الفهرس | Only 14 pages are availabe for public view |
Abstract SLE is a multisystem autoimmune disease that commonly affects females in the childbearing period, lupus nephritis is one of the most serious manifestations of SLE, most cases of lupus nephritis develop within the first 5 years of diagnosis of SLE, the clinical presentation of LN ranges from asymptomatic to heavy proteinuria. Premature atherosclerosis is a major comorbid condition in systemic lupus erythematosus, one of the SLE specific risk factors is lupus nephritis, especially with impaired renal functions, also antiphospholipid antibodies, low total white blood cell count and lymphopenia were associated with atherosclerosis in SLE. Carotid intima-media thickness (CIMT) measurement is a noninvasive method to detect early subclinical atherosclerosis which correlates with severity of coronary artery disease. So it is a reliable tool for detecting early atherosclerosis in lupus nephritis patients. Irisin is a myokine secreted by skeletal muscles in an exercise dependent fashion as well as adipose tissue (subcutaneous adipose tissue is more relevant than visceral adipose tissue). It is an antiatherogenic myokine promotes endothelial cells proliferation by upregulating microRNA126-5p, irisin serve as a potential therapeutic strategy to protect against atherosclerosis, after proteolytic cleavage from the membrane protein fibronectin type III domain containing 5 (FNDC5). The expression of FNDC5 and subsequent irisin are induced by exercise and peroxisome proliferator-activated receptor-γ coactivator -1a (PGC-1a) in skeletal muscle. We aimed to evaluate the possible correlation between irisin in lupus nephritis female adults and CIMT as a biomarker for subclinical atherosclerosis. We included 110 subjects in the period from January 2020 to August 2022, fifty-five subjects were sequentially selected from SLE patients coming to the rheumatology and immunology outpatient clinics and those who were admitted in inpatients wards of rheumatology division, Internal medicine department at Menoufia University Hospital and Mansoura university hospital, & fifty-five; age and sex matched healthy controls were enrolled. Full history, physical examination and investigations were done and included CBC, creatinine, urinary protein creatinine ratio, anti-DNA, lipid profile, carotid intima media thickness by doppler ultrasound and irisin serum level was done using ELISA technique. o Then our results were statistically analyzed and tabulated, we found that; there was statistically significant positive correlation between CIMT on one side and WBC, platelets count, protein/creatinine ratio, Anti ds DNA titre, SLEDAI and LDL on the other side. o While negative correlation was detected with HDL and serum irisin which was statistically significant. o Regarding irisin serum level, it showed statistically significant negative correlation with platelet count, Anti ds DNA titre, SLEDAI and LDL, while statistically significant positive correlation was detected with HDL. o Univariate logistic regression showed that only serum irisin level was the most important predictor of CIMT increment and is independent risk factor for atherosclerosis. |