scholarly journals Nocturnal Blood Pressure Dipping As a Marker of Endothelial Function and Subclinical Atherosclerosis in Pediatric-onset Systemic Lupus Erythematosus

2019 ◽  
Author(s):  
Joyce C Chang ◽  
Rui Xiao ◽  
Kevin E Meyers ◽  
Laura Mercer-Rosa ◽  
Shobha S Natarajan ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Endothelial Function ◽  
Lupus Erythematosus ◽  
Aortic Stiffness ◽  
Subclinical Atherosclerosis ◽  
Intima Media Thickness ◽  
Systemic Lupus ◽  
Media Thickness ◽  
Pediatric Onset ◽  
Onset Systemic Lupus Erythematosus

Abstract Background: Loss of the normal nocturnal decline in blood pressure (BP), known as non-dipping, is a potential measure of cardiovascular risk identified by ambulatory blood pressure monitoring (ABPM). We sought to determine whether non-dipping is a useful marker of abnormal vascular function and subclinical atherosclerosis in pediatric-onset systemic lupus erythematosus (pSLE). Methods: Twenty subjects 9-19 years of age with pSLE underwent ABPM, peripheral endothelial function testing, carotid-femoral pulse wave velocity/analysis for aortic stiffness, and carotid intima-media thickness. We assessed the prevalence of non-dipping and other ABPM abnormalities. Pearson or Spearman rank correlation tests were used to evaluate relationships between nocturnal BP dipping, BP load (% of abnormally elevated BPs over 24-hours) and vascular outcome measures. Results: The majority (75%) of subjects had inactive disease, with mean disease duration of 3.2 years (±2.1). The prevalence of non-dipping was 50%, which occurred even in the absence of nocturnal or daytime hypertension. Reduced diastolic BP dipping was associated with poorer endothelial function (𝒓 0.5, p=0.04). Intima-media thickness was significantly greater in subjects with non-dipping (mean standard deviation score of 3.0 vs 1.6, p=0.02). In contrast, higher systolic and diastolic BP load were associated with increased aortic stiffness (𝜌 0.6, p=0.01 and 𝜌 0.7, p<0.01, respectively), but not with endothelial function or intima-media thickness. Conclusion: In a pSLE cohort with low disease activity, isolated nocturnal BP non-dipping is prevalent and associated with endothelial dysfunction and atherosclerotic changes. In addition to hypertension assessment, ABPM has a promising role in risk stratification and understanding heterogeneous mechanisms of cardiovascular disease in pSLE.

scholarly journals Nocturnal Blood Pressure Dipping As a Marker of Endothelial Function and Subclinical Atherosclerosis in Pediatric-onset Systemic Lupus Erythematosus

2020 ◽  
Author(s):  
Joyce C Chang ◽  
Rui Xiao ◽  
Kevin E Meyers ◽  
Laura Mercer-Rosa ◽  
Shobha S Natarajan ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Endothelial Function ◽  
Lupus Erythematosus ◽  
Aortic Stiffness ◽  
Subclinical Atherosclerosis ◽  
Intima Media Thickness ◽  
Systemic Lupus ◽  
Media Thickness ◽  
Pediatric Onset ◽  
Onset Systemic Lupus Erythematosus

Abstract Background: Loss of the normal nocturnal decline in blood pressure (BP), known as non-dipping, is a potential measure of cardiovascular risk identified by ambulatory blood pressure monitoring (ABPM). We sought to determine whether non-dipping is a useful marker of abnormal vascular function and subclinical atherosclerosis in pediatric-onset systemic lupus erythematosus (pSLE). Methods: Twenty subjects 9-19 years of age with pSLE underwent ABPM, peripheral endothelial function testing, carotid-femoral pulse wave velocity/analysis for aortic stiffness, and carotid intima-media thickness. We assessed the prevalence of non-dipping and other ABPM abnormalities. Pearson or Spearman rank correlation tests were used to evaluate relationships between nocturnal BP dipping, BP load (% of abnormally elevated BPs over 24-hours) and vascular outcome measures. Results: The majority (75%) of subjects had inactive disease, with mean disease duration of 3.2 years (±2.1). The prevalence of non-dipping was 50%, which occurred even in the absence of nocturnal or daytime hypertension. Reduced diastolic BP dipping was associated with poorer endothelial function (𝒓 0.5, p=0.04). Intima-media thickness was significantly greater in subjects with non-dipping (mean standard deviation score of 3.0 vs 1.6, p=0.02). In contrast, higher systolic and diastolic BP load were associated with increased aortic stiffness (𝜌 0.6, p=0.01 and 𝜌 0.7, p<0.01, respectively), but not with endothelial function or intima-media thickness. Conclusion: In a pSLE cohort with low disease activity, isolated nocturnal BP non-dipping is prevalent and associated with endothelial dysfunction and atherosclerotic changes. In addition to hypertension assessment, ABPM has a promising role in risk stratification and understanding heterogeneous mechanisms of cardiovascular disease in pSLE.

