Predicting flow-mediated dilation of brachial artery in systemic lupus erythematosus patients by reproducible and operator-independent inflammatory and immunologic markers and development of a novel score

Background Early detection of endothelial dysfunction in patients with systemic lupus erythematosus (SLE) is important since they show accelerated atherosclerosis and an increased risk of cardiovascular mortality. Aim The aim of the study was to describe the correlation of flow-mediated dilation (FMD) with common inflammatory and immunological markers in patients with SLE. An attempt was made to predict a model of FMD with the help of these markers. Material and methods The study included 44 treatment-naive SLE patients as per American College of Rheumatology (ACR) criteria (1982) and 44 age- and sex-matched healthy controls. Each group consists of 42 females and 2 males. FMD of the brachial artery by B-mode ultrasonography was performed in both groups to compare the FMD value. Serum hsCRP, fibrinogen, uric acid, fasting insulin, serum ferritin, total cholesterol, triglyceride, VLDL, LDL, and HDL levels were measured as markers of inflammation in SLE patients to determine whether there was any correlation with FMD. Results There were no significant differences in age and gender between the SLE and control groups. The mean FMD was 16.85 ± 10.64 and 21.89 ± 4.6 among cases and controls, respectively. FMD was significantly less among SLE patients (p = 0.005). The hsCRP, uric acid, fibrinogen, insulin resistance, and ferritin values were found to have significant correlations with FMD values among treatment-naive SLE patients. Multiple linear regression by the ENTER method was used to predict a model of FMD: FMD = 48.252 − 1.565 hsCRP − 0.143 fibrinogen − 0.217 uric acid + 0.001 ferritin + 7.658 IR. Conclusion Inflammatory markers of SLE, such as hsCRP, fibrinogen, insulin resistance, and uric acid positively correlate with FMD values. FMD can be predicted from the value of these biochemical parameters.