| 摘要: |
| 系统性红斑狼疮（SLE）是一种慢性系统性自身免疫性疾病，心血管疾病（CVD）是其主要的致死原因之一。传统心血管风险评估模型在SLE患者中预测能力有限，提示其心血管事件可能由与炎症、免疫及代谢重编程密切相关的非传统机制驱动。近年来，脂质代谢组学作为一种高通量、机制导向的组学技术，逐渐揭示了SLE患者中存在特征性的脂质代谢紊乱，包括鞘磷脂代谢异常、载脂蛋白功能障碍及氧化低密度脂蛋白的病理积累。这些代谢改变与免疫细胞功能失衡、泡沫细胞形成及血管内皮功能损伤密切相关，构成了SLE心血管并发症的关键代谢基础。研究还发现，特定脂质分子具有良好的诊断与风险预测价值，尤其在神经精神型SLE（NPSLE）患者中表现出较高的特异性和敏感性。本文综述了脂质代谢组学在SLE心血管风险机制研究中的最新进展，探讨其作为新型生物标志物的潜力，并展望靶向脂质代谢干预在SLE个体化心血管管理中的应用前景，以期为临床精准治疗提供理论支持和策略依据。 |
| 关键词: 系统性红斑狼疮 脂质代谢组学 心血管风险 鞘磷脂代谢 氧化低密度脂蛋白 载脂蛋白功能障碍 生物标志物 |
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| 基金项目:国家自然科学基金项目（面上项目，重点项目，重大项目）；江苏省中医药科技发展计划项目（MS2022106）；淮安市自身免疫性疾病重点实验室项目（HAP202302）徐州医科大学附属医院科技发展基金(XYFM202230) |
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| Lipid metabolomics reveals new mechanisms of cardiovascular risk in systemic lupus erythematosus. |
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yan dandan1, Wang xu2, xu ling xiao3, zhang xue qin4, meng de qian2, wang kai2, zhu ping5, li ju2
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1.The Affiliated Huai’an First People’s Hospital of Nanjing Medical University、Huaian Chuzhou Hospital of Traditional Chinese Medicine;2.The Affiliated Huai’an First People’s Hospital of Nanjing Medical University;3.Department of Rheumatology and Immunology, Jiangsu Provincial People’s Hospital;4.Department of Rheumatology and Immunology, Huai’an Clinical College of Xuzhou Medical University;5.Huaian Chuzhou Hospital of Traditional Chinese Medicine
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| Abstract: |
| Systemic lupus erythematosus (SLE) is a chronic, systemic autoimmune disorder, and cardiovascular disease (CVD) stands as one of its leading causes of mortality. Traditional cardiovascular risk assessment models demonstrate limited predictive utility in SLE patients, suggesting that their cardiovascular events may be driven by non-traditional mechanisms closely linked to inflammation, immune dysregulation, and metabolic reprogramming.
In recent years, lipid metabolomics, a high-throughput, mechanism-oriented omics technology, has gradually uncovered characteristic disruptions in lipid metabolism among SLE patients. These include sphingolipid metabolic abnormalities, apolipoprotein dysfunction, and the pathological accumulation of oxidized low-density lipoprotein (oxLDL). Such metabolic alterations are intimately associated with immune cell dysregulation, foam cell formation, and vascular endothelial dysfunction—forming the metabolic underpinnings of cardiovascular complications in SLE.
Furthermore, studies have identified specific lipid molecules with promising diagnostic and risk-predictive value—exhibiting particularly high specificity and sensitivity in patients with neuropsychiatric SLE (NPSLE). This article reviews the latest advances in using lipid metabolomics to unravel the mechanisms underlying cardiovascular risk in SLE, explores the potential of lipidomic markers as novel biomarkers, and envisions how interventions targeting lipid metabolism could be applied in personalized cardiovascular management for SLE patients, ultimately offering theoretical support and strategic guidance for precision clinical care. |
| Key words: Systemic lupus erythematosus lipid metabolomics cardiovascular risk sphingolipid metabolism oxidized LDL apolipoprotein dysfunction biomarkers. |