Endothelial dysfunction in systemic lupus erythematosus - a case-control study and an updated meta-analysis and...

Area of Science:

• Cardiovascular Medicine
• Rheumatology
• Vascular Biology

Background:

• Endothelium-dependent flow-mediated dilation (ED-FMD) is a key marker of endothelial function.
• Previous studies on endothelial dysfunction in systemic lupus erythematosus (SLE) have yielded inconsistent results.

Purpose of the Study:

• To assess and compare brachial artery ED-FMD (baED-FMD) in SLE patients without cardiovascular disease versus healthy controls (HC).
• To conduct a meta-analysis of case-control studies examining baED-FMD differences between SLE patients and HC.
• To explore factors influencing baED-FMD discrepancies through meta-regression.

Main Methods:

• Ultrasonography was used to measure baED-FMD in 71 SLE patients and 71 HC.
• A meta-analysis included 25 case-control studies (1,313 SLE patients, 1,012 HC).
• Standardized mean difference (SMD) was calculated to determine the effect size of baED-FMD.

Main Results:

• SLE patients demonstrated significantly lower baED-FMD compared to HC (3.72% vs 4.63%, p=0.032).
• Meta-analysis confirmed lower baED-FMD in SLE patients (SMD -1.077, p<0.001).
• Diabetes mellitus, elevated diastolic blood pressure, renal involvement, and aspirin use were associated with greater baED-FMD differences.

Conclusions:

• Systemic lupus erythematosus patients without pre-existing cardiovascular disease exhibit impaired endothelial function.
• Diabetes mellitus, renal disease, and diastolic hypertension are significant contributors to endothelial dysfunction in SLE.