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

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.