Ibrahim-Achi Zeina, Jorge-Pérez Pablo, Abreu-González Pedro, López-Mejías Raquel, Martín-González Candelaria, González-Gay Miguel Á, Ferraz-Amaro Iván
Division of Angiology and Vascular Surgery, Hospital Universitario de Canarias, 38320 Tenerife, Spain.
Division of Cardiology, Hospital Universitario de Canarias, 38320 Tenerife, Spain.
Antioxidants (Basel). 2023 Aug 25;12(9):1668. doi: 10.3390/antiox12091668.
Systemic sclerosis (SSc) is a chronic disease characterized by vasculopathy with the involvement of dysfunctional microcirculatory vessels. Features of the disease include progressive fibrosis of the skin and internal organs and systemic inflammation characterized by the presence of circulating autoantibodies and proinflammatory cytokines. Furthermore, macrovascular disease and atherosclerosis are more common in patients with SSc than in the general population. Oxidative stress plays a crucial role in the development of several processes, including endothelial dysfunction, cancer, inflammation, and atherogenesis. Malondialdehyde (MDA) is a well-established marker of oxidative stress. In this work, we have analyzed the relationship between serum MDA levels and clinical, laboratory, and vascular characteristics in a well-characterized cohort of 53 patients with SSc. A multivariable analysis was performed to study the relationship between circulating MDA and disease characteristics in patients with SSc. Cardiovascular assessment was also performed, including ultrasonography of the carotid and aorta, and echocardiography. MDA showed a significant and positive relationship with the serum levels of lipid profile molecules such as total cholesterol (β coefficient = 0.006 (95% CI: 0.0004 to 0.01), nmol/mL, = 0.037) and LDL cholesterol (β coefficient = 0.008 (95% CI: 0.001 to 0.01) nmol/mL, = 0.017). On the contrary, most manifestations of the disease, including skin, lung, and joint involvement, as well as the presence of digital ulcers, were not related to MDA. However, high MDA levels were significantly and independently associated with lower ventricular ejection fraction after adjustment for covariates (β coefficient = -0.04 (95% CI: -0.06 to -0.02), nmol/mL, = 0.001). In conclusion, serum MDA levels were related to higher levels of total and LDL cholesterol and a lower left ventricular ejection fraction in patients with SSc. MDA could serve as a potential biomarker of dyslipidemia and heart failure in SSc.
系统性硬化症（SSc）是一种慢性疾病，其特征为血管病变，伴有功能失调的微循环血管受累。该疾病的特征包括皮肤和内脏器官的进行性纤维化以及以循环自身抗体和促炎细胞因子的存在为特征的全身性炎症。此外，与普通人群相比，SSc患者中大血管疾病和动脉粥样硬化更为常见。氧化应激在包括内皮功能障碍、癌症、炎症和动脉粥样硬化形成在内的多个过程的发展中起着关键作用。丙二醛（MDA）是一种公认的氧化应激标志物。在这项研究中，我们分析了53例特征明确的SSc患者队列中血清MDA水平与临床、实验室及血管特征之间的关系。进行了多变量分析以研究SSc患者循环MDA与疾病特征之间的关系。还进行了心血管评估，包括颈动脉和主动脉超声检查以及超声心动图检查。MDA与总胆固醇（β系数 = 0.006（95%置信区间：0.0004至0.01），nmol/mL，P = 0.037）和低密度脂蛋白胆固醇（β系数 = 0.008（95%置信区间：0.001至0.01）nmol/mL，P = 0.017）等血脂谱分子的血清水平呈显著正相关。相反，该疾病的大多数表现，包括皮肤、肺部和关节受累以及指端溃疡的存在，均与MDA无关。然而，在对协变量进行调整后，高MDA水平与较低的心室射血分数显著且独立相关（β系数 = -0.04（95%置信区间：-0.06至-0.02），nmol/mL，P = 0.001）。总之，SSc患者的血清MDA水平与总胆固醇和低密度脂蛋白胆固醇水平升高以及左心室射血分数降低有关。MDA可作为SSc患者血脂异常和心力衰竭的潜在生物标志物。
