Abstract: Objective To investigate the complex interplay between autoimmune disorders, metabolic dysfunction, and vascular health, we assessed the relationship between ADAMTS13, systemic sclerosis-scleroderma (SSc), and insulin resistance. Methods A cross-sectional study was conducted involving 81 individuals diagnosed with SSc and 76 healthy age- and sex-matched controls. Comprehensive clinical and laboratory characterisations were performed for both groups. Serum levels of ADAMTS13, standard lipid profiles, and indices of insulin resistance were assessed in all participants. To determine whether ADAMTS13 serum levels differed significantly between SSc patients and healthy controls, as well as to examine the relationship between ADAMTS13 values, disease characteristics, and cardiometabolic features, multivariable linear regression analyses were performed. Results Serum ADAMTS13 levels were significantly decreased in patients with SSc compared to healthy controls after multivariable analysis. A significant negative correlation was observed between C-reactive protein levels and circulating ADAMTS13 levels. However, disease characteristics, including pulmonary, articular, and cutaneous manifestations, did not show significant associations with ADAMTS13 values. Regarding cardiometabolic features, ADAMTS13 levels demonstrated a significant positive association with indices of insulin resistance, a relationship not observed in the control group. Conclusion ADAMTS13 serum levels are decreased in patients with SSc. Additionally, a positive correlation exists between ADAMTS13 levels and insulin resistance in SSc.

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