Эндотелиальная дисфункция у больных системной красной волчанкой как ранний маркер атеросклероза

N. V. Lazareva; O. V. Bugrova; N. E. Artemova; R. I. Saifutdinov; K. M. Ivanov; K. A. Nagornova

doi:10.34687/2219-8202.JAD.2022.04.0005

Authors

N. V. Lazareva The Orenburg State Medical University
O. V. Bugrova The Orenburg State Medical University.
N. E. Artemova The Orenburg State Medical University.
R. I. Saifutdinov The Orenburg State Medical University.
K. M. Ivanov The Orenburg State Medical University.
K. A. Nagornova North-Western State Medical University named after I.I. Mechnikov

DOI:

https://doi.org/10.34687/2219-8202.JAD.2022.04.0005

Keywords:

endothelial dysfunction, systemic lupus erythematosus, risk factors, atherosclerosis

Abstract

Abstract

Objective. In patients with systemic lupus erythematosus (SLE) evaluate the incidence and severity of endothelial dysfunction (ED) as a marker of early atherosclerosis, risk factors for cardiovascular diseases (CVD) and SLE course related with ED.

Methods. Seventy-two patients with SLE, mainly women aged 36 (26; 47) years were compared with age-matched 15 healthy individuals. Both groups were without clinical signs of atherosclerosis. Traditional risk factors for cardiovascular diseases and indicators of antiphospholipid syndrome (APS) have been studied. Endothelium-dependent and -independent vasodilation of the brachial artery were determined by ultrasound to evaluate ED.

Results. Patients with SLE were more likely to have arterial hypertension (73.61%), burdened heredity for CVD (12.52%), smoking (6.94%), dyslipidemia (63.88%). ED was detected in 51 (70.83%) patients, most of them (56.93%) had moderate and severe ED. The presence of endothelial dysfunction correlated with elevated body mass index (BMI) and increased levels of atherogenic lipoproteins. In the presence of ED, a higher activity of SLE was noted, lupus nephritis and antiphospholipid syndrome were more common. Significant correlations of brachial artery diameter with BMI, levels of atherogenic lipoproteins, the presence of arterial hypertension and the level of Willebrand factor have been discovered. Blood flow velocity correlated with SLEDAI-K2 and SLICC/ACR indexes, levels of hs-CRP and fibrinogen.

Conclusion. The endothelial dysfunction, as an early marker of atherosclerosis is present in better part of patients with SLE. The presence and severity of ED is associated with increased BMI and high levels of atherogenic lipoproteins. There is a significant relationship between the endothelial dysfunction and the activity of the disease, the presence of lupus nephritis and APS.

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