ABSTRACT
Vascular endothelium of patients with systemic lupus erythematosus [SLE] after prolonged exposure to circulating immune complexes shows generative changes, which are significant source of mortality and morbidity. To access the endothelial function in patients with SLE and to find the risk factors that may deteriorate that function, three indices of endothelial function were studied including: carotid artery intima/ media thickness, brachial artery diameter and endothelial dependent [EDD] and independent dilatation [EID] of the brachial artery by measuring flow mediated dilatation of the artery before and after sublingual glyceryl trinitrate. Risk factors including: SLE-dependent [disease duration. steroid use, C-reactive protein, double stranded DNA antibody [anti-dsDNA], complement [C3,C4],antibody to Sjogrens syndrome A [SSA[Ro]] and SLE independent [blood pressure, cholesterol, triglycerides, fasting blood sugar, body mass index] were also studied. Thirty women were selected with mean SLE duration was 7.1 +/- 2.6 years, the mean brachial artery diameter was 0.50 +/- 0.03 cm. and the mean carotid artery intima/media thickness was 0.8 +/- 0.03 mm. Our patients with SLE had significantly impaired endothelial dependent dilatation compared with controls. SLE patients show higher incidence of hypertension, hyperlipidemia, thicker carotid intima media thickness and brachial artery diameter. Hypertriglyceridemia, higher levels of C-reactive protein, Anti-dsDNA, SSA [Ro] antibody and lower levels of C3, C4 all are associated with thicker carotid intima/media. Severe degree of SLE is associated with significant decrease in EDD and EID of brachial artery. In conclusion SLE patients are more liable to hypertension, hypertriglyceridemia and hyperglycemia that predisposed to degenerative vascular changes. Longer SLE duration, prolonged steroid use, high fasting blood sugar, high triglycerides, C-reactive protein, antidsDNA, antiSSA [Ro] are strong predictors of endothelial dysfunction. Severe degree of SLE is associated with more impairment in endothelial dependent dilatation and endothelial independent dilatation of brachial artery