ArticleThe Journal of international medical research2026
Reduced serum Sestrin-1 is associated with subclinical cardiovascular alterations in systemic lupus erythematosus: A controlled cross-sectional study.
Article in The Journal of international medical research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
ObjectiveSystemic lupus erythematosus is associated with increased cardiovascular morbidity, even in the absence of overt clinical disease. Sestrin-1 is a stress-responsive antioxidant protein implicated in oxidative homeostasis and cardiovascular protection. This study aimed to evaluate serum Sestrin-1 levels in patients with systemic lupus erythematosus and examine their relationship with subclinical cardiovascular findings.MethodsIn this controlled cross-sectional study, 60 patients with systemic lupus erythematosus and 60 age-matched healthy controls underwent clinical assessment, laboratory testing, 12-lead electrocardiography, transthoracic echocardiography, and carotid intima-media thickness measurement. Serum Sestrin-1 was measured by enzyme-linked immunosorbent assay (ELISA). Between-group comparisons used parametric or nonparametric tests according to data distribution. Within the systemic lupus erythematosus cohort, correlations between Sestrin-1 and disease activity (Systemic Lupus Erythematosus Disease Activity Index), as well as cardiovascular parameters, were assessed. An exploratory multivariable logistic regression model including Sestrin-1, left atrial diameter, corrected QT interval, age, and sex was constructed to identify variables associated with case status.ResultsSerum Sestrin-1 levels were significantly lower in patients with systemic lupus erythematosus than in controls (9.99 ± 2.01 vs. 17.79 ± 5.11 ng/mL; p < 0.001). Patients with systemic lupus erythematosus had a significantly longer corrected QT interval (429.65 ± 32.42 vs. 376.26 ± 33.41 ms; p < 0.001). In the exploratory multivariable logistic regression analysis, lower Sestrin-1 (per 1ng/mL increase, odds ratio 0.63; 95% confidence interval: 0.54-0.75; p < 0.001), larger left atrial diameter (per 1 mm increase, odds ratio 1.13; 95% confidence interval: 1.06-1.22; p < 0.001)), and longer corrected QT interval (per 1ms increase, odds ratio 1.03; 95% confidence interval: 1.02-1.05; p < 0.001) were independently associated with systemic lupus erythematosus status.ConclusionPatients with systemic lupus erythematosus exhibit markedly reduced serum Sestrin-1 levels together with subclinical cardiovascular abnormalities. The inverse relationship between Sestrin-1 and left atrial diameter suggests a possible link between reduced antioxidant defense and early atrial remodeling in systemic lupus erythematosus. Sestrin-1 may represent a promising candidate biomarker for subclinical cardiovascular involvement in patients with systemic lupus erythematosus; however, prospective studies are needed to confirm its clinical utility.
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