Parlak Selman, Sahin Ahmet Taha, Sertdemir Ahmet Lütfü, Küçük Adem, İçli Abdullah
Department of Rheumatology, Beyhekim Training and Research Hospital, Konya, Türkiye.
Department of Cardiology, Beyhekim Training and Research Hospital, Konya, Türkiye.
Arch Rheumatol. 2025 Jun 23;40(2):230-234. doi: 10.5152/ArchRheumatol.2025.11138.
Background/Aims: Radiographic axial spondyloarthritis (r-axSpA) is a chronic inflammatory arthritis associated with an increased cardiovascular (CV) risk due to persistent inflammation. Sestrin-1, a stress-inducible protein with antioxidant and anti-inflammatory properties, has been implicated in cardiovascular protection. This study aimed to investigate the relationship between Sestrin-1 levels, cardiovascular markers, and echocardiographic findings in r-axSpA patients. Materials and Methods: This controlled study included 48 r-axSpA patients diagnosed according to the modified New York criteria and 48 age- and sex-matched healthy controls. Demographic, biochemical, and echocardiographic data were collected. Sestrin-1 levels were measured using an enzyme-linked immunosorbent assay kit, and carotid intima-media thickness (CIMT) was assessed via ultrasound. Statistical analyses evaluated differences between groups, as well as correlations between Sestrin-1 levels and inflammatory and cardiovascular parameters. Results: r-axSpA patients exhibited significantly lower Sestrin-1 levels compared to controls (P= .003). Sestrin-1 levels were negatively correlated with C-reactive protein (CRP) (r =-0.42) and erythrocyte sedimentation rate (ESR) (r =-0.38). Echocardiographic findings revealed increased CIMT (P < .001), reduced right ventricular systolic motion (RVSM), and lower tricuspid annular plane systolic excursion (TAPSE) in r-axSpA patients. No significant correlation was observed between Sestrin-1 levels and disease activity, as measured by the Ankylosing Spondylitis Disease Activity Score (ASDAS)-CRP. Conclusion: r-axSpA patients exhibit reduced Sestrin-1 levels and significant subclinical cardiovascular changes, including increased CIMT and impaired right ventricular function. These findings suggest that diminished Sestrin-1 may exacerbate oxidative stress and inflammation, thereby contributing to cardiovascular risk in r-axSpA. Further research is needed to explore the potential of Sestrin-1 as a biomarker for cardiovascular complications in r-axSpA.
背景/目的：影像学轴向性脊柱关节炎（r-axSpA）是一种慢性炎症性关节炎，由于持续炎症导致心血管（CV）风险增加。Sestrin-1是一种具有抗氧化和抗炎特性的应激诱导蛋白，与心血管保护有关。本研究旨在探讨r-axSpA患者中Sestrin-1水平、心血管标志物和超声心动图结果之间的关系。
这项对照研究纳入了48例根据改良纽约标准诊断的r-axSpA患者和48例年龄及性别匹配的健康对照。收集了人口统计学、生化和超声心动图数据。使用酶联免疫吸附测定试剂盒测量Sestrin-1水平，并通过超声评估颈动脉内膜中层厚度（CIMT）。统计分析评估了组间差异以及Sestrin-1水平与炎症和心血管参数之间的相关性。
与对照组相比，r-axSpA患者的Sestrin-1水平显著降低（P = 0.003）。Sestrin-1水平与C反应蛋白（CRP）（r = -0.42）和红细胞沉降率（ESR）（r = -0.38）呈负相关。超声心动图结果显示，r-axSpA患者的CIMT增加（P < 0.001）、右心室收缩运动（RVSM）降低以及三尖瓣环平面收缩期位移（TAPSE）降低。根据强直性脊柱炎疾病活动评分（ASDAS）-CRP测量，Sestrin-1水平与疾病活动度之间未观察到显著相关性。
r-axSpA患者的Sestrin-1水平降低，且存在明显的亚临床心血管变化，包括CIMT增加和右心室功能受损。这些发现表明，Sestrin-1减少可能会加剧氧化应激和炎症，从而导致r-axSpA患者的心血管风险增加。需要进一步研究来探索Sestrin-1作为r-axSpA心血管并发症生物标志物的潜力。
