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Vascular Reactivity of Adult-Onset Systemic Lupus Erythematosus Patients
Mohammad Adawi1,2, Tair Abu-Gabel1,2, Firas Sabbah1,2
1Department of Rheumatology, Padeh Medical Center, Poriya, Israel.
Insights
Systemic lupus erythematosus (SLE) patients, particularly women, face higher cardiovascular disease (CVD) risks. This study found impaired endothelial function in adult-onset SLE females despite modern treatments, indicating a persistent CVD risk.
Area of Science:
- Rheumatology and Immunology
- Cardiology
- Vascular Biology
Background:
- Systemic lupus erythematosus (SLE) significantly increases cardiovascular disease (CVD) risk compared to the general population.
- Women with SLE are disproportionately affected, often developing CVD at younger ages, including pre-menopause, unlike the general female population.
Purpose of the Study:
- To assess endothelial function in adult-onset SLE female patients from Northern Israel.
- To investigate if contemporary management strategies, including biological therapies, mitigate CVD risk in these patients.
Main Methods:
- A prospective study involving 13 pre-menopausal females with adult-onset SLE (without renal involvement) and 11 age-matched healthy female controls.
- Evaluation of clinical parameters (age, BMI, height), laboratory markers (CRP, hemoglobin), and vascular responsiveness (flow-mediated dilation percentage change [FMD%]).
- Statistical comparison using the Student's t-test to identify significant differences between the SLE and control groups.
Main Results:
- No significant differences were found in age, BMI, or hemoglobin levels between SLE patients and controls.
- SLE patients exhibited significantly higher C-reactive protein (CRP) levels (P=0.001) and impaired vascular responsiveness (FMD%) (P=0.012).
- A significant difference in height was also noted (P=0.009).
Conclusions:
- Adult-onset SLE in females is associated with impaired endothelial function, a key indicator of cardiovascular risk.
- Current treatment protocols, even those including biological agents, do not fully restore endothelial function in these patients.
- This suggests a continued elevated CVD risk in pre-menopausal women with SLE, necessitating ongoing monitoring and potentially novel therapeutic approaches.
Background:
Cardiovascular disease (CVD) is more frequent in patients with systemic lupus erythematosus (SLE) compared with age- and sex-matched healthy subjects. SLE is an autoimmune disease that is more prevalent in women (9:1). Women tend to develop CVD in post-menopausal years; however, women with SLE may develop endothelial dysfunction and CVD at a younger age in the pre-menopausal years.
Objectives:
To study the endothelial function of adult-onset SLE patients from the north of Israel (the Galilee region) and to determine whether modern management (including biological treatments) changes the risk of developing CVD.
Methods:
Thirteen females with adult-onset SLE without renal involvement were recruited to this prospective study. Clinical parameters (age, height, body mass index [BMI]), laboratory parameters (C-reactive protein [CRP] and hemoglobin level), and vascular responsiveness (flow mediated diameter percent change [FMD%]) were evaluated and compared to 11 age-matched healthy females. Student's t-test was used to find differences between the two groups.
Results:
No difference was observed in adult-onset SLE female patients and their age- and sex-matched controls with regard to age (42.1 ± 11.8 years vs. 36.6 ± 10.8 years, P = NS), BMI (25 ± 1.8 kg/m2 vs. 25 ± 2.5 kg/m2, P = NS), and hemoglobin level (11.9 ± 0.9 gr% vs. 12.7 ± 1.2 gr%, P = NS). However, a significant difference was found in CRP (2.57 ± 2.2 mg vs. 0.60 ± 0.37 mg, P = 0.001), vascular responsiveness (0.94 ± 6.6 FMD% vs. 9.2 ± 8.1 FMD%, P = 0.012), and height (165.7 ± 4.5 cm vs. 171.6 ± 5.8 cm, P = 0.009).
Conclusions:
Adult-onset SLE females had impaired endothelial function even though they were treated by modern protocols.
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