Determination of cardiovascular risk in patients with axial spondyloarthritis and the relationship between cardiovascular risk and radiographic and clinical findings

Objective: Axial spondyloarthritis (axSpA) is a systemic inflammatory disease associated with increased cardiometabolic risk. This study aimed to evaluate cardiovascular risk in axSpA patients using visceral adiposity index (VAI), atherogenic index (AI), and conicity index (CI), and to compare these markers with healthy controls, as well as to assess their relationship with clinical and radiological findings in axSpA subgroups. Materials and Methods: A total of 168 axSpA patients and 101 healthy individuals without comorbidities, aged 18–65, were included between 2020 and 2024. AxSpA patients were categorized as radiographic axSpA (r-axSpA, n=112) and non-radiographic axSpA (nr-axSpA, n=56). Demographic, clinical, and laboratory data were recorded. VAI, AI, and CI were calculated using standard formulas. Comparative and correlation analyses were performed between and within groups. Results: The case and control groups were similar in age, gender, and most clinical parameters (p>0.05). VAI was significantly higher in the axSpA group (p<0.05), while AI and CI showed no significant differences. No significant differences were observed between r-axSpA and nr-axSpA groups in terms of cardiovascular indices. VAI, AI, and CI were significantly correlated with age, BMI, waist circumference, HDL, triglycerides, and disease duration. Conclusion: Elevated VAI in axSpA patients may reflect inflammation-related metabolic imbalance and increased visceral adiposity. VAI may serve as a valuable tool in cardiovascular risk assessment and management in axSpA. Further large-scale, multicenter prospective studies are warranted. Keywords: Axial spondyloarthritis, r-axSpA, nr-axSpA, cardiometabolic risk, VAI, AI, CI.