Serum Endocan in Systemic Lupus Erythematosus: Implication for Endothelial Dysfunction and Cardiovascular Risk

Systemic lupus erythematosus (SLE) is a chronic multisystem autoimmune disease. Endothelial dysfunction is an early change in atherosclerosis. Endocan is a new indicator of endothelial dysfunction and is probably involved in proinflammatory processes in SLE. This study aimed to assess the serum endocan level in SLE patients and its relation to disease activity, endothelial dysfunction, and subclinical atherosclerosis.

This study included 60 SLE patients and 60 healthy controls. Demographic data were collected, and disease activity was assessed using the SLEDAI score for SLE patients. Functional assessment was done using the Health Assessment Questionnaire (HAQ). Serum endocan level was measured, and subclinical atherosclerosis was assessed using brachial artery flow-mediated dilation (FMD) and carotid intima-media thickness (cIMT).

Endocan levels in the SLE group (632.2 ± 70.58 ng/L) were significantly higher than controls (125.83 ± 16.23 ng/L). cIMT was significantly higher in SLE patients (8.18 ± 1.13 mm) than in controls (6.43 ± 0.54), and the mean flow-mediated dilation value in SLE patients was 9.57 ± 2.59, whereas in the control group, it was 21.8 ± 4.27. The serum level of endocan was significantly correlated with the duration of the disease, triglycerides, and cIMT, and it had a significant negative correlation with flow-mediated dilation. cIMT and flow-mediated dilation were significantly correlated with age, disease duration, and triglycerides.

Elevated serum levels of endocan in SLE patients may be associated with subclinical atherosclerosis and endothelial dysfunction.