensive patients. A carotid ultrasound was done to all 177 patients, using linear transducer /3–12 MHz/ on Philips En Visor HD echo machine. Results: The mean values of the serum UA were: 264,59 ± 118,52 mmol/l for the patrients with rheumatic diseases and 290,17 ± 90,16 mmol/l in the hypertensive group. The correlation analysis in the group of patients with rheumatic diseases showed statistically significant correlation between UA and IMT. No such correlation was found in the group of hypertensive patients. A binary regression analysis was also done. The levels of serum UA again showed statistical significance in the group of patients with rheumatic diseases, but not in the hypertensive group. Conclusions: Our results indicate that in patients with rheumatic diseases, where vascular aging is accelerated by chronic inflammation, even normal values of serum UA may be associated with subclinical atherosclerosis.