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Association between sarcoidosis, pulse wave velocity, and other measures of subclinical atherosclerosis: a systematic review and meta-analysis

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Abstract

Chronic inflammation from autoimmune diseases has shown to be a risk factor for atherosclerosis, subsequently leading to cardiovascular disease. Endothelial dysfunction is the early pathogenesis of atherosclerosis in chronic inflammation, but the risk of atherosclerosis in sarcoidosis is less well defined. This meta-analysis aimed to explore the association of subclinical atherosclerosis and arterial stiffness in sarcoidosis. A comprehensive search of the MEDLINE and EMBASE databases was performed from date of inception through August 2017. The inclusion criterion was observational studies evaluating the association between sarcoidosis, subclinical atherosclerosis, and arterial stiffness by measuring pulse wave velocity (PWV). Definitions of sarcoidosis and methods to assess PWV were recorded for each study. The pooled standardized mean difference (SMD) of PWV and 95% confidence interval (CI) was calculated using a random-effects meta-analysis. The between-study heterogeneity of effect size was quantified using the Q statistic and I 2. Data were extracted from five observational studies involving 499 subjects. Pooled result demonstrated a significant increase in PWV in patients who have sarcoidosis compared with controls (SMD = 0.57 m/s; 95% CI 0.21–0.92, p value = 0.002, I 2 = 75%, P heterogeneity < 0.01). After excluding studies with low or moderate quality, there was an increase in PWV in sarcoidosis compared with controls (SMD = 0.29 m/s; 95% CI 0.00–0.57, p value = 0.05, I 2 = 55%, P heterogeneity = 0.08). Our study suggests that sarcoidosis is associated with increased arterial stiffness and therefore at risk of subclinical atherosclerosis. Prospective study is required to investigate the association of subclinical atherosclerosis causing overt cardiovascular disease in patients with sarcoidosis.

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Authors and Affiliations

  1. Department of Internal Medicine, Greenfield Family Medicine, Baystate Franklin Medical Center, 48 Sanderson Street, Greenfield, MA, USA

    Wai Chung Yong

  2. Division of Nephrology, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Anawin Sanguankeo

  3. Department of Preventive and Social Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand

    Anawin Sanguankeo & Sikarin Upala

  4. Section of Endocrinology, Diabetes, and Metabolism, Department of Medicine, University of Chicago, Chicago, IL, USA

    Sikarin Upala

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Correspondence to Wai Chung Yong.

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Yong, W.C., Sanguankeo, A. & Upala, S. Association between sarcoidosis, pulse wave velocity, and other measures of subclinical atherosclerosis: a systematic review and meta-analysis. Clin Rheumatol 37, 2825–2832 (2018). https://doi.org/10.1007/s10067-017-3926-9

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  • DOI: https://doi.org/10.1007/s10067-017-3926-9

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