TRADITIONAL RISK FACTORS OR ADMA IN PATIENTS WITH RHEUMATOLOGIC DISEASES – WHAT IS MORE IMPORTANT FOR CARDIOVASCULAR RISK?

Abstract

Objective: Causes and mechanisms of increased cardiovascular morbidity and mortality in patients with rheumatologic diseases now are in epicenter of research. The aim of the present study was to compare traditional risk factors and asymmetric dimethyl arginine (ADMA), as a marker of endothelial dysfunction, in patients with various rheumatologic diseases and patients with increased intima-media thickness (IMT) without cardiovascular diseases (CVD). Design and method: The study included 208 patients with rheumatologic diseases: 67 patients with systemic sclerosis (SSc), 49 patients with rheumatoid arthritis (RA), 41 patients with Sjogren disease (SD) and 51 patients with systemic lupus erythematosus (SLE). Comparison group consisted of 63 patients with 3 or more traditional cardiovascular risk factors and subclinical carotid atherosclerosis (carotid IMT more than 0.9 mm) without clinical signs of CVD. Hypercholesterolemia was determined at a total cholesterol level> 4.9 mmol/L or statins intake. Hypertension was detected in patients with systolic blood pressure > 140 mm Hg and/or diastolic blood pressure > 90 mm Hg or antihypertensive medication intake. Hyperglycemia was determined at a glucose level> 5.6 mmol/L. Obesity was detected in body mass index>30 kg/m2. Statistical analysis was performed using SPSS Statistics 20. Results: Results of comparison of groups are presented in table.Conclusions: In comparison group prevalence of obesity, metabolic disorders and increased cardiovascular risk was significantly higher than in rheumatologic patients. Despite that increased level of ADMA was more common for rheumatologic diseases group. It can be assumed that increased cardiovascular morbidity and mortality in rheumatologic patients can be associated more with disease-specific endothelial dysfunction than with the influence of traditional cardiovascular risk factors.