Abstract
BACKGROUND: Dyslipidemia may contribute to pathogenesis and disease complications in limited cutaneous systemic sclerosis (lcSSc), while data about its associations with endothelial dysfunction and clinical lcSSc-specific parameters as well as its predictive role on disease complications are limited. This study investigated the relationship between lipid parameters, endothelial dysfunction, and disease complications in patients with lcSSc. METHODS: 38 patients with lcSSc and 38 matched controls with primary Raynaud's phenomenon were analyzed at baseline regarding lipid parameters, parameters of endothelial dysfunction and clinical lcSSc-specific parameters. During a subsequent 3-year follow-up period, patients with lcSSc were prospectively observed for disease complications. RESULTS: Patients with lcSSc exhibited lower high-density lipoprotein (HDL) levels (p = 0.032) and total HDL particles (p = 0.001) as well as higher triglyceride levels (p = 0.018), triglycerides/HDL ratio (p = 0.013) and atherogenic index (p = 0.012) compared to controls. Large low-density lipoprotein (LDL) particles correlated positively with endothelial microparticles (r = 0.464, p = 0.044), while very low-density lipoprotein size correlated negatively with symmetric dimethylarginine (r = -0.480, p = 0.033). No significant correlations were observed between lipid parameters and clinical lcSSc-specific parameters. Incidence of macrovascular events and interstitial lung disease were associated with a few selected lipid parameters (all p < 0.05). CONCLUSION: Patients with lcSSc showed a more pro-atherogenic lipid profile. Although statistically significant, these results were of modest magnitude and should be interpreted in the context of the exploratory design. Associations with endothelial dysfunction and clinical disease parameters were minimal or non-significant. Selected lipid parameters may be associated with disease complications in lcSSc, but these findings require confirmation in larger, adequately powered studies due to the small sample size and exploratory analyses.