Elsevier

Archives of Medical Research

Volume 36, Issue 4, July–August 2005, Pages 387-392
Archives of Medical Research

Original article
Lipid Profile and Anticardiolipin Antibodies in Behcet's Disease

https://doi.org/10.1016/j.arcmed.2005.03.019Get rights and content

Background

Behcet's disease (BD) is a multisystem disorder characterized by a relapsing inflammatory process of unknown etiology. It is well known that atherothrombosis in systemic inflammatory disorders is closely related to coagulation and lipid metabolism abnormalities. The purpose of this study was to investigate some parameters of lipid metabolism, lipoprotein (a) [Lp(a)] and anticardiolipin antibody (ACA) levels and the relationship of these parameters with the clinical activity of BD.

Methods

Thirty three patients with BD (15 active, 18 inactive cases) and 20 healthy controls participated in the study. After performing a detailed physical exam, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), very-low-density lipoprotein cholesterol (VLDL-C), apoprotein A and B (apo-A, apo-B), Lp(a), and ACA levels (ACA-IgG and IgM) were measured in all participants.

Results

Patients with active BD had higher ESR, CRP and Lp(a) levels, and lower apo-A and HDL-C levels compared with the patients with inactive BD and healthy controls. ACA-IgG and IgM levels were higher in patients with active BD than healthy controls but not higher than patients with inactive BD. On the other hand, ACA-IgG level was higher in active and inactive cases with vascular involvement than in those of active and inactive cases without vascular involvement. In the analyses of correlation, in active BD patients we found a positive correlation between CRP and Lp(a) levels.

Conclusions

Our findings suggest that Lp(a) behaves as an acute phase reactant and ACA levels are increased in patients with active BD. Data from patients with active BD may be compatible with the serum profile, which is accepted as a risk for the development of atherothrombosis.

Introduction

Behcet's disease (BD) is a multisystem disorder characterized by a relapsing inflammatory process of unknown etiology (1). In this disease, there are four major symptoms including recurrent oral aphthous ulcers, skin lesions, ocular lesions, and genital ulcers, in addition to minor symptoms such as articular symptoms, involvement of the digestive tract, epididymitis, vascular involvement and neuropsychiatric symptoms. In BD, venous involvement is common, whereas arterial involvement is rare (2). Both small- and large-sized vasculature may be subsequently involved in the course of the disease. Based on the findings that thrombotic episodes were common in BD as seen also in primary antiphospholipid syndrome, antiphospholipid antibody levels under this condition have been investigated by many researchers 3, 4.

It is well known that atherothrombosis in systemic inflammatory disorders is closely related to the abnormalities of coagulation and lipid metabolism abnormalities (5). Likewise, in many studies, it has already been shown that changes in lipid profile occur in inflammatory conditions 6, 7 and relationship between acute phase reactants, which have effects on inflammation and lipid metabolism (8).

Although antiphospholipid antibodies and some lipid and lipoprotein levels in BD were investigated separately in many studies 3, 4, 9, 10, we are not aware of any previous studies of antiphospholipid antibodies, lipoprotein (a) [Lp (a)], which is cholesterol-rich plasma lipoprotein (11), along with lipid and lipoprotein profile in BD. The purpose of this study was to investigate some parameters of lipid metabolism, such as total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), very-low-density lipoprotein cholesterol (VLDL-C), apolipoprotein-A (apo-A), apolipoprotein-B (apo-B) and Lp(a) and anticardiolipin antibody (ACA) levels (ACA-IgG and IgM), and the relationship of these parameters with the clinical activity of BD.

Section snippets

Patients and controls

This study was carried out in patients followed up at the Internal Medicine Clinics. Patient group consisted of 33 (28 male, 5 female) patients with BD (15 active, 18 inactive), aged 21–52 years. The diagnosis of BD was made according to the criteria proposed by International Study Group for BD (12). The disease activity was defined clinically. Clinical features included oral and genital ulcerations, eye involvement (uveitis and/or retinal vasculitis), skin manifestations (papuler pustuler

Demographic characteristics of patients and controls

Age, sex and body mass index (BMI) of the patients and the controls were shown in Table 1. As seen in Table 1, there was no statistically significant difference among the study groups for these three parameters.

Comparison of lipid profile and ACA levels in patient and control groups

Results of parameters of lipid metabolism of BD patients and control groups were shown in Table 2. Patients with active BD had higher ESR, CRP and Lp(a) levels, and lower apo-A and HDL-C levels when compared to patients with inactive BD and control group. TC, TG, LDL-C, VLDL-C and apo-B

Discussion

In a previous report, a higher level of CRP was found in patients with clinically active BD than in healthy controls (16). We also found that clinically active patients had higher levels of ESR and CRP than the inactive patients with BD and healthy controls.

Presentations of changes in lipid metabolism in patients with BD were already reported. A study by Mitamura and co-workers showed that HDL-C levels in male patients with BD were lower than in healthy controls, whereas VLDL and LDL-C levels

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