Guo Simin, Wang Yujiao, Sun Lingyun
Department of Rheumatology and Immunology, Nanjing Drum Tower Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No 321 Zhongshan Road, Nanjing, 210008, China.
Clin Rheumatol. 2025 Mar;44(3):1103-1111. doi: 10.1007/s10067-025-07336-9. Epub 2025 Jan 23.
As a prevalent and severe complication of systemic lupus erythematosus (SLE), cardiovascular autonomic neuropathy (CAN) has garnered increasing attention. Reports suggested that CAN may be related to the disease activity of SLE. This study aims to explore whether Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) is associated with CAN and to evaluate its diagnostic value for CAN.
Altogether, 144 patients with SLE from the Rheumatology Department of Nanjing Drum Tower Hospital were included. Each patient underwent assessment with the SLEDAI and cardiovascular reflex tests (CARTs). Patients were classified into three groups: non-CAN, early-CAN and diagnosed-CAN based on the CARTs results. The relationship of CARTs and SLEDAI were analyzed using SPSS 26.0.
After being divided into three groups, there were significant differences in SLEDAI among them. With increasing SLEDAI score (P < 0.05), both CARTs scores and four individual parameters score increased significantly, both before and after adjusting for influencing factors (P < 0.05). Besides, in Logistic regression analysis, it identified that SLEDAI as an independent risk factor for CAN (OR = 1.227, 95%CI = 1.143-1.316, P < 0.001). Finally, after accounting for the influence of glucocorticoids, a significant positive correlation between CARTs and SLEDAI remained (P < 0.05).
As the gold standard in the diagnosing CAN, CARTs and four parameters are significantly correlated with SLEDAI. Furthermore, SLEDAI is also an independent risk factors for its development. In conclusion, this research demonstrated that SLEDAI is a dependable indicator for the onset and progression of CAN. Key Points • This study is the first to demonstrate a strong association between SLEDAI and cardiovascular autonomic neuropathy, identifying SLEDAI as a risk factor for CAN in SLE patients. • This study offers a convenient and rapid method for the clinical evaluation of CAN in SLE patients, providing significant value in assessing cardiovascular complications.
作为系统性红斑狼疮（SLE）常见且严重的并发症，心血管自主神经病变（CAN）日益受到关注。报告显示，CAN可能与SLE的疾病活动有关。本研究旨在探讨系统性红斑狼疮疾病活动指数（SLEDAI）是否与CAN相关，并评估其对CAN的诊断价值。
共纳入南京鼓楼医院风湿科144例SLE患者。每位患者均接受SLEDAI评估和心血管反射测试（CARTs）。根据CARTs结果将患者分为三组：非CAN组、早期CAN组和确诊CAN组。使用SPSS 26.0分析CARTs与SLEDAI的关系。
分为三组后，三组间SLEDAI存在显著差异。随着SLEDAI评分增加（P<0.05），调整影响因素前后，CARTs评分及四个单项参数评分均显著增加（P<0.05）。此外，Logistic回归分析确定SLEDAI是CAN的独立危险因素（OR=1.227，95%CI=1.143-1.316，P<0.001）。最后，在考虑糖皮质激素影响后，CARTs与SLEDAI仍存在显著正相关（P<0.05）。
作为诊断CAN的金标准，CARTs及四个参数与SLEDAI显著相关。此外，SLEDAI也是其发生发展的独立危险因素。总之，本研究表明SLEDAI是CAN发病和进展的可靠指标。要点• 本研究首次证明SLEDAI与心血管自主神经病变之间存在强关联，确定SLEDAI是SLE患者发生CAN的危险因素。• 本研究为SLE患者CAN的临床评估提供了一种便捷快速的方法，在评估心血管并发症方面具有重要价值。
