Relationship between kardiovascular morbidity and inflamation in psoriatic arthritis

OBJECTIVE: Psoriatic Arthritis (PsA) is a chronic inflammatory disease that is characterised with joint destruction and bothlocal and systemic bone loss. Cardiovascular disease (CVD), diabetes mellitus (DM) and metabolic syndrom's rate is increased at psoriasis and PsA. In patients with PsA, without risc factors for CVD, is endothelial disfunction and increased karotis intima media thickness(cIMT) shown as early indicators for atherosclerosis. The predisposition to CVD is associated with inflamation in psoriasis and PsA. Glucagon like peptide (GLP)-1, an incretin hormone, except his effects of glucose metabolism, has anti-inflammatory and anti-atherogenic features. It's determined in recent years, that fetuin-A, a sirculating glicopeptide, has many physiological and pathological role, like atherosclerosis and inflammatory process. In this study we aimed to investigate the potential relation between cIMT, total plaque area (TPA), serum GLP-1 levels, inflammatory markers and disease activity indices in PsA paitents, without DM. METHODS: We included 53 nondiabetic PsA patients who fulfilled the CASPAR criteria for PsA and 30 age, sex and Body Mass Index (BMI) matched healthy controls in this study. Disease activity was assessed in the patients by using "Composite Psoriatic Disease Activity Index (CPDAI)" (which assessed five domains of disease: peripheral arthritis, dactylitis, enthesitis, axial involvement and skin findings). cIMT and TPA of right and left Common Carotid Arteria (CCA) are measured with Doppler USG B-Mode. After minimum 8 hours hunger measured GLP-1, fetuin-A, hsCRP, erythrocyte sedimentation rate (ESR), fasting blood glucose (FBG), total cholesterol (TC), triglyseride (TG), low dense lipoprotein (LDL), high dense lipoprotein (HDL) values have been used. Parameters of all cases are loaded in Windows compatible SPSS v 15.0 package program at PC. RESULTS: 53 PsA, 30 healthy controls is included in this study. Compared to healthy controls in patients age (p<0.001), ESR (p<0.001), LDL (p=0.024) waist circumference (p=0.015), hypertansion (HT) (p=0.013), smoking (p=0.016) and cIMT (p=0.014) was high expressively. cIMT measurements had meaningful correlation with age, LDL, ESR and disease duration. The other demografic, clinic, laboratory, disease activity/life quality indices and treatment agents didn't have any correlation with TPA and cIMT. DISCUSSION: cIMT, an indicator of subclinical atherosclerosis, is found meaningful higher in patients. There was correlation with inflammatory markers and risk factors of atherosclerosis. But there was any correlation with disease activity, life quality indices and treatment agents. KEY WORDS: Psoriatic arthritis, Glucagon Like Peptide-1, Fetuin-A, Carotis Intima Media Thickness, Subclinical Atherosclerosis