Exploring the Nexus of Subclinical Atherosclerosis and Syndecan-4 Levels in Patients with Systemic Lupus Erythematosus

INTRODUCTION: Systemic Lupus Erythematosus (SLE) represents a persistent inflammatory autoimmune disorder. In an endeavor to juxtapose disease activity against the acknowledged occurrence of subclinical atherosclerosis in SLE patients, our study sought to evaluate the interrelation between carotid intima media thickness (CIMT), disease activity index (SLEDAI), and syndecan-4 levels.
METHODS: In this study, a cohort comprising 70 Systemic Lupus Erythematosus (SLE) patients, aged 18 years and older, devoid of concomitant systemic diseases, was assembled, alongside a control group consisting of 68 healthy volunteers attending the rheumatology outpatient clinic. The assessment involved the quantification of Syndecan-4 levels utilizing the Enzyme-Linked Immunosorbent Assay (ELISA) method. Carotid intima media thickness measurements were conducted for both the patient and control groups. The Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) scores, as well as the sociodemographic and laboratory data pertaining to both the patient and control groups, were systematically extracted from the hospital's digitalized medical records system.
RESULTS: The syndecan-4 levels within the patient cohort (8.211 ± 9.069) exhibited a statistically significant reduction in comparison to the syndecan-4 levels observed in the control group ( 26.221 ± 24.653). Furthermore, the carotid intima media thickness (CIMT) values for the patient group (0.558 ± 0.116) demonstrated a statistically significant variance in contrast to the CIMT values of the control group (0.49 ± 0.117). Remarkably, a noteworthy correlation emerged between syndecan-4 and CIMT. Additionally, a significant association was identified between syndecan-4 levels and body mass index (p<0.05). Further correlations were discerned between syndecan-4 levels and the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) within the patient group. Correspondingly, a statistically significant correlation was observed between CIMT and SLEDAI in the patient group.
DISCUSSION AND CONCLUSION: Despite the statistically significant elevation in carotid intima media thickness, an essential indicator of subclinical atherosclerosis, within our patient group as compared to the control group, we posit that Syndecan-4 levels may not be deemed reliable in predicting atherosclerosis.