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

Background and Objectives: Behcet'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 Behcet'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 I-2. Results: Data were extracted from four observational studies that included 303 subjects. PWV is significantly higher in patients with Behcet's disease compared with controls (MD=0.74; 95%, CI: 0.28-1.20, p=0.002, I-2=63%). Conclusion: In this meta-analysis, we observed that PWV, an ideal indicator of arterial stiffness, is increased in patients with Behcet'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.