Evaluation of cardiovascular disease risk factors, inflammatory markers and subclinical atherosclerosis in patients with hemophilia

Sukriye Miray Kilincer Bozgul; Fatoş Dilan Atilla; Güneş Ak; Uğur Önsel Türk; Burcu Barutcuoğlu; Güray Saydam; Fahri Şahin

doi:10.19161/etd.1208982

TR EN

Hemofili hastalarında kardiyovasküler hastalık risk faktörlerinin, inflamatuar belirteçlerin ve subklinik aterosklerozun değerlendirilmesi

Öz

Amaç: Türkiye'de tek merkezli bir çalışmada hemofili hastaları ile sağlıklı kontroller arasında kardiyovasküler hastalık (KVH) risk faktörlerini değerlendirmek ve karşılaştırmak. Gereç ve Yöntem: Boy, kilo ve vücut kitle indeksi gibi antropometrik parametreler kaydedildi. Açlık glukozu, HbA1c, yüksek duyarlıklı C-Reaktif Protein (hs-CRP), adiponektin, lipid parametreleri (total kolesterol, HDL-kolesterol, LDL-kolesterol, trigliserit) değerlendirildi. Uluslararası Fiziksel Aktivite Anketi (IPAQ) ve karotis intima media kalınlık (KIMK) ölçümleri yapıldı. Hemofili (n=80) ve sağlıklı kontrollerden (n=36) elde edilen veriler karşılaştırıldı. KIMK değerinin bağımsız değişkenleri analiz edildi. Bulgular: Hipertansiyon, diabetes mellitus, metabolik sendrom ve sigara içme sıklığı hemofili hastalarında dikkat çekiciydi. Ailede KVH öyküsü anlamlı olarak daha sıktı ( p=0,005) ve IPAQ skorları ile değerlendirildiğinde; hemofili hastaları, kontrollere göre daha sedantardi (p<0,001). Total kolesterol, LDL-kolesterol kontrol grubunda anlamlı olarak daha yüksekti (p =0.003,=0.003), hs-CRP seviyeleri ise hemofili hastalarında daha yüksekti (p=0.009). Yaş ve IPAQ skoru KIMK'nin anlamlı bağımsız belirleyicileri (sırasıyla p=0,004 ve 0,003). Sonuç: Yaşlanma sonucunda; hemofili hastaları genel popülasyonla aynı KVH risk faktörlerine maruz kalmaktadır. Hemofili değerlendirmesi dışında; KVH risk faktörlerinin taranması da gerekli olacaktır.

Anahtar Kelimeler

Evaluation of cardiovascular disease risk factors, inflammatory markers and subclinical atherosclerosis in patients with hemophilia

Abstract

Aim: To assess and compare the risk factors of cardiovascular disease (CVD) between patients with hemophilia (PwH) and healthy controls in a single center cohort in Türkiye.

Materials and Methods: Anthropometric parameters including height, weight, and body mass index were recorded. Fasting glucose, HbA1c, high sensitive C-Reactive Protein (hs-CRP), adiponectin, lipid parameters (total cholesterol, HDL-cholesterol, LDL-cholesterol, triglycerides) were assessed. International Physical Activity Questionnaires (IPAQ) and carotid intima media thickness (CIMT) measurements were performed. The data from PwH (n=80) and healthy controls (n=36) were compared. Independent associates of CIMT value were analyzed.

Results: Hypertension, diabetes mellitus, metabolic syndrome and smoking frequencies were remarkable in PwH. Family history of CVD was significantly more frequent ( p=0.005) and when considered with IPAQ scores; PwH was much more sedentary than controls (p<0.001). Total cholesterol, LDL-cholesterol were significantly higher in the control group (p =0.003,=0.003) while hs-CRP levels were higher in PwH (p=0.009). Age and IPAQ score were significant independent predictors of CIMT (p=0.004 and 0.003, respectively).

Conclusion: As a result of aging; PwH exposure to the same CVD risk factors as the general population. Screening for CVD risk factors in PwH other than hemophilia evaluation will be essential.

Keywords

Kaynakça

Darby SC, Kan SW, Spooner RJ, et al. Mortality rates, life expectancy, and causes of death in people with hemophilia A or B in the United Kingdom who were not infected with HIV. Blood. 2007; 110: 815-25.
Sood SL, Cheng D, Ragni M, et al. A cross-sectional analysis of cardiovascular disease in the hemophilia population. Blood Adv. 2018; 2: 1325-33.
Biere-Rafi S, Tuinenburg A, Haak BW, et al. Factor VIII deficiency does not protect against atherosclerosis. J Thromb Haemost. 2012; 10 (1): 30-7.
Minuk L, Jackson S, Iorio A, et al. Cardiovascular disease (CVD) in Canadians with haemophilia: Age-Related CVD in Haemophilia Epidemiological Research (ARCHER study). Haemophilia. 2015; 21 (6): 736-41.
Jensen MD, Ryan DH, Apovian CM, et al. 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society. Circulation. 2014; 129: 102-38.
Alberti KG, Zimmet P, Shaw J. Metabolic syndrome--a new world-wide definition. A Consensus Statement from the International Diabetes Federation. Diabet Med. 2006; 23: 469-80.
Saglam M, Arikan H, Savci S, et al. International physical activity questionnaire: reliability and validity of the Turkish version. Percept Mot Skills. 2010; 111: 278-84.
Jellinger PS, Smith DA, Mehta AE, et al. American Association of Clinical Endocrinologists' Guidelines for Management of Dyslipidemia and Prevention of Atherosclerosis. Endocr Pract. 2012;18 (Supplement 1):1-78.

