Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 May;43(5):1559-1570.
doi: 10.1007/s10067-024-06913-8. Epub 2024 Mar 6.

Increased carotid intima-media thickness in patients with radiographic axial spondyloarthritis compared to controls and associations with markers of inflammation

Lucy Law  1 , Per Lindqvist  2 , Per Liv  3 , Urban Hellman  4 , Kristina Lejon  5 , Mats Geijer  6   7   8 , Stefan Söderberg  4 , Helena Forsblad-d'Elia  4   9   10
Affiliations

Increased carotid intima-media thickness in patients with radiographic axial spondyloarthritis compared to controls and associations with markers of inflammation

Lucy Law et al. Clin Rheumatol. 2024 May.

Abstract

Objective: There is an increased risk for cardiovascular disease (CVD) in patients with radiographic axial spondyloarthritis (r-axSpA). In this cross-sectional study, we aimed to, overall and stratified by sex, (i) compare ultrasound derived carotid intima media thickness (cIMT), between patients and controls, and (ii) investigate associations between cIMT, clinical disease activity and inflammation-related laboratory markers in patients with r-axSpA.

Method: In total, 155 patients diagnosed with r-axSpA using the modified New York criteria and 400 controls were included. Bilateral carotid ultrasound, laboratory testing, and questionaries were acquired. Disease-specific assessments were carried out for patients. Linear regression analysis was used to assess associations.

Results: Linear regression analyses showed that patients with r-axSpA had increased mean cIMT compared to controls (mean ± SD, 0.8 ± 0.1 mm vs 0.7± 0.1 mm, respectively, unstandardized β (95% CI) -0.076 (-0.10, -0.052), P < 0.001) adjusted for smoking status and age. Linear regression analyses for patients with r-axSpA showed that only males presented significant associations between cIMT and inflammation-related laboratory markers, white blood cell (WBC) count (mean ± SD, 6.8 ± 1.6 109/L) and monocytes (0.6 ± 0.2 109/L); WBC count (unstandardized β (95% CI) 0.019 (0.0065, 0.031), P = 0.003, R2 = 0.57) and monocytes (0.13 (0.0047, 0.26), P = 0.041, R2 = 0.55), adjusted for age, smoking status, body mass index, hypertension, dyslipidemia, diabetes mellitus, ASDAS-CRP, and treatment with DMARDs and glucocorticoids. No significant association was found between cIMT and clinical disease activity assessed by ASDAS-CRP.

Conclusion: Patients with r-axSpA had significantly increased cIMT compared to controls. In male patients, higher WBC and monocyte count were associated with an increase in cIMT suggesting the role of inflammation in the development of atherosclerosis. Key Points •Carotid intima-media thickness was increased in patients with radiographic axial spondyloarthritis compared to controls. •White blood cell and monocyte counts were associated with carotid intima-media thickness in male patients with radiographic axial spondyloarthritis.

Keywords: Cardiovascular disease (CVD); Carotid intima-media thickness (cIMT); Radiographic axial spondyloarthritis (r-axSpA); Ultrasound.

PubMed Disclaimer

Conflict of interest statement

L.L, P. Ld, P.Lv, U.H, K.L and HFdE have declared no conflicts of interest. S.So reports consultancy and speakers honoraria from Actelion Ltd. P. Ld reports consultancy and speakers honoraria from Pfizer. MG reports speakers bureau Abbvie and UBC.

Figures

Fig. 1
Fig. 1
Graphical presentation of spline exploration regarding the relationship between a) WBC (leukocytes) and b) monocytes with mean cIMT, respectively, in patients with radiographic axial spondyloarthritis in the Backbone study. cIMT: carotid intima media thickness, WBCs: white blood cells
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Bengtsson K, Forsblad-d'Elia H, Lie E, Klingberg E, Dehlin M, Exarchou S, Lindström U, Askling J, Jacobsson LTH. Are ankylosing spondylitis, psoriatic arthritis and undifferentiated spondyloarthritis associated with an increased risk of cardiovascular events? A prospective nationwide population-based cohort study. Arthritis Res Ther. 2017;19(1):102. doi: 10.1186/s13075-017-1315-z. - DOI - PMC - PubMed
    1. Exarchou S, Lie E, Lindström U, Askling J, Forsblad-d'Elia H, Turesson C, Kristensen LE, Jacobsson LT. Mortality in ankylosing spondylitis: results from a nationwide population-based study. Ann Rheum Dis. 2016;75(8):1466–1472. doi: 10.1136/annrheumdis-2015-207688. - DOI - PubMed
    1. Theofilis P, Sagris M, Oikonomou E, Antonopoulos AS, Siasos G, Tsioufis C, Tousoulis D (2021) Inflammatory mechanisms contributing to endothelial dysfunction. Biomedicines 9(7). 10.3390/biomedicines9070781 - PMC - PubMed
    1. Deanfield JE, Halcox JP, Rabelink TJ. Endothelial Function and Dysfunction. Circulation. 2007;115(10):1285–1295. doi: 10.1161/CIRCULATIONAHA.106.652859. - DOI - PubMed
    1. Steyers CM, Miller FJ (2014) Endothelial dysfunction in chronic inflammatory diseases. Int J Mol Sci 15(7). 10.3390/ijms150711324 - PMC - PubMed