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Early ultrasonographic markers of atherosclerosis in patients with familial Mediterranean fever

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Systemic inflammation plays an important role in the development of atherosclerosis (AS). The aim of this study was to evaluate the presence of early AS in patients with familial Mediterranean fever (FMF) that is characterized by recurrent inflammatory attacks of serositis. Sixty-one FMF patients (30 Male/31 Female; 31.5 [18–54] years) and 31 healthy controls (16 Male/15 Female; 31 [22–58] years) were studied. All FMF patients were on regular daily colchicine treatment and during attack-free periods. Both the FMF patients and controls with a history of diabetes mellitus (DM), hypertension, and hyperlipidemia were excluded. Body mass index (BMI) was calculated. Serum lipids, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) were assessed. Two-hour oral glucose tolerance test was performed to rule out DM and glucose intolerance. To investigate early AS “endothelium-dependent flow-mediated dilatation (FMD%),” “nitroglycerin-induced endothelium-independent peripheral vasodilatation (NTG%),” and intima-media thickness (IMT) of common carotid arteries (CCA) were measured by ultrasonograpy. The median disease duration for FMF patients was 16 (1–45) years. Age, sex, BMI, smoking status, and serum lipids were comparable in patients and controls (p > 0.05). However, ESR and standard CRP were significantly higher in the patients group (p < 0.05). There were no differences in the measurements of right, left, and averaged IMT of CCA between patients and controls ([0.49 vs 0.5], [0.51 vs 0.52] and [0.5 vs 0.51]; p > 0.05, respectively). None of the subjects had carotid artery plaques. FMD% and NTG% were also similar in patients and controls group ([18.2 vs 20.6] and [24.2 vs 22.5]; p > 0.05, respectively). This study suggests that the markers of early AS are not impaired in FMF patients on regular daily colchicine treatment.

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Fig. 1

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brachial artery diameter


body mass index


common carotid artery


C-reactive protein




diabetes mellitus


erythrocyte sedimentation rate


flow-mediated dilatation


familial Mediterranean fever


high density lipoprotein




intima-media thickness


low density lipoprotein




rheumatoid arthritis


systemic lupus erythematosus


Statistical Package of Social Science


total cholesterol




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Correspondence to Fatos Onen.

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Sari, I., Karaoglu, O., Can, G. et al. Early ultrasonographic markers of atherosclerosis in patients with familial Mediterranean fever. Clin Rheumatol 26, 1467–1473 (2007).

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