Mehmet ERDOĞAN, Ahmet KASAPKARA, Serdal BAŞTUĞ, Yakup ALSANCAK, Akın AKTAŞ, Ayşe SAATCI YAŞAR

MUKOZAL VE KUTANÖZ TUTULUM İLE SEYREDEN LİKEN PLANUS HASTALARINDA SUBKLİNİK KARDİYOVASKÜLER HASTALIK RİSKİNİN DEĞERLENDİRİLMESİ Evaluation of Subclinical Cardiovascular Disease Risk in Lichen Planus Patients with Mucosal and Cutaneous Involvement

ÖZET Amaç: Liken planus (LP) kronik inflamatuar bir hastalıktır. Karotis intima-medya kalınlığı (KİMK) ölçülmesi ve lipit profilinin değerlendirilmesi aterosklerotik risk tahmini için kabul görmüş bir metottur. Bu çalışmada LP hastalarında kardiyovasküler hastalık (KVH) risk faktörlerinin prevalansı ve subklinik ateroskleroz riskinin değerlendirilmesi amaçlanmıştır. Gereç ve Yöntemler: Bu olgu-kontrolü çalışmaya LP tanısı alan 60 hasta grubu ile yaş ve demografik özellikler açısından benzer 60 kontrol grubu dahil edildi. Gruplar arasında bazal karakteristik özellikleri, KVH risk faktörleri, biyokimyasal ve hematolojik parametreleri, konvansiyonel 2-boyutlu ve Doppler transtorasik ekokardiyografi parametreleri, sol ventrikül kitle indeksi (SoVKİ) ve KİMK karşılaştırıldı. Bulgular: Çalışmaya yaş ortalaması 46±13 yıl olan, 73’ü kadın (%61), 47’si erkek (%39) olmak üzere toplam 120 hasta alındı. Total kolesterol (TK) seviyeleri LP grubunda kontrol grubuna kıyasla daha yüksek bulundu (sırasıyla 209, 192, p=0,038). Gruplar arasında SoVKİ ve konvansiyonel ekokardiyografik ölçümler benzer bulundu. LP grubunda KİMK 0,88±0,16 mm iken kontrol grubunda 0,59±0,10 mm olarak ölçüldü (p<0,001). Kutanöz LP ile mukozal LP arasında ise KİMK benzer bulunmuştur. LP grubunda hastalık süresi ile KİMK arasında anlamlı bir korelasyon izlenmiştir (r=0,61, p<0,001). Hasta grubunda yapılan çok değişkenli doğrusal regresyon analizinde ise yaş, TK seviyesi ve LP hastalık süresinin KİMK’in bağımsız belirleyicileri olduğu gösterildi. Sonuç: LP hastalık süresi ve TK seviyeleri bağımsız olarak KİMK ile ilişkilidir ve LP hastalarının hem mukozal hem de kutanöz tutulumunda KİMK ile önemli ölçüde ilişkilidir. Anahtar Kelimeler: Liken planus; Karotis iç-orta kalınlığı; Ateroskleroz; İnflamasyon; Dislipidemi. ABSTRACT Objective: Lichen planus (LP) is a chronic inflammatory disease. Measurement of the carotid intima-media thickness (CIMT) and lipid profile is an established method for atherosclerotic risk estimation. The aim of this study was to evaluate the prevalence of cardiovascular disease (CVD) risk factors and the risk of subclinical atherosclerosis in patients with LP. Material and Methods: In this case-control study included 60 patient group diagnosed with LP and 60 control group similar in terms of age and demographic characteristics. Baseline characteristics, CVD risk factors, biochemical and haematological parameters, conventional 2-dimensional and Doppler transthoracic echocardiographic parameters, left ventricular mass index (LVMI) and CIMT were compared between the groups. Results: A total of 120 patients, 73 female (61%) and 47 male (39%), with a mean age of 46 ± 13 years, were included in the study. Total cholesterol (TC) levels were found to be higher in the LP group compared to the control group (209, 192, p = 0.038, respectively). The LVMI and conventional echocardiographic measurements were comparable between the groups. CIMT was 0.88 ± 0.16 mm in the LP group and 0.59 ± 0.10 mm in the control group (p <0.001). CIMT was similar between cutaneous LP and mucosal LP. In the group of LP, a significant correlation was observed between disease duration and CIMT (r = 0.61, p <0.001). Multivariate linear regression analysis demonstrated that, age, TC levels and LP disease duration were independent determinants of CIMT in the patients group Conclusion: LP disease duration and TC levels are independently associated with CIMT and significantly correlates with CIMT in both mucosal and cutaneous involvement of LP patients. Keywords: Lichen Planus; Carotid İntima-Media Thickness; Atherosclerosis; İnflammation; Dyslipidemia.

Anahtar Kelimeler:

MUKOZAL VE KUTANÖZ TUTULUM İLE SEYREDEN LİKEN PLANUS HASTALARINDA SUBKLİNİK KARDİYOVASKÜLER, HASTALIK RİSKİNİN DEĞERLENDİRİLMESİ, Evaluation of Subclinical Cardiovascular Disease Risk in Lichen Planus Patients with Mucosal and Cutaneous Involvement

THE QUADRATE TUBERCLE: A MORPHOMETRIC STUDY

ABSTRACT Objective Quadratus femoris muscle originates from ischial tuberosity and inserts into the quadrate tubercle of femur. Simply quadrate tubercle may be defined to be localized on the intertrochanteric crest. There are only a few more detailed descriptions of its localization. Consequently we have aimed to describe the exact localization of the quadrate tubercle. Material and Methods Morphometric measurements related with quadrate tubercle were performed on 144 adult human femurs. Afterwards proportional calculations between the measured morphometric measurements related with quadrate tubercle were made. Results Mean vertical distance between the most prominent points of greater and lesser trochanters was found as 63.13 mm. Mean vertical distance between the most prominent point of greater trochanter and origin of quadrate tubercle was measured as 21.78 mm. Mean vertical distance between the origin and end of quadrate tubercle was determined as 17.16 mm. Mean vertical distance between the end of quadrate tubercle and most prominent point of lesser trochanter was 24.26 mm. Mean length of femur was measured as 425.47 mm. Origin of quadrate tubercle was meanly found in the upper 35% of the distance between the most prominent points of greater and lesser trochanters and end of quadrate tubercle was meanly found to be located in the upper 62% of the same distance. Conclusion As location of quadrate tubercle hasn’t been discussed in detail yet, we believe that this study will be instructive for further anatomical or clinical studies related with it.

Keywords:

Quadrate tubercle, Intertrochanteric crest, Quadratus femoris muscle,

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