AB1104 THE RELATIONSHIP BETWEEN QUALITY OF SLEEP AND CYTOKINES IN SYSTEMIC LUPUS ERYTHEMATOSUS (2024)

Results: We included in our study 53 SLE patients, mostly female (47 cases, 88,7%) with a mean age of 50,15 ± 16,30 years-old and mean disease duration of 11,49 ± 9,57 years. As for comorbidities, 9.43% of our group had anxious-depressive syndrome (5/53). Analysis of the overall group identified mean serum values of 6.32 ± 2.20 pg/ml for IL-17A and 8.10 ± 7.66 pg/ml for IL-6, 19.10 ± 34.20 pg/ml for IL-10, and 18.74 ± 8.17 pg/ml for TNF-α.

The mean value for PSQI score was 6,70 ± 3,41 and for ESS 6,09 ± 4,06. PSQI classified patients into good sleepers (PSQI ≤ 5) and sleep disorder group (PSQI > 5). The poor sleep was noted in 52,83% (28/53) of SLE patients. Furthermore, only one patient had ESS greater than 16, indicating excessive daytime sleepiness. Although the most frequent reported symptom at admission was joint pain (77,36%), it was not associated with sleep quality in our study group.

The mean value of SLEDAI was 3,94 ± 3,16. Using a SLEDAI cutoff score≥6, SLE patients were divided as either having active (30,19%) or inactive disease (69,81%). Poor sleep was noted in 43,75% (7/16) of patients with clinically active and in 56,76% (21/37) of patients with inactive disease. Particularly in patients with inactive disease, high levels of IL-17A correlated with elevated levels of ESS (p=0.031), but not in active disease.

In good sleepers patients with inactive disease, elevated levels of IL-10 (p=0.025) and inflammatory markers such as erythrocyte sedimentation rate (p=0.003) and C-reactive protein (p=0.029) showed a positive correlation with total PSQI score.

We found increased levels of ESS that were directly associated to a medical history of anxiety and depressive disorders (p=0.042) in patients with active disease; further, we wanted to evaluate the potential link between these comorbidities and cytokines.

IL-17A concentration correlated with these psychiatric diseases (p=0.043). In both patients with active and inactive disease, the correlation maintained statistically significant (p=0.038 and p=0.027). Moreover, positive correlation between CRP and depression-anxiety conditions was seen in active disease (p=0.002). Also in active disease, TNF-α appeared to be positively associated with the comorbid depression in patients with sleep disorders (p=0.021).

Interestingly, the increase in PSQI score is directly associated (p=0.020) with older age of patients (Figure 1).

REFERENCES: [1] Ditmer M, Gabryelska A, Turkiewicz S et al. Problems in Chronic Inflammatory Diseases: Prevalence, Treatment, and New Perspectives: A Narrative Review. J Clin Med. 2021 Dec 23;11:67