Increased serum leptin levels are associated with metabolic syndrome and carotid intima media thickness in premenopausal systemic lupus erythematosus patients without clinical atherosclerotic vascular events

Lupus ◽  
2018 ◽  
Vol 27 (9) ◽  
pp. 1509-1516 ◽  
Author(s):  
S Demir ◽  
G Erten ◽  
B Artım-Esen ◽  
Y Şahinkaya ◽  
Ö Pehlivan ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Metabolic Syndrome ◽  
Lupus Erythematosus ◽  
Subclinical Atherosclerosis ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Systemic Lupus ◽  
Media Thickness ◽  
History Of ◽  
The Mean

Aim To assess subclinical atherosclerosis and the role of inflammatory mediators, vascular endothelial cell activation markers and adipocytokines in systemic lupus erythematosus (SLE) in the presence or absence of metabolic syndrome (MetS). Methods We studied 66 premenopausal female SLE patients (20 with MetS) and 28 female healthy controls (HCs) without history of cardiovascular disease (CVD). Subclinical atherosclerosis was screened by measuring carotid intima media thickness (CIMT). Serum levels of high sensitivity C-reactive protein (hs-CRP), tumour necrosis factor α (TNFα), interleukin 6 (IL-6), soluble intercellular adhesion molecule 1 (sICAM-1), soluble E-selectin, leptin and visfatin were measured. Results The mean age of MetS+SLE, MetS- and HC were 38.3 ± 6.7, 32.7 ± 9.3 and 29.9 ± 5.6 years, respectively. The mean disease duration, SLICC (Systemic Lupus International Collaborating Clinics damage index) and Systemic Lupus Erythematosus Disease Activity Index scores were 74.8 ± 54.9 months, 0.16 ± 0.48 and 1.18 ± 1.5, respectively, and were similar between MetS+and MetS- SLE patients. CIMT values were higher in both MetS+ and MetS- SLE patients than HCs ( p < 0.001). sICAM-1 and erythrocyte sedimentation rate levels were higher in both MetS+ and MetS- SLE patients than HCs ( p < 0.001; p = 0.002, p = 0.001). The SLE MetS+ group had higher CIMT values than SLE MetS- (right: p = 0.003; left: p = 0.025). Leptin levels and homeostatic model assessment (HOMA) scores were significantly higher in SLE MetS+ than SLE MetS- ( p = 0.018; p = 0.04). Leptin and CRP levels and body mass index, SLICC and HOMA scores were correlated with CIMT values (right: p = 0.03, p < 0.001, p < 0.001, p = 0.026 and p < 0.001, and left: p = 0.028, p = 0.03, p = 0.003, p = 0.002 and p = 0.025). Conclusions In premenopausal women with SLE without a history of CVD, CIMT values were increased and related to MetS. Leptin was increased in patients with MetS and correlated with CIMT values.

scholarly journals Plasma osteopontin versus intima media thickness of the common carotid arteries in well-characterised patients with systemic lupus erythematosus

Lupus ◽  
2021 ◽  
pp. 096120332110138
Author(s):  
Lina Wirestam ◽  
Muna Saleh ◽  
Christina Svensson ◽  
Michele Compagno ◽  
Helene Zachrisson ◽  
...  
Keyword(s):  
Lupus Erythematosus ◽  
Carotid Arteries ◽  
Subclinical Atherosclerosis ◽  
Intima Media Thickness ◽  
Healthy Controls ◽  
Systemic Lupus ◽  
Disease Phenotypes ◽  
Media Thickness ◽  
The Common ◽  
Common Carotid Arteries

Objective The progress of accelerated atherosclerosis in systemic lupus erythematosus (SLE) is incompletely understood. Circulating osteopontin (OPN) is increased in autoimmune conditions, e.g. SLE, and its serum concentration was recently reported to associate with subclinical atherosclerosis in SLE, as measured by carotid intima-media thickness. The aim of this study was to investigate whether OPN may be used as a surrogate biomarker of subclinical atherosclerosis in SLE patients with different disease phenotypes. Methods We recruited 60 well-characterised SLE cases and 60 age- and sex-matched healthy controls. The SLE cases were divided into three different disease phenotypes: SLE with antiphospholipid syndrome (APS), lupus nephritis, and isolated skin and joint involvement. Plasma OPN was detected by ELISA (Quantikine®, R&D Systems). Common carotid arteries intima media thickness was compared between the studied groups in relation to OPN levels and risk factors for vascular changes. Intima media thickness of common carotid arteries was measured by using a sensitive ultrasound technique (LOGIQ™ E9 ultrasound, GE Healthcare). Results OPN levels were significantly higher among the entire SLE group ( n = 60) compared to the healthy controls ( P = 0.03). SLE cases with concomitant APS ( n = 20) showed higher OPN levels than the controls ( P = 0.004), whereas none of the other two subgroups differed significantly from the healthy controls. OPN and intima media thickness were correlated to several traditional risk factors of atherosclerosis, as well as to SLE-related factors. Yet, no significant correlation was observed between OPN levels and ultrasound findings of the common carotid arteries. Conclusions In line with previous studies, we observed increased OPN levels among SLE patients as compared to matched controls. However, the OPN concentrations did not correlate with intima media thickness of the common carotid arteries. Based on our findings, the use of OPN as a surrogate biomarker of subclinical atherosclerosis in SLE subjects, regardless of clinical phenotypes, cannot be recommended.

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