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Vascular endothelial dysfunction in pediatric rheumatic diseases: a systematic review and meta-analysis

Marieta P Theodorakopoulou1, Vasiliki Sgouropoulou2, Fotini Iatridi1

  • 11st Department of Nephrology, Aristotle University of Thessaloniki, Thessaloniki, Greece.

Expert Review of Clinical Immunology
|May 26, 2025
PubMed

Insights

Children with rheumatic diseases exhibit impaired endothelial function, a finding linked to increased cardiovascular risk. Further research is needed to confirm this association in pediatric rheumatic conditions.

Area of Science:

  • Pediatric Rheumatology
  • Cardiovascular Health
  • Endothelial Function

Background:

  • Endothelial dysfunction is a known risk factor for cardiovascular disease.
  • Autoimmune diseases, including pediatric rheumatic conditions, are associated with heightened cardiovascular risk.
  • Assessing endothelial function in children with rheumatic diseases is crucial for understanding their long-term health outcomes.

Purpose of the Study:

  • To systematically review and meta-analyze studies evaluating endothelial function in children with rheumatic diseases compared to healthy controls.
  • To determine if children with rheumatic diseases have impaired endothelial function.
  • To explore potential differences in endothelial function across various types of pediatric rheumatic diseases.

Main Methods:

  • A comprehensive literature search was conducted in PubMed and Scopus databases up to February 2024.
  • Studies utilizing functional methods to assess endothelial function were included.
  • Quality assessment of included studies was performed using the Newcastle-Ottawa scale.

Main Results:

  • The meta-analysis included 24 studies with 880 children with rheumatic diseases and 784 controls.
  • Significantly impaired endothelial function was observed in children with rheumatic diseases (SMD: -0.74).
  • Subgroup analyses revealed impaired endothelial function in juvenile idiopathic arthritis, vasculitis, and juvenile systemic sclerosis.

Conclusions:

  • Children diagnosed with rheumatic diseases demonstrate impaired endothelial function.
  • Further investigation is warranted to establish the role of endothelial dysfunction in the elevated cardiovascular risk observed in these pediatric patients.
Abstract

Keywords:
Cardiovascularendothelial dysfunctionendotheliummeta-analysispediatric rheumatic disease

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