Original articleLipid Profile and Anticardiolipin Antibodies in Behcet's Disease
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.
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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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2012, Journal of Lipid ResearchCitation Excerpt :In contrast, the expression of the antiatherogenic genes Rhob, which is involved in angiogenesis and EC survival (37) and Tfpi, an anticoagulant factor protein (38), were increased in Tie2 hABCA1 transgenic mice compared with control mice on a HFHC diet (Fig. 6A). It is known that a number of inflammatory disorders, such as systemic vasculitis, Kawasaki disease, and Behcet's disease, are associated with low HDL, endothelial dysfunction, and pro-atherogenic gene expression (54–57). Endothelial dysfunction can also occur in diabetes (58) and hypertension (59), and it is often also associated with decreased HDL-C (60, 61).