{"title":"儿童系统性红斑狼疮的早期动脉粥样硬化：系统回顾和荟萃分析","authors":"Pratap Kumar Patra, Aaqib Zaffar Banday, Adil Asghar, Rashmi Ranjan Das, Pakkiresh Reddy, Priyanka Priyanka, Pallavi Singh, Nutan Sharma, Shagufta Naaz, Rahila Nisar, Dharmagat Bhattarai, Abdus Sami Bhat, Anju Gupta","doi":"10.1111/1756-185X.70217","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Objective</h3>\n \n <p>Adults with systemic lupus erythematosus (SLE) are at a higher risk of cardiovascular complications. Numerous meta-analyses in adults with SLE have consistently demonstrated altered surrogate parameters of atherosclerosis (subclinical atherosclerosis). However, meta-analyses assessing the impact of pediatric SLE (pSLE) on cardiovascular health are lacking. Herein, we perform a systematic review and meta-analysis of studies assessing subclinical atherosclerosis in pSLE.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>Embase, Web of Science, and PubMed databases were systematically searched for pertinent literature published between January 1965 and February 2024. Patients with SLE and healthy participants were included as cases and controls, respectively. Online PICO portal, Newcastle–Ottawa scale, Review Manager and R software, and GRADEpro GDT tool were used for study deduplication and data extraction, study quality evaluation, data synthesis/analysis (including meta-regression), and certainty of evidence assessment, respectively.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>A total of 9 studies (out of 126 citations), including 1021 participants (528 cases and 493 controls), were included in the analysis. Carotid intima–media thickness (CIMT) and pulse wave velocity (PWV) were significantly higher in cases as compared to controls [mean difference (MD) 0.04 (95% CI 0.01–0.08) mm, <i>p</i> = 0.007 and MD 0.48 (95% CI 0.02–0.94) m/s, <i>p</i> = 0.04, respectively]. The flow-mediated dilatation was similar in the two groups. Significant heterogeneity was observed for all the outcome measures. On meta-regression analysis, disease duration correlated significantly with both CIMT MD and PWV MD.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>A “low”-quality evidence suggests that pSLE may adversely impact vascular microanatomy and physiology. Longitudinal studies are needed to precisely quantify the cardiovascular risk in pSLE.</p>\n </section>\n \n <section>\n \n <h3> Registration</h3>\n \n <p>PROSPERO (CRD42022323752).</p>\n </section>\n </div>","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 4","pages":""},"PeriodicalIF":2.4000,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Early Atherosclerosis in Pediatric Systemic Lupus Erythematosus: A Systematic Review and Meta-Analysis\",\"authors\":\"Pratap Kumar Patra, Aaqib Zaffar Banday, Adil Asghar, Rashmi Ranjan Das, Pakkiresh Reddy, Priyanka Priyanka, Pallavi Singh, Nutan Sharma, Shagufta Naaz, Rahila Nisar, Dharmagat Bhattarai, Abdus Sami Bhat, Anju Gupta\",\"doi\":\"10.1111/1756-185X.70217\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Objective</h3>\\n \\n <p>Adults with systemic lupus erythematosus (SLE) are at a higher risk of cardiovascular complications. 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引用次数: 0
摘要
目的：成人系统性红斑狼疮（SLE）患者发生心血管并发症的风险较高。许多针对SLE成人患者的荟萃分析一致表明，动脉粥样硬化（亚临床动脉粥样硬化）的替代参数发生了改变。然而，缺乏评估小儿SLE （pSLE）对心血管健康影响的荟萃分析。在此，我们对评估pSLE亚临床动脉粥样硬化的研究进行了系统回顾和荟萃分析。方法系统检索Embase、Web of Science和PubMed数据库1965年1月~ 2024年2月发表的相关文献。SLE患者和健康参与者分别作为病例和对照组。使用在线PICO门户网站、纽卡斯尔-渥太华量表、Review Manager和R软件以及GRADEpro GDT工具分别进行研究重复删除和数据提取、研究质量评价、数据综合/分析（包括元回归）和证据确定性评估。结果共纳入9项研究（共126篇引用），共纳入1021名受试者（528例，493例对照）。与对照组相比，病例颈动脉内膜-中膜厚度（CIMT）和脉波速度（PWV）显著升高[平均差（MD） 0.04 (95% CI 0.01-0.08) mm, p = 0.007, MD 0.48 (95% CI 0.02-0.94) m/s, p = 0.04]。两组血流介导的扩张相似。所有结果测量均观察到显著的异质性。meta回归分析显示，疾病持续时间与CIMT MD和PWV MD均显著相关。结论“低”质量的证据表明，pSLE可能对血管显微解剖和生理产生不利影响。需要进行纵向研究来精确量化pSLE患者的心血管风险。注册普洛斯彼罗（CRD42022323752）。
Early Atherosclerosis in Pediatric Systemic Lupus Erythematosus: A Systematic Review and Meta-Analysis
Objective
Adults with systemic lupus erythematosus (SLE) are at a higher risk of cardiovascular complications. Numerous meta-analyses in adults with SLE have consistently demonstrated altered surrogate parameters of atherosclerosis (subclinical atherosclerosis). However, meta-analyses assessing the impact of pediatric SLE (pSLE) on cardiovascular health are lacking. Herein, we perform a systematic review and meta-analysis of studies assessing subclinical atherosclerosis in pSLE.
Methods
Embase, Web of Science, and PubMed databases were systematically searched for pertinent literature published between January 1965 and February 2024. Patients with SLE and healthy participants were included as cases and controls, respectively. Online PICO portal, Newcastle–Ottawa scale, Review Manager and R software, and GRADEpro GDT tool were used for study deduplication and data extraction, study quality evaluation, data synthesis/analysis (including meta-regression), and certainty of evidence assessment, respectively.
Results
A total of 9 studies (out of 126 citations), including 1021 participants (528 cases and 493 controls), were included in the analysis. Carotid intima–media thickness (CIMT) and pulse wave velocity (PWV) were significantly higher in cases as compared to controls [mean difference (MD) 0.04 (95% CI 0.01–0.08) mm, p = 0.007 and MD 0.48 (95% CI 0.02–0.94) m/s, p = 0.04, respectively]. The flow-mediated dilatation was similar in the two groups. Significant heterogeneity was observed for all the outcome measures. On meta-regression analysis, disease duration correlated significantly with both CIMT MD and PWV MD.
Conclusions
A “low”-quality evidence suggests that pSLE may adversely impact vascular microanatomy and physiology. Longitudinal studies are needed to precisely quantify the cardiovascular risk in pSLE.
期刊介绍：
The International Journal of Rheumatic Diseases (formerly APLAR Journal of Rheumatology) is the official journal of the Asia Pacific League of Associations for Rheumatology. The Journal accepts original articles on clinical or experimental research pertinent to the rheumatic diseases, work on connective tissue diseases and other immune and allergic disorders. The acceptance criteria for all papers are the quality and originality of the research and its significance to our readership. Except where otherwise stated, manuscripts are peer reviewed by two anonymous reviewers and the Editor.
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