Does Sestrin-1 Mitigate Cardiovascular Risks in Radiographic Axial Spondyloarthritis?
Selman Parlak1
, Ahmet Taha Sahin2, Ahmet Lütfü Sertdemir3, Adem Küçük4, Abdullah İçli3
1Department of Rheumatology, Beyhekim Training and Research Hospital, Konya, Türkiye
2Department of Cardiology, Beyhekim Training and Research Hospital, Konya, Türkiye
3Department of Cardiology, Necmettin Erbakan University Medicine Faculty, Konya, Türkiye
4Department of Rheumatology, Necmettin Erbakan University Medicine Faculty, Konya, Türkiye
Keywords: Cardiovascular involvement, CIMT, echocardiography, r-axSpA, Sestrin-1
Abstract
Background/Aims: Radiographic axial spondyloarthritis (r-axSpA) is a chronic inflammatory arthritis associated with an increased cardiovascular (CV) risk due to persistent inflammation. Sestrin-1, a stress-inducible protein with antioxidant and anti-inflammatory properties, has been implicated in cardiovascular protection. This study aimed to investigate the relationship between Sestrin-1 levels, cardiovascular markers, and echocardiographic findings in r-axSpA patients.
Materials and Methods: This controlled study included 48 r-axSpA patients diagnosed according to the modified New York criteria and 48 age- and sex-matched healthy controls. Demographic, biochemical, and echocardiographic data were collected. Sestrin-1 levels were measured using an enzyme-linked immunosorbent assay kit, and carotid intima-media thickness (CIMT) was assessed via ultrasound. Statistical analyses evaluated differences between groups, as well as correlations between Sestrin-1 levels and inflammatory and cardiovascular parameters.
Results: r-axSpA patients exhibited significantly lower Sestrin-1 levels compared to controls (P= .003). Sestrin-1 levels were negatively correlated with C-reactive protein (CRP) (r =−0.42) and erythrocyte sedimentation rate (ESR) (r =−0.38). Echocardiographic findings revealed increased CIMT (P < .001), reduced right ventricular systolic motion (RVSM), and lower tricuspid annular plane systolic excursion (TAPSE) in r-axSpA patients. No significant correlation was observed between Sestrin-1 levels and disease activity, as measured by the Ankylosing Spondylitis Disease Activity Score (ASDAS)-CRP.
Conclusion: r-axSpA patients exhibit reduced Sestrin-1 levels and significant subclinical cardiovascular changes, including increased CIMT and impaired right ventricular function. These findings suggest that diminished Sestrin-1 may exacerbate oxidative stress and inflammation, thereby contributing to cardiovascular risk in r-axSpA. Further research is needed to explore the potential of Sestrin-1 as a biomarker for cardiovascular complications in r-axSpA.
Cite this article as: Parlak S, Taha Sahin A, Lütfü Sertdemir A, Küçük A, İçli A. Does sestrin-1 mitigate cardiovascular risks in radiographic axial spondyloarthritis? ArchRheumatol. 2025;40(2):230-234.