A. Cypiene

Arterial wall dysfunction in systemic lupus erythematosus

Carotid-radial pulse wave velocity (PWV), aortic augmentation index (AIx) and endothelium-dependent flow-mediated dilatation (FMD) have been repeatedly showed to be related to premature atherosclerosis and cardiovascular diseases in different settings of population. The increased arterial stiffness and endothelium dysfunction may add to premature aging of the arteries in systemic lupus erythematosus (SLE) patients. Still data about arterial stiffness and endothelium function in inflammatory rheumatic diseases are not well described. The aim of this study was to determine the PWV, its derivate marker AIx and FMD and factors possibly influencing them in young SLE women without significant organ damage. Thirty women between 23 and 55 years with an established SLE diagnosis and 66 healthy women were consequently included in the study and both groups were comparable according to age, body mass index (BMI), serum lipid profile and creatinine. PWV was determined by measuring carotid-radial pulse wave transit time with the help of applanation tonometry and AIx, its derivate marker, was calculated as a difference between two waveform peaks expressed as a percentage of the pulse pressure. The FMD was performed by obtaining the repeated scans of the brachial artery at rest and during reactive hyperemia. In SLE women, PWV and AIx were significantly higher and FMD was not different from controls. In linear multiple stepwise regression analysis if patients and controls were both considered, PWV was weakly related to mean blood pressure (MBP), AIx was mostly predicted by age and MBP and FMD was predicted by the diameter of blood vessel, BMI, high density lipoproteins. If the sole SLE setting was analyzed, PWV was not related to any of the pending parameters, AIx turned out to be related to organ damage measured by Systemic Lupus International collaborative Clinics (SLICC) index and age, and FMD obtained strong and significant relation with vessel diameter, and BMI, and disease duration. Regardless of the small number of study group patients, we can state that controlling for MBP and taking measures towards organ damage prevention can partially slow down the process of early atherosclerosis in SLE patients.

Vitamin D, cardiovascular and bone healthin postmenopausal women with metabolic syndrome

BACKGROUND The evidence highlights the importance of improving vitamin D levels in the general population for the prevention of adverse long-term health risks, including cardiovascular events, metabolic syndrome, cancer, anxiety and depression, and overall mortality, although controversies in the research are common. OBJECTIVES The purpose of this study was to investigate the relationship between vitamin D and vascular and bone health among postmenopausal metabolic women, controlling for traditional cardiovascular factors, and thus seeking to explore their plausible relation. The secondary aim was to look specifically for the relation between artery stiffness and bone health. MATERIAL AND METHODS This is a cross-sectional study designed to evaluate the relation between vitamin D level and vascular and bone health among women with metabolic syndrome. Two hundred and ten women visiting a cardiologist were recruited consecutively into the study. The study variables included clinical examination, laboratory findings, measurements of vascular stiffness, and bone turnover markers. RESULTS We found 126 (60%) metabolic women with a vitamin D deficiency (50 nmol/L) among the study group. We discovered no statistically significant correlation between vitamin D and vascular stiffness. Vitamin D was not associated neither with femoral neck bone mineral density (BMD) and T score, nor with lumbar spine BMD and T score. Nevertheless, there was an indirect weak correlation between vascular stiffness, in particular the augmentation index (AIx), and all bone health markers, including BMD and T score in both the femur head and lumbar spine. CONCLUSIONS We showed a high proportion of postmenopausal metabolic women with a vitamin D deficiency, but there was no relation between vitamin D and vascular health or vitamin D and bone health. Nevertheless, the relation between vascular health and bone health exists, although the role of vitamin D in this link has not yet been established.

753 THE INFLUENCE OF AGEs ON KIDNEY FUNCTION AMONG PATIENTS WITH METABOLIC SYNDROME

Objectives: The aim of this study was to evaluate the impact of advanced glycation end-products (AGEs) on kidney function among patients with metabolic syndrome. Methods: The retrospective cohort study included 249 patients, who were investigated in a tertiary medical centre from 2011-08-01 till 2011-12-01 and matched NCEP metabolic syndrome criterions. Kidney function was evaluated by albuminuria and glomerular filtration rate, calculated by MDRD formula. AGEs were measured using non-invasive device, the skin autofluorescence reader. AGEs were classified into three groups: 1st-from 0.9 to 1.6 (n = 70), 2nd-from 1.7 to 1.9 (n = 82), 3rd-from 2.0 to 4.0 (n = 97). The kidney function was compared to the amount of AGEs. The data was analysed by using SPSS 19.0 programs. Results: Among 249 patients, there were 159 (63.9%) women and 90 (36.1%) men. Mean age was 53.88 ± 6.18. According to the amount of albumins in urine, specimens were ascribed as normoabuminuria (89.16%), microalbuminuria (10.04%) and macroalbuminuria (0.80%). Analysing albuminuria with AGEs groups, there was no correlation found (p > 0.05). According to GFR, we distributed three groups: GFR >90mls/min/1.73m2, or normal GFR (63.14%), 60-89mls/min/1.73m2, or slightly declined GFR (35.59%), 30–59mls/min/1.73m2, or stage 3 chronic kidney disease (1.27%). We found a negative correlation between GFR and AGEs rates (Pearson correlation coefficient r = 0.232, p < 0.0001). When comparing the distribution of GFR among AGEs’ groups, we found a statistically significant difference between 1st and 3rd groups (p = 0.013). Conclusions: The quantity of AGEs is not associated with the amount of albumins in urine, but higher amount of AGEs do correlate with decreased GFR.