Cardiovascular autonomic neuropathy is associated with SLEDAI in patients with systemic lupus erythematosus.

Abstract

Introduction: As a prevalent and severe complication of systemic lupus erythematosus (SLE), cardiovascular autonomic neuropathy (CAN) has garnered increasing attention. Reports suggested that CAN may be related to the disease activity of SLE. This study aims to explore whether Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) is associated with CAN and to evaluate its diagnostic value for CAN.

Method: Altogether, 144 patients with SLE from the Rheumatology Department of Nanjing Drum Tower Hospital were included. Each patient underwent assessment with the SLEDAI and cardiovascular reflex tests (CARTs). Patients were classified into three groups: non-CAN, early-CAN and diagnosed-CAN based on the CARTs results. The relationship of CARTs and SLEDAI were analyzed using SPSS 26.0.

Results: After being divided into three groups, there were significant differences in SLEDAI among them. With increasing SLEDAI score (P < 0.05), both CARTs scores and four individual parameters score increased significantly, both before and after adjusting for influencing factors (P < 0.05). Besides, in Logistic regression analysis, it identified that SLEDAI as an independent risk factor for CAN (OR = 1.227, 95%CI = 1.143-1.316, P < 0.001). Finally, after accounting for the influence of glucocorticoids, a significant positive correlation between CARTs and SLEDAI remained (P < 0.05).

Conclusions: As the gold standard in the diagnosing CAN, CARTs and four parameters are significantly correlated with SLEDAI. Furthermore, SLEDAI is also an independent risk factors for its development. In conclusion, this research demonstrated that SLEDAI is a dependable indicator for the onset and progression of CAN. Key Points • This study is the first to demonstrate a strong association between SLEDAI and cardiovascular autonomic neuropathy, identifying SLEDAI as a risk factor for CAN in SLE patients. • This study offers a convenient and rapid method for the clinical evaluation of CAN in SLE patients, providing significant value in assessing cardiovascular complications.