Abstract
Background
Vascular involvement in Behçet’s disease (BD) is one of the major causes of mortality and morbidity. Modifiable cardiovascular risk factors such as high blood pressure, dyslipidemia, hyperglycemia, overweight, and smoking have been demonstrated to have a significant impact on cardiovascular disease in the general population with or without other diseases.
Objective
The aim of this study was to evaluate whether modifiable cardiovascular disease risk factors differ among patients with BD in comparison with the general population.
Patients and methods
This was a multicenter case–control study carried out on 182 BD patients identified by analysis of the databases of the International Study Group Classification Criteria. The patients were compared with 80 controls matched for age, sex, and study period. Full clinical history taking and medical examination were carried out for all patients, and investigations including lipid profile and blood glucose were carried out and data on hypertension, height, weight, and smoking were collected and recorded.
Results
Levels of serum low-density lipoprotein (P<0. 005) and cholesterol (P<0.005) were significantly high in the Behçet patient group, but no statistical difference was detected as regards triglycerides, diabetes mellitus, or BMI. Smoking and hypertension increase the risk of cardiovascular manifestations in our patients. The mean±SD age of BD patients was 31.6±9.008, 76.9% were male individuals and 23.1% were female individuals.
Conclusion
Patients with BD had a high prevalence of cardiovascular comorbidities. Optimal control of blood pressure, lipids and blood sugar with reduction in body weight and stoppage of smoking may be an effective strategy to reduce vascular complications in these populations.
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References
Hasan MS, Ryan PL, Bergmeier LA, Fortune F. Circulating NK cells and their subsets in Behçet’s disease. Clin Exp Immunol 2017; 188:311–322.
Cho SB, Cho S, Bang D. New insights in the clinical understanding of Behçet’s disease. Yonsei Med J 2012; 53:35–42.
Demirelli S, Degirmenci H, Inci S. Cardiac manifestations in Behcet’s disease. Intractable Rare Dis Res 2015; 4:70–75.
Alibaz-Oner F, Direskeneli H. Management of vascular Behcet’s disease. Int J Rheum Dis 2019; 1:105–108.
Yazici H, Seyahi E, Hatemi G. Behçet syndrome: a contemporary view. Nat Rev Rheumatol 2018; 14:107–117.
Cocco G, Gasparyan AY. Behçet’s disease: an insight from a cardiologist’s point of view. Open Cardiovasc Med J 2010; 4:63–70.
Zeidan MJ, Saadoun D, Garrido David M. Behcet’s disease physiopathology: a contemporary review. Auto Immun Highlights 2016; 7:4
El-Gazzar I, El-Dakrony AH, Sayed S. Clinical significance of metabolic syndrome and carotid intima-media thickness in Behçet’s disease patients: relation to disease activity. Egypt Rheumatol 2017; 39:171–174.
Sundström B, Johansson G, Johansson I. Modifiable cardiovascular risk factors in patients with ankylosing spondylitis. Clin Rheumatol 2014; 33:111–117.
Pandey A, Garg J, Krishnamoorthy P. Predictors of coronary artery disease in patients with Behcet’s disease. Cardiology 2014; 129:203–206.
Kechida M, Salah S, Kahloun R. Cardiac and vascular complications of Behçet disease in the Tunisian context: clinical characteristics and predictive factors. Adv Rheumatol 2018; 58:32.
Ayari J, Mourali MS, Farhati A, Mechmeche R. Left main coronary artery thrombosis revealing angio-Behçet syndrome. Egypt J Intern Med 2014; 26:88–90.
Gheita TA, El-Latif EA, El-Gazzar II. Behçet’s disease in Egypt: a multicenter nationwide study review of the literature. Clin Rheumatol 2019; 38:1–11.
Davatchi F. Behcet’s disease. Int J Rheum Dis 2014; 17:355–357.
El Menyawi MM, Raslan HM, Edrees A. Clinical features of Behcet’s disease in Egypt. Rheumatol Int 2009; 29:641–646.
Sula B, Batmaz I, Ucmak D. Demographical and clinical characteristics of Behcet’s disease in Southeastern Turkey. J Clin Med Res 2014; 6:476–481.
Kim JH, Jeong MH. Can family history of premature coronary artery disease be a risk factor for clinical outcomes in patients with acute myocardial infarction?. Korean J Intern Med 2013; 28:538–540.
Aksu T, Güler E, Arat N. Cardiovascular involvement in Behçet’s disease. Arch Rheumat 2015; 30:109–115.
Wu CY, Yu HS, Chai CY. Increased ischemic stroke risk in patients with Behcet’s disease: a nationwide population based cohort study. PLoS ONE 2019; 14:e0218652.
Koca SS, Kara M, Özgen M. Low prevalence of obesity in Behçet’s disease is associated with high obestatin level. Eur J Rheumatol 2017; 4:113–117.
Pancar GS, Kalkan G. Diagnostic value of HbA1c level in Behcet’s disease and evaluation of neutrophil-lymphocyte ratio, mean platelet volume and body mass index. J Hematol 2015; 4:219–222.
Erdem H, Dinc A, Pay A. Peripheral insulin resistance in patients with Behçet’s disease. Eur Acad Dermatol Venereol 2006;391–395
Hassan S, Gheita T, Ghoneim S. Subclinical atherosclerosis in Behçet’s disease. Turk J Rheumatol 2012; 27:109–114.
Messedi M, Jamoussi K, Frigui M. Atherogenic lipid profile in Behçet’s disease: evidence of alteration of HDL subclasses. Arch Med Res 2011; 42:211–218.
Seyahi E, Ugurlu S, Cumali R. Atherosclerosis in Behçet’s syndrome. Semin Arthritis Rheum 2008; 38:1–12.
Kayatas K, Karatoprak C, Cebeci F. Presence of low lipid levels in patients with Behcet’ s disease as a protector against atherosclerosis. Eur Rev Med Pharmacol Sci 2013; 17:2330–2334.
Lee SS, Choi CB, Lee EK. The association between smoking and clinical manifestations in patients with Behcet’s disease. Korean J Med 2008; 75:202–209
Malek Mahdavi A, Khabbazi A, Yaaghoobian B. Cigarette smoking and risk of Behcet’s disease: a propensity score matching analysis. Mod Rheumatol 2018; 29:1439–7595.
Ridker PM, Hennekens CH, Buring JE. C-reactive protein and other markers of inflammation in the prediction of cardiovascular disease in women. New Engl J Med 2000; 342:836–843.
Muftuoclu A, Yazici H, Yurdakul S. Relation of serum C-reactive protein and erythrocyte sedimentation rates to disease activity. Int J Dermatol 1986; 25:235–239.
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El-Shebiny, E., El-Fakharany, A., Zahran, E. et al. Modifiable cardiovascular risk factors in patients with Behçet’s disease: a multicenter experience. Egypt J Intern Med 31, 726–732 (2019). https://doi.org/10.4103/ejim.ejim_112_19
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DOI: https://doi.org/10.4103/ejim.ejim_112_19