American Diabetes Association Diagnosis and classification of diabetes mellitus. Diabetes Care. 2013;36 (Supplement 1): 67-74.
Nagao A, Suzuki N, Takedani H, et al. Ischaemic events are rare, and the prevalence of hypertension is not high in Japanese adults with haemophilia: First multicentre study in Asia. Haemophilia. 2019; 25: 223-30.
Terpstra WF, May JF, Smit AJ, et al. Effects of amlodipine and lisinopril on intima-media thickness in previously untreated, elderly hypertensive patients (the ELVERA trial). J Hypertens. 2004; 22: 1309-16.
Burke GL, Evans GW, Riley WA, et al. Arterial wall thickness is associated with prevalent cardiovascular disease in middle-aged adults. The Atherosclerosis Risk in Communities (ARIC) Study. Stroke 1995. 1995; 26: 386-91.
Biere-Rafi S, Baarslag MA, Peters M, et al. Cardiovascular risk assessment in haemophilia patients. Thromb Haemost. 2011; 105:274-8.
von Drygalski A, Kolaitis NA, Bettencourt R, et al. Prevalence and risk factors for hypertension in hemophilia. Hypertension. 2013; 62: 209-15.
Lövdahl S, Henriksson KM, Baghaei F, Holmström M, Berntorp E, Astermark J. Hypertension and cardiovascular diseases in Swedish persons with haemophilia - A longitudinal registry study. Thromb Res. 2019;181:106-11.
Lim MY, Pruthi RK. Cardiovascular disease risk factors: prevalence and management in adult hemophilia patients. Blood Coagul Fibrinolysis. 2011; 22: 402-6.
Hofstede FG, Fijnvandraat K, Plug I, Kamphuisen PW, Rosendaal FR, Peters M. Obesity: a new disaster for haemophilic patients? A nationwide survey. Haemophilia. 2008; 14: 1035-8.
Kulkarni R, Soucie JM, Evatt BL. Prevalence and risk factors for heart disease among males with hemophilia. Am J Hematol. 2005; 79: 36-42.
Yıldız M, Özdemir N, Önal H, Koç B, Eliuz Tipici B, Zülfikar B. Evaluation of Unfavorable Cardiovascular and Metabolic Risk Factors in Children and Young Adults with Haemophilia. J Clin Res Pediatr Endocrinol. 2019; 11: 173-80.
Shimizu K, Soroida Y, Sato M, et al. Eradication of hepatitis C virus is associated with the attenuation of steatosis as evaluated using a controlled attenuation parameter. Sci Rep. 2018; 8: 7845.
Lear SA, Hu W, Rangarajan S, et al. The effect of physical activity on mortality and cardiovascular disease in 130 000 people from 17 high-income, middle-income, and low-income countries: the PURE study. Lancet. 2017;390:2643-2654.
Jeong SW, Kim SH, Kang SH, et al. Mortality reduction with physical activity in patients with and without cardiovascular disease. Eur Heart J. 2019; 40: 3547-3555.
Taylor S, Room J, Barker K. Physical activity levels in men with Haemophilia-A single centre UK survey. Haemophilia. 2020; 26 (4): 718-725.
Ridker PM, Danielson E, Fonseca FA, et al. Reduction in C-reactive protein and LDL cholesterol and cardiovascular event rates after initiation of rosuvastatin: a prospective study of the JUPITER trial. Lancet. 2009;373:1175-82.
Zwiers M, Lefrandt JD, Mulder DJ, et al. Coronary artery calcification score and carotid intima–media thickness in patients with hemophilia. J Thromb Haemost. 2012; 10 (1): 23-9.
Kadoglou NP, Iliadis F, Liapis CD. Exercise and carotid atherosclerosis. Eur J Vasc Endovasc Surg. 2008; 35: 264-72.
Salonen JT, Salonen R. Ultrasonographically assessed carotid morphology and the risk of coronary heart disease. Arterioscler Thromb. 1991; 11: 1245-9.
Nezu T, Hosomi N, Aoki S, Matsumoto M. Carotid Intima-Media Thickness for Atherosclerosis. J Atheroscler Thromb. 2016; 23: 18-31.
Baldassarre D, De Jong A, Amato M, et al. Carotid intima-media thickness and markers of inflammation, endothelial damage and hemostasis. Ann Med. 2008; 40: 21-44.

Ayrıntılar

Birincil Dil

İngilizce

Konular

Sağlık Kurumları Yönetimi

Bölüm

Araştırma Makalesi

Yazarlar

Sukriye Miray Kilincer Bozgul ^*
0000-0002-3995-5096
Türkiye

Fatoş Dilan Atilla
0000-0002-3947-0355
Türkiye

Güneş Ak
0000-0001-6780-1812
Türkiye

Uğur Önsel Türk
0000-0001-6348-6616
Türkiye

Burcu Barutcuoğlu
0000-0001-6570-5229
Türkiye

Güray Saydam
0000-0001-8646-1673
Türkiye

Fahri Şahin
0000-0001-9315-8891
Türkiye

Yayımlanma Tarihi

12 Aralık 2022

Gönderilme Tarihi

1 Nisan 2022

Kabul Tarihi

9 Mayıs 2022

Yayımlandığı Sayı

Yıl 2022 Cilt: 61 Sayı: 4

DOI

https://doi.org/10.19161/etd.1208982

IZ

https://izlik.org/JA78CR36EZ

Kaynak Göster

RIS / Bibtex

Vancouver

1.Sukriye Miray Kilincer Bozgul, Fatoş Dilan Atilla, Güneş Ak, Uğur Önsel Türk, Burcu Barutcuoğlu, Güray Saydam, Fahri Şahin. Evaluation of cardiovascular disease risk factors, inflammatory markers and subclinical atherosclerosis in patients with hemophilia. ETD. 01 Aralık 2022;61(4):549-57. doi:10.19161/etd.1208982