Background: The increased risk of atherosclerosis is most likely multifactorial in patients with Spondyloarthritis (SpA). Ultrasound measurements of Intima Media Thickness and (IMT) Flow Mediated Dilation (FMD) can be used to investigate infra-clinical atherosclerosis [1].

Objectives: We aimed to investigate the relationship between socio-demographic parameters in SpA patients with the IMT and FMD.

Methods: It was a case control study conducted over a period of 12 months and including patients with SpA, aged less than 50 years old and without cardiovascular disease, and age and sex matched healthy controls. Sociodemographic and clinical features were recorded in our patients. All subjects had Doppler ultrasound with measurement of carotid IMT and FMD.

Results: There were 47 SpA patients and 47 controls. The median age was 36 years for patients group (18-50) and 32 years for controls (18-50). For the patients group: there were 14 female (28.8%) and 33 male (70.2%). The median duration of the disease was 11 years (1-32). For the marital status, 55.32% were single, 40.43% were married, and 4.26% were divorced. Thirty seven patients (79%) were living in an urban area. For the education level, 17% had a primary education, 64% a secondary education, and 19% were university graduates. Occupational status was recorded as follows: 17% unemployed, 11% students, and 72% employed.

The median IMT was 0.55 millimeters (mm)(0.32 -0.83). We found a higher mean, right and left IMT (p<0.0001) in SpA patients compared with controls. Carotid IMT was positively correlated with age (p<0.0001; r= 0,578 ). The analysis by 10-year age group showed a statistically significant difference in the IMT between patients (p=0.004). Median IMT increased significantly with age (every 10 years). IMT was significantly associated with occupational status (p=0.036); unemployed patients had the higher IMT (0.58 mm).

The median FMD was 14.6% (2-32%). A significantly lower FMD (p=0.008) was noted in SpA patients compared with controls. FMD were negatively correlated with age (p=0.017; r= -0,347 ). FMD was also associated with sex (p=0.036), and with the marital status (p=0.013). The median FMD was significantly lower in male 13.8% (IQR;8-17.5) vs 22.5% (IQR; 10-25), and married patients (10%; 6-18). There was no significant difference with the other sociodemographic variables (living environment, educational level, occupation). In multiple regression analysis, age was an independent predictor of increased carotid IMT (B=0.004; T=3.146; p=0.003; CI 95% 0.001-0.006].

Conclusion: Our study showed that subclinical atherosclerosis in patients with SpA was strongly associated with age, although we included young patients with a limit age at 50 years.

REFERENCES:

[1]Yuan Y, Yang J, Zhang X, Han R, Chen M, Hu X, et al. Carotid Intima-Media Thickness in Patients with Ankylosing Spondylitis: A Systematic Review and Updated Meta-Analysis. J AtherosclerThromb . 2019;26(3):260-271.

Disclosure of Interests: None declared