Department of Internal Medicine, Nephrology Unit, School of Medicine, Cairo University, Giza, Egypt.
Department of Internal Medicine, Endocrinology Unit, School of Medicine, Cairo University, Giza, Egypt.
Saudi J Kidney Dis Transpl. 2021 May-Jun;32(3):671-679. doi: 10.4103/1319-2442.336761.
Systemic lupus erythematosus (SLE) is a multisystem chronic autoimmune disease characterized by tissue inflammation. There is increased cardiovascular mortality in cases with SLE. Endothelial dysfunction is an early stage of atherosclerosis, which can be reversed early. We aimed to study noninvasive assessment of endothelial dysfunction in Egyptian patients with SLE. Three hundred individuals were recruited; 100 SLE patients with lupus nephritis (LN), 100 SLE patients free of LN as well as 100 healthy volunteers. The vascular endothelial function was evaluated through ultrasonographic assessment of brachial artery diameter to determine the flow-mediated dilation (FMD) as well as a blood endothelial marker called platelet endothelial cell adhesion molecule-1, also known as cluster of differentiation 31 (CD31), was measured. CD31 is abnormal in 93% of cases with LN and 79% in cases without nephritis. There was a significant higher level in CD31 in cases of LN compared with lupus without nephritis with P = 0.016. FMD is impaired in all cases with LN, 95% in cases without nephritis, and in 20% of the controls. There was a significant lower FMD in cases of LN compared with lupus without nephritis with P <0.001. Multiple regression analysis showed that FMD of the brachial artery (P <0.001) is an independent factor to predict LN. Endothelial dysfunction is increased in cases with SLE especially those with nephritis. CD31 and FMD can be used as noninvasive methods for early detection of endothelial dysfunction.
系统性红斑狼疮（SLE）是一种多系统慢性自身免疫性疾病，其特征是组织炎症。SLE 患者的心血管死亡率增加。内皮功能障碍是动脉粥样硬化的早期阶段，可以早期逆转。我们旨在研究埃及 SLE 患者内皮功能障碍的无创评估。招募了 300 人；100 例狼疮肾炎（LN）SLE 患者、100 例无 LN 的 SLE 患者和 100 名健康志愿者。通过超声评估肱动脉直径来评估血管内皮功能，以确定血流介导的扩张（FMD），并测量一种称为血小板内皮细胞黏附分子-1（也称为分化群 31（CD31）的血液内皮标志物。LN 患者中有 93%、无肾炎患者中有 79%的 CD31 异常。LN 患者的 CD31 水平明显高于狼疮无肾炎患者，P = 0.016。所有 LN 患者的 FMD 均受损，无肾炎患者的 FMD 受损 95%，对照组的 FMD 受损 20%。LN 患者的 FMD 明显低于狼疮无肾炎患者，P <0.001。多元回归分析显示，肱动脉 FMD（P <0.001）是预测 LN 的独立因素。SLE 患者的内皮功能障碍增加，特别是那些有肾炎的患者。CD31 和 FMD 可作为早期检测内皮功能障碍的无创方法。
