Key result
Familial Mediterranean fever was associated with higher fibrinogen and CRP levels than healthy controls, but not with increased carotid intima media thickness (p>0.05).
Why the study?
This study aimed to investigate the presence of early atherosclerosis due to inflammation and its relationship with microalbuminuria in newly diagnosed Familial Mediterranean fever (FMF) patients.
Is there a relationship between early atherosclerosis (measured by carotid IMT), inflammation, and microalbuminuria in newly diagnosed Familial Mediterranean fever patients compared to healthy volunteers?
Case-Control (n=111)
Is there a relationship between early atherosclerosis (measured by carotid IMT), inflammation, and microalbuminuria in newly diagnosed Familial Mediterranean fever patients compared to healthy volunteers?
p-value: p=>0.05
In newly diagnosed FMF patients, despite elevated inflammatory markers, there is no significant increase in carotid IMT or correlation with microalbuminuria, suggesting routine carotid Doppler ultrasound is not warranted for early atherosclerosis screening in this population.
May support microalbuminuria screening for early vascular risk in new FMF; leaves open causal links and need for prospective validation.
Aim:This study aimed to investigate the presence of early atherosclerosis due to inflammation and its relationship with microalbuminuria in newly diagnosed Familial Mediterranean fever (FMF) patients. Material and Methods:Seventy-seven FMF patients who were newly diagnosed and 34 healthy volunteers were enrolled in this study. In all study groups, microalbuminuria in 24 hours urine sample, C-reactive protein (CRP), hemogram, erythrocyte sedimentation rate (ESR), fibrinogen, routine biochemistry, and lipid panels were performed. Carotid intima media thickness (IMT) was measured in both groups using the same ultrasonography device using a 12 MHz linear probe. To minimize technical errors, patients were also evaluated by the same radiologist. In all patients, both the main carotid arteries and internal carotid arteries were examined for morphology. Results:IMT, triglyceride, high-density lipoprotein, low-density lipoprotein, and cholesterol levels did not differ significantly between the groups (p>0.05). The fibrinogen levels of the FMF group were significantly higher (p<0.01). The CRP levels of the FMF group were significantly higher (p<0.05). On the other hand, ESR, red blood cell, hematocrit, hemoglobin, platelet, and microalbumin measurements did not show statistically significant difference according to the groups (p>0.05). The positive 15.2% correlation between IMT and fibrinogen levels was not statistically significant (r=0.152; p=0.109; p>0.05). There was no statistically significant relationship between IMT and CRP and ESR levels. The negative 10.2% difference between IMT and microalbumin values was not statistically significant (r=-0.102; p=0.289; p>0.05). Conclusion:The significant difference between the inflammatory markers, such as fibrinogen and CRP between FMF patients and the healthy controls demonstrates that subclinical inflammation continued in the patient group, even if the patient did not develop FMF attack. Although microalbuminuria is known to be an early diagnostic criterion of atherosclerosis, no correlation was detected between microalbuminuria and inflammatory markers and carotid IMT. In summary, since no remarkable correlation was found between FMF-related inflammation and carotid IMT, we do not recommend clinical follow-up with carotid Doppler ultrasound in addition to routine outpatient controls.
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Gündoğdu et al. (2024) conducted a case-control in Familial Mediterranean fever (n=111). Familial Mediterranean fever vs. Healthy volunteers was evaluated on Carotid intima media thickness (IMT) (p=>0.05). Familial Mediterranean fever was associated with higher fibrinogen and CRP levels than healthy controls, but not with increased carotid intima media thickness (p>0.05).
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