Abstract
Systemic lupus erythematosus (SLE) presents diagnostic and disease monitoring challenges due to its heterogeneity and variable activity. In this cross-sectional study, we investigated the association of plasma catecholamine (CA) metabolites with SLE status and disease activity. Plasma samples from 88 SLE patients and 64 healthy controls were analyzed using targeted liquid chromatography-tandem mass spectrometry to quantify dopamine (DA), epinephrine (E), norepinephrine (NE), 3-methoxytyramine (3MT), metanephrine (MN), and normetanephrine (NMN). Significant alterations in CA metabolites levels were observed in SLE patients compared to controls, independent of glucocorticoid treatment. Orthogonal partial least squares-discriminant analysis (OPLS-DA) suggested distinct metabolic profiles in active SLE. NE, NMN, MN, and E showed notable group differences and correlations with inflammatory markers, clinical features, complement levels, and SLE Disease Activity Index (SLEDAI) scores. Receiver operating characteristic analysis demonstrated strong diagnostic performance for individual CA biomarkers, while combined plasma CA metabolites assessment yielded superior predictive capability for SLE activity (AUC: 0.866, 95% CI: 0.785–0.947). These findings highlight the potential of plasma CA metabolites, particularly NE and NMN, are associated with SLE disease activity and may serve as potential associative biomarkers. Further validation in independent and longitudinal cohorts is warranted. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1038/s41598-025-31031-z.