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Relationship of serum inflammatory cytokines with anemia and vascular endothelial function in children with systemic lupus erythematosus.

OBJECTIVE
To analyze the relationship of the serum levels of inflammatory cytokines with the degree of anemia and vascular endothelial function in children with systemic lupus erythematosus (SLE), as well as to explore the predictive value of risk factors for SLE in children.


METHODS
A total of 88 patients with SLE diagnosed in the Pediatric Department of our hospital from March 2015 to February 2017 were selected as the observation group, and 30 healthy controls with comparable age were selected as the control group. Basic characteristics of all enrolled individuals, such as age, sex, height and weight, and the related biochemical indexes, including the levels of inflammatory cytokines [C-reactive protein (CRP), tumor necrosis factor α (TNF-α), interleukin-6 (IL-6), erythrocyte sedimentation rate (ESR)], blood routine test including hemoglobin (Hb), platelet (PLT) and mean corpuscular volume as well as related indexes of vascular endothelial function, such as homocysteine (Hcy), carbonic oxide (NO), endothelial nitric oxide synthase (eNOS) were measured. In addition, the SLE disease activity index (SLEDAI) score of patients was also recorded.


RESULTS
There were no significant differences regarding age, sex, body mass index (BMI), triglyceride (TG), low density lipoprotein-cholesterol (LDL-C) and high density lipoprotein-cholesterol (HDL-C) between observation group and control group (p >  0.05), but the total cholesterol (TC) level in observation group was significantly higher than that in control group (p <  0.05). In addition, the levels of CRP, TNF-α, IL-6 and ESR in serum in observation group were significantly higher than those in control group (p <  0.05). However, the Hb, PLT and mean corpuscular volume in observation group were significantly lower than those in control group (p <  0.05). Moreover, the levels of Hcy, NO and eNOS in observation group were significantly higher than those in control group (p <  0.05). Furthermore, correlation analyses showed that CRP was positively correlated with SLEDAI score (r = 0.791, p <  0.001) and Hcy level (r = 0.817, p <  0.001), but negatively correlated with Hb level (r = -0.663, p <  0.001).


CONCLUSION
There is a close relationship between serum inflammatory cytokines and SLE severity, Hcy or Hb level in children, suggesting these inflammatory cytokines might be novel indicators for evaluating the severity of SLE.