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Assessment of vascular damage in children and young adults with Familial Mediterranean Fever

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Abstract

Familial Mediterranean Fever (FMF) is the most frequent autoinflammatory disease. This study aimed to evaluate the risk of subclinical vascular damage in FMF children, and young adults, using both imaging and laboratory tests. Forty-five FMF patients (mean age 14.3 ± 9.5 years, 33 children) and 44 healthy controls(mean age 13.3 ± 8.6 years, 36 children) were included in the study. The patients were diagnosed according to Tel-Hashomer criteria, were positive for MEFV gene mutation, were treated with colchicine and were evaluated during an attack free-period. The arterial stiffness parameters studied were carotid–femoral pulse wave velocity (PWV), Augmentation Index (Aix), subendocardial viability ratio (SEVR) and carotid intima-media thickness (cIMT). Laboratory parameters, inflammation markers and lipid profile were also evaluated for all participants. There were no significant differences between patients and healthy individuals, as well as in our children population regarding PWV, SEVR, Aix and cIMT. However, significantly higher ESR, CRP and fibrinogen levels were detected in the total population of FMF patients and higher amyloid levels in FMF children, compared to controls. Atherogenic Index of Plasma was significantly higher both in the total patient population and in the subgroup of children, compared to controls. Furthermore, a significant positive correlation between Aix and CRP and a negative correlation between SEVR and ESR became apparent in the pediatric subgroup. Our study demonstrated no significant differences in vascular measurements between FMF patients and controls. The above could be attributed to the regular colchicine treatment, which seems to have a cardioprotective role against vascular damage.

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Abbreviations

AIP:

Atherogenic index of plasma

Aix:

Augmentation index

ApoA1:

Apolipoprotein A1

ApoB:

Apolipoprotein B

BMI:

Body mass index

BP:

Blood pressure

cDBP:

Central diastolic blood pressure

cfPWV:

Carotid to femoral pulse wave velocity

cIMT:

Carotid intima-media thickness

cSBP:

Central systolic blood pressure

CRP:

C-reactive protein

CVD:

Cardiovascular disease

dBP:

Brachial diastolic blood pressure

ESR:

Erythrocyte sedimentation rate

ESC:

European society of cardiology

FMF:

Familial mediterranean fever

HDL-C:

High-density lipoprotein-cholesterol

ISSF:

International Severity Scoring System for Familial Mediterranean Fever

LDL-C:

Low-density lipoprotein-cholesterol

Lp(a):

Lipoprotein (a)

MEFV:

Familial mediterranean fever gene

PWV:

Pulse wave velocity

sBP:

Brachial systolic blood pressure

SEVR:

Subendocardial viability ratio

TC:

Total cholesterol

TG:

Triglycerides

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Authors and Affiliations

  1. 4th Department of Pediatrics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Papageorgiou Hospital, Thessaloniki, Greece

    Olga Vampertzi, Kyriaki Papadopoulou-Legbelou, Sofia Alataki & Efimia Papadopoulou-Alataki

  2. 3rd Department of Internal Medicine, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Papageorgiou Hospital, Thessaloniki, Greece

    Areti Triantafyllou, Nikolaos Koletsos & Stella Douma

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  1. Olga Vampertzi
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  2. Kyriaki Papadopoulou-Legbelou
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  3. Areti Triantafyllou
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  4. Nikolaos Koletsos
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  5. Sofia Alataki
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  7. Efimia Papadopoulou-Alataki
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and literature searching were performed by OV, KP and SA. Vascular measurements were performed by AT. Data analysis was performed by AT and NK. The first draft of the manuscript was written by OV. KP and SD commented on previous versions of the manuscript. Data management, interpretation and supervising were done by EP. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Efimia Papadopoulou-Alataki.

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None declared.

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The study has been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. The study protocol was approved by the Institutional Ethics Committee. Written informed consent of the subjects themselves or their guardians when age was lower than 18 years was obtained before inclusion in the study.

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Vampertzi, O., Papadopoulou-Legbelou, K., Triantafyllou, A. et al. Assessment of vascular damage in children and young adults with Familial Mediterranean Fever. Rheumatol Int 42, 59–69 (2022). https://doi.org/10.1007/s00296-021-04991-4

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