Publication:

The use of atherogenic indices as a useful marker to predict cardiovascular risk in patients with spondyloarthritis

Background The atherogenic index of plasma (AIP), linked to cholesterol esterification and its correlation with small dense low-density lipoprotein (LDL) levels in the blood, can predict atherosclerosis and coronary heart disease.

Methods The study examined 45 SpA patients from the Institute of Rheumatology, RGGGH, and MMC. They underwent baseline assessments, lipid profiles, measurements, and blood tests. Atherogenic indices (AIP, Castelli's Risk I and II, atherogenic coefficient) were calculated and defined using thresholds.

Results In this study, most patients were males (68.9%) with a mean age of 37.73. Primary ankylosing spondylitis (AS) was (62.2%), and HLAB27 was positive in 33.3% of cases. Elevated AI was prevalent: AIP>0.11 (51.1%), CR-I>3.5 (males) or >3.0 (females) (77.8%), CR-II>3.0 (26.7%), and AC>3.0 (44.4%). Significant correlations were found between AIP and waist-hip ratio (p=0.045) and AIP and fasting blood sugar [FBS] (p=0.023). High AIP was significantly associated with metabolic syndrome (21.7%) but not high disease activity. CR-I was associated with elevated FBS levels (p=0.033). CR-II was linked to higher uric acid levels (p=0.043) and current TNF inhibitor use (p=0.041), and AC showed no significant associations with the assessed factors.

Conclusions This study underscores AI's role in assessing cardiovascular risk in spondyloarthritis patients. AIP, CR-I, and CR-II provide vital risk assessment and management insights. AIP effectively identifies metabolic syndrome, while increased Castelli's risk index II warrants further investigation in a broader population, especially among TNF inhibitor users.