South Clin Ist Euras. 2018; 29(2): 94-98 | DOI: 10.14744/scie.2018.64936

Enflamatuvar Hastalýklarda Sekonder Amiloidoz ile Karotis Ýntima Media Kalýnlýðý Ýliþkisi

Uður Arslantaþ¹, Ersin Engin Þimsek², Mustafa Bulut¹, Nimet Bilge Kalkan², Selçuk Pala^1
1Kartal Koþuyolu Yüksek ÝhtisasEðitim ve Araþtýrma Hastanesi, Kardiyoloji Bölümü, Ýstanbul
²Lütfü Kýrdar Eðitim ve Araþtýrma Hastanesi, Aile Hekimliði Kliniði, Ýstanbul

GÝRÝÞ ve AMAÇ: Ateroskleroz ve sekonder amiloidoz patogenezlerinde enflamasyonun çok önemli rolü olmasýna raðmen, her iki hastalýk arasýndaki iliþki tam olarak bilinmemektedir. Bu çalýþmanýn amacý, karotis intima media kalýnlýðý (IMK) deðerlendirerek, sekonder amiloidoz olan hastalarla, olmayan uygun kontrol gruplarýnda bu iliþkiyi incelemek.
YÖNTEM ve GEREÇLER: Çalýþma popülasyonu 14 amiloidoz geliþmiþ enflamatuvar hastalýklý hasta ile 34 amiloidoz geliþmemiþ enflamatuvar hastalýklý hasta ve 34 saðlýklý gönüllüden oluþmaktadýr. Tüm hastalar sigara içmeyenlerden seçildi. Aterosklerotik damar hastalýðý ve diyabetes mellitus tanýsý olan hastalar çalýþmaya alýnmadý. Subklinik ateroskleroz B-mod ultrasonografi kullanýlarak karotis arterden IMK ölçülerek deðerlendirildi ve tüm hastalarýn CRP düzeyleri ölçüldü.
BULGULAR: Korotis IMK istatiksel olarak anlamlý olarak, amiloidoz bulunan hastalarda (0.71±0.8 mm), bulunmayan hastalara (0.56±0.1 mm, p<0.001) ve saðlýklý kontrol grubuna (0.43±0.4 mm, p<0.001) göre daha kalýn ölçüldü. Ayný zamanda C-reaktif protein düzeyleri de amiloidoz hastalarýnda (5.7±2.5) kontrol gruplarýna göre anlamlý olarak yüksek ölçüldü (3.7±3.1, 1.5±1.2) (p<0.001).
TARTIÞMA ve SONUÇ: Amiloidoz hastalýðýnýn varlýðýnda bulunan artmýþ IMK, enflamasyona baðlý geliþen aterosklerotik deðiþikliklere baðlý olabilir.

Anahtar Kelimeler: Ailevi Akdeniz ateþi, aterosklerosis, carotid artery; intima-media-thickness; sistemik amiloyidosis AA.

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Relationship Between Secondary Amyloidosis and Carotid Intima Media Thickness in Inflammatory Disease

Uður Arslantaþ¹, Ersin Engin Þimsek², Mustafa Bulut¹, Nimet Bilge Kalkan², Selçuk Pala^1
1Department of Cardiology, Kartal Koþuyolu Training and Research Hospital, Ýstanbul, Turkey
²Department of Family Medicine, Kartal Dr. Lütfü Kýrdar Traning and Research Hospital, Ýstanbul, Turkey

INTRODUCTION: Inflammation takes significant part in the pathogenesis of atherosclerosis and secondary amyloidosis but little is known about its relationship with both. Assessment of this relationship via carotid intima–media thickness (IMT) in patients with secondary amyloidosis and suitable controls, is the aim of our study.
METHODS: 14 amyloidal inflammatory disease patients, 34 non-amyloidal inflammatory disease patients and 34 healthy volunteers formed the study population. All patients were non-smoker. Patient with history of atherosclerotic vascular disease and presence of diabetes mellitus excluded the study. Investigating the measuring IMT from carotid arteries using ultrasonography was managed to assess subclinical atherosclerosis and CRP levels were measured from the all study population.
RESULTS: Amyloidal inflammatory disease patients demonstrated a significantly greater carotid IMT (0.71±0.8 mm) compared with the non-amyloidal inflammatory disease patients (0.56±0.1 mm; p<0.001) and the healthy controls (0.43±0.4 mm; p<0.001). The patients with
amyloidal inflammatory disease had a significantly greater CRP level (5.7±2.5 mg/L) than the other groups (3.7±3.1 mg/L, 1.5±1.2 mg/L; p<0.001).
DISCUSSION AND CONCLUSION: Increased carotid arterial wall thickness was associated with the presence of amyloidosis, perhaps due to an increase in atherosclerotic changes related to chronic lowlevel inflammation.

Keywords: Atherosclerosis, familial Mediterranean fever, systemic serum amyloid A amyloidosis, carotid artery; intima–media thickness.

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