Association Between Arterial Stiffness And Circulating Adipokines In Patients With Systemic Lupus Erythematosus In Ghana

Abstract

Background: Cardiovascular complication accounts for greater number of deaths that occur in lupus patients who have chronic inflammation. However, arterial stiffness is used to predict diseases of the cardiovascular system, characterized by persistent inflammation which affects adipose tissues, dysregulation of adipokines and hyperinsulinemia, tend to quicken hardening of arteries in patients with systemic lupus erythematosus (SLE). Aim: This study investigated association existing between arterial stiffness and adipokines in patients with SLE in Ghana. Methodology: The study was case-control designed. The cases were males and females with systemic lupus erythematosus (SLE) and were matched by age and gender with non-SLE individuals. Patients with SLE were recruited and examined at the Central Out-Patient Department (COPD), Korle-Bu Teaching Hospital. After obtaining informed consent, a data abstraction sheet was used to collect socio-demographic information, and recording of physical measurements were taken. Heavy-duty floor scale was used to measure the weights of the participants, body height measured with a stadiometer, and percentage body fat by Omron body fat monitor. Systolic BP and diastolic BP were assessed using semi-automated digital sphygmomanometer. Arterial stiffness was measured as CAVI together with haPWV by VaSera VS-1500N. Enzyme-linked immunosorbent Assay kit by R&G laboratories was used to analyze adipokines, insulin and C-reactive protein concentrations. Lipid profile and blood biochemistry were done with RT-900 Semi-auto chemical analyzer. Results: Compared to non-SLE controls, patients with SLE had higher levels of CAVI (7.3±1.1 vs 6.1±1, p<0.001), haPWV (7.7±1.3 vrs 6.5±0.8 m/s, p=<0.001), insulin [76.8 (45.9 – 184.8) vs 39.8 (22.9 – 86.3) pmol/ml, p=0.007], leptin [856.1 (364.8 – 1509.3) vrs 426.7 (426.8 (84.7 – 1178.7) ng/ml, p=0.039], adiponectin [1.1 (0.8 – 2.3) vrs 1.6 (1.3 – 2.6) ngml-1, p = 0.039] and CRP [1.6 (0.8 – 2.2) vrs 0.9 (0.6 – 1.2) mgml-1, p = 0.021]. In an adjustment in age and BMI for correlation, CAVI showed association with leptin (r=0.21, p=0.031), CRP (r=2.9, p<0.001) and insulin (r=0.18, p=0.04), but not adiponectin (r=-0.15, p=0.068). Conclusion: Patients who have systemic lupus erythematosus recorded higher arterial stiffness, which is associated to low-grade inflammation and deranged circulating adipokines levels