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
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.
Evaluation of cardiovascular disease risk factors, inflammatory markers and subclinical atherosclerosis in patients with hemophilia
Öz
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.
Anahtar Kelimeler
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 Makaleleri |
| Yazarlar | |
| Yayımlanma Tarihi | 12 Aralık 2022 |
| Gönderilme Tarihi | 1 Nisan 2022 |
| Yayımlandığı Sayı | Yıl 2022Cilt: 61 Sayı: 4 |
