Does Sestrin-1 Mitigate Cardiovascular Risks in Radiographic Axial Spondyloarthritis?

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.