The Correlation Study Of Asymmetric Dimethylarlginine In Systemic Lupus Erythematosus With Atherosclerosis

Objective: Systemic lupus erythematosus(SLE)is a chronic and inflammatory autoimmune disease involving multiple systems and organs.The main cause of death is disease activity in the early stage of SLE.Cardiac involvement is a severe complication of SLE patients.Cardiovascular disease became the main cause of death in SLE patients with the development of diagnosis and treatment technology.Atherosclerosis(AS)is one of the important reasons for coronary heart disease.Many factors,including immune abnormalities,drug effects and other factors,lead to high incidence and early onset of AS in SLE patients,and the incidence of AS in SLE is occult,so it is particularly important for focussing on SLE patients with early AS.Carotid intimae-media thickness(IMT)is one of the important indexes for early atherosclerosis.The detection of IMT by high frequency ultrasound has great significance for the early detection,treatment and prevention of cardiovascular events in patients with SLE.Asymmetry dimethylarginine(ADMA)induces vascular endothelial dysfunction by inhibiting the activity of nitric oxide synthese(NOS)and reducing the synthesis of NO,then these decrease the compliance of blood vessels,increase the vascular resistance,limit the blood flow velocity and cause the formation of AS.The high levels of ADMA can detect in patients with atherosclerosis.ADMA level was positively correlated with intimae media thickness.Therefore,ADMA was considered to the important marker of reflecting vascular endothelial cell function.We can accurately evaluate the situation,guide the treatment and evaluate the prognosis by detecting the level of IMT and ADMA in SLE patients with early AS.This subject aims at:(1)To analyze difference of related indexes,such as normal blood lipid,blood glucose etc,between SLE patients and normal control group.(2)To analyze difference of ADMA level between SLE patients and normal control group,and ultrasound detects IMT between them.(3)To analyze the correlation of IMT,ADMA level and activity of disease in SLE.(4)To analyze the correlation between plasma ADMA level and IMT,and to explore the risk factors of early AS in patients with SLE.Method:1 Subjects and groups:Selected 60 SLE patients and 30 healthy control individuals,these SLE patients met 2009 ACR classification and diagnostic criteria.SLE patients were divided into two groups according to the value of IMT,IMT ?1.0mm patients as SLE with atherosclerosis group,IMT < 1.0 mm for SLE without AS.2 Method : General conditions were recorded for all the subjects,including age,sex,height,weight,blood pressure,BMI,the course of disease and treatment.Venous blood was taken before eating food,low density lipoprotein cholesterol,total cholesterol,uric acid,homocysteine and blood glucose were detected by automatic biochemical analyzer.Related immune indexes were detected,Antinuclear antibody(ANA)were detected by the indirect immunofluorescence assay,Anti-double stranded DNA titer were detection by radioimmunoassay,Immunoglobulin and complement were detected the immunology turbidimetric method;Inflammatory markers including ESR and C reactive protein were detected simultaneously.The plasma ADMA level was detected by ELISA,and IMT was detected by Doppler ultrasound.3 Statistical analysis:Statistical analysis was performed by using SPSS l7.0 statistical software.All data were tested for normality,the mean and standard deviation were used to express normal distribution data.The comparion of mean between two groups used by T test,and the comparsion of multiple groups was made by ANOVA or rank sum test.The rate between groups were compared using x2 test.Multivariate analysis used multiple linear regression analysis.Pearson correlation coefficient was used to analyze the correlation between two variables,and the correlation coefficient between the data of the two grades was analyzed by Spearman correlation coefficient,which was used to test the level of alpha =0.05,P < 0.05 was statistically significant.Results:1 The level of plasma ADMA SLE combined with AS group(0.455±0.15)umol/L significantly increased when comparing with SLE without AS group(0.328±0.14)umol/L(P<0.05)and healthy controls(0.234±0.08)umol/L(P<0.05).There was a significant difference among them.2 The plasma levels of ADMA were related with pressure,fasting blood glucose,duration and IMT in SLE patients.There was a statistically significant difference between them.3 The value of IMT increased in SLE group when comparing with the control group,the difference was statistically significant(P<0.01);the occurrence rate of carotid plaque in SLE group was higher than that in control group,and this result has a statistically significant difference(P<0.05).4 the abnormal of IMT was related with age,systolic blood pressure,BMI,fasting blood glucose,triglyceride,disease duration and ADMA,and there was a statistically significant difference(P<0.05).5 The plasma ADMA level was positively correlated with carotid IMT(P<0.05),and the difference was statistically significant(P<0.05).Conclusion:1 AS was more likely to occur in SLE patients than healthy controls,and the age,duration of disease,disease activity were associated with AS in SLE.2 The level of plasma ADMA correlated with age,course of disease,blood glucose and blood pressure in SLE patients,and The ADMA level was one of the predictors of AS in SLE patients.3 Carotid IMT can be used to monitor the occurrence of AS in the early stage of SLE,Carotid IMT can be used as an indicator of AS.?4 The plasma level of ADMA was related to SLE with AS,The ADMA level can be used as one of the indexes to detect SLE complicated with AS.5 The plasma level of ADMA was significantly correlated with IMT,ADMA combining with IMT can help to predict SLE with early AS.