Background It is well known, that atherosclerosis associated cardiovascular diseases in many cases determine the life expectancy in RA patients. At the same time, risk factors which promote the development of premature atherosclerosis, including comorbidities, remain uncertain.

Objectives to analyze comorbid conditions in RA patients under age of 50 years and assess their impact on the vascular wall (evaluated by ultrasound investigation of the carotid arteries).

Methods The study was conducted at the Department of Family Medicine, Shupyk NMAPE at the Kyiv Regional Clinical Hospital. The study included 126 RA patients, aged from 18 to 49 years (women - 102 (81%), men - 24 (19%), average age 43.82±8.8 years, who provided written consent to participate in research. As a control group 30 persons without any autoimmune diseases (women - 25 (83.3%) men - 5 (16.7%), average age 42.4±8.6 years) were examined.

All RA patients and control group underwent comprehensive clinical, laboratory and instrumental examination to identify comorbid conditions including evaluation of atherogenesis by use of ultrasound examination of the carotid arteries with intima-media thickness (IMT) measurement and atherosclerosis plagues (AP) assessment.

Results The frequency of identified comorbid conditions and diseases in RA patients and control group are presented in Table 1.

The average number of comorbid diseases/conditions per RA patient significantly exceeded its number in controls (4.13 and 1.67 respectively, p<0.05); most frequently among RA patients was determined: dyslipidemia (60.32%), nonalcoholic fatty liver disease (61.11%), chronic cholecystitis (36.51%), cholesterosis of the gallbladder (30.16%), hypertension (37.30%), autoimmune thyroiditis (27.77%), spinal osteoarthritis (33.33%).

Results of the carotid ultrasonography and assessment of atherosclerosis surrogate markers (IMT, AP) showed higher severity of atherosclerotic process in patients with RA compared to controls; the most important risk factors for increasing IMT and atherosclerotic plaques in carotid arteries were dyslipidemia, autoimmune thyroiditis with hypothyroidism and nonalcoholic fatty liver disease.

Conclusions Patients with RA have a higher frequency of comorbid conditions and diseases than controls without RA; some of comorbidities have significant influence on atherogenesis; RA patients require a multidisciplinary and holistic approach for effective management of their health related problems.

References

1. Characteristics of comorbid stennov u hvorih on rheumatoid arthritis. Characteristics of comorbid conditions in patients with rheumatoid arthritis. Family Medicine 2015;3(59):219-222.

References

Disclosure of Interest None declared