Background/Purpose: Oxidized low-density lipoprotein (LDL), especially malondialdehyde modified LDL (MDA-LDL) has attracted attention as a predictive serum marker for the secondary development of atherosclerotic lesions. Although increased levels of MDA-LDL have been found in patients with rheumatoid arthritis and systemic lupus erythematosus, few studies have described MDA-LDL levels in patients with systemic sclerosis (SSc). The aim of this study was to investigate the correlation between MDA-LDL and clinical symptoms in patients with SSc.

Methods: The study involved 58 patients with SSc consisting of 10 male and 48 female patients with a mean age of 63.1 ± 14.0 years. The serum of 10 patients with SLE was used as controls. Of 58 patients, 16 patients had diffuse cutaneous systemic sclerosis (dcSSc) and 42 had limited cutaneous systemic sclerosis (lcSSc). The oxidized LDL levels were measured using the oxidized-LDL ELISA kit (Sekisui Medical Co., Ltd., Japan) according to the manufacturer’s protocol.

Results:  Increased levels of oxidized LDL were found in patients with dcSSc when compared with patients with SLE. The MDA-LDL/LDL-C ratio was higher in patients with dcSSc and lcSSc than in those with SLE. A significant negative correlation was observed between the %DLco and MDA-LDL levels as well as between %DLco and MDA-LDL/LDL-C. The MDA-LDL/LDL-C ratio strongly correlated with %DLco, more so than did the MDA-LDL levels. Right ventricular systolic pressure measured by echocardiography, immunoglobulin G (IgG), KL-6, and surfactant protein D showed positive correlations to oxidized LDL/LDL-C. When we defined patients with increased MDA-LDL levels by using the standard values mentioned above, and analyzed associations with clinical signs, significantly more patients in the increased MDA-LDL group had complications with lung pulmonary hypertension, and the positivity rate for anti-centromere antibodies was higher in the increased MDA-LDL group.

Conclusion: Many patients with SSc had increased levels of oxidized LDL, which may be a reflection of increased atherosclerosis lesions in patients with SSc. A positive correlation between decreased levels of %DLco, KL-6, and SP-D and oxidized LDL/LDL-C was observed and this may indicate that oxidized LDL is involved in the progression of interstitial pulmonary lesions in patients with SSc. Little is known about abnormal lipid metabolism in patients with SSc when compared with that of patients with RA and SLE. However, the frequency of complications in lipid metabolism is high in patients with SSc and the pathology of SSc remains unclear.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/the-correlation-between-oxidized-low-density-lipoprotein-and-clinical-manifestations-in-patients-with-systemic-sclerosis/