Korean Circ J.  2017 Jul;47(4):477-483. 10.4070/kcj.2017.0004.

Increased Arterial Stiffness in Behçet's Disease: a Systematic Review and Meta-Analysis

• Upala S
• Yong WC
• Sanguankeo A

• KMID: 2392885
• DOI: http://doi.org/10.4070/kcj.2017.0004

Abstract

BACKGROUND AND OBJECTIVES
Behçet's disease (BD) is a systemic vasculitis that is characterized by genital, oral, or skin lesions, uveitis, and vascular complications. Studies have shown that increased arterial stiffness is common in systemic immune and inflammatory diseases such as rheumatoid arthritis and systemic lupus erythematosus. However, current research has not yet determined whether patients with BD have increased arterial stiffness. This meta-analysis compares arterial stiffness parameters in subjects with a BD diagnosis to normal subjects.
SUBJECTS AND METHODS
A comprehensive search of the MEDLINE and EMBASE databases was performed from the database beginning through May 2016. Observation studies were included in this analysis if they assessed the association between BD and arterial stiffness in adult subjects. BD patients met the International Study Group criteria for a diagnosis of Behçet's disease. Aortic stiffness was assessed using carotid-femoral pulse wave velocity (PWV) measurements as an indicator. Pooled mean difference (MD) of PWV and 95% confidence intervals (CI) were calculated using a random-effect, generic inverse variance meta-analysis. The between-study heterogeneity of effect-size was quantified using the Q statistic and I².
RESULTS
Data were extracted from four observational studies that included 303 subjects. PWV is significantly higher in patients with Behçet's disease compared with controls (MD=0.74;95%, CI: 0.28-1.20, p=0.002, I²=63%).
CONCLUSION
In this meta-analysis, we observed that PWV, an ideal indicator of arterial stiffness, is increased in patients with Behçet's disease compared with the controls. Prospective studies in a large population should be done to determine the pathophysiological and prognostic implications of increased arterial stiffness in BD.

Keyword

Meta-analysis; Vascular stiffness; Pulse wave analysis; Behçet's disease

MeSH Terms

Adult
Arthritis, Rheumatoid
Diagnosis
Humans
Lupus Erythematosus, Systemic
Population Characteristics
Prospective Studies
Pulse Wave Analysis
Skin
Systemic Vasculitis
Uveitis
Vascular Stiffness*

Figure

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  Fig. 1 Search methodology and selection process.

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  Fig. 2 Forest plot of arterial stiffness (pulse wave velocity), for patients with and without Behçet's disease. CI: confidence interval.

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  Fig. 3 Funnel plots showing studies that reported arterial stiffness (pulse wave velocity) in patients with and without Behçet's disease. Circles represent observed published studies.

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