This study investigates the relationship between serum catestatin levels and systemic sclerosis (SSc), with a focus on cardiovascular involvement and microvascular alterations, to determine catestatin's potential as a biomarker of disease activity and severity.

Systemic sclerosis is a chronic autoimmune disease characterized by fibrosis, autoimmunity, and vasculopathy, with cardiovascular complications accounting for a significant proportion of morbidity and mortality. Despite advances in diagnostic tools, early identification of high-risk patients remains challenging. Catestatin, a peptide derived from chromogranin A, has recently gained attention as a biomarker with regulatory roles in cardiovascular physiology, including hypertension, endothelial function, and vascular remodeling. This cross-sectional study will assess serum catestatin levels in patients with SSc compared with healthy controls. It aims to correlate these levels with disease activity indices, cardiovascular involvement (using echocardiography, ECG, and blood pressure monitoring), and microvascular abnormalities identified via nailfold capillaroscopy. Findings from this study may establish catestatin as a promising biomarker, paving the way for improved management and cardiovascular risk stratification in SSc patients.

Inclusion Criteria:

• Patients diagnosed with systemic sclerosis according to 2013 ACR-EULAR classification criteria.

Age >18 years.

Exclusion Criteria:

• Other autoimmune disorders.

Cardiovascular conditions not linked to systemic sclerosis.

Comorbidities affecting catestatin metabolism (e.g., diabetes, chronic kidney disease, obesity).

Participants will include 35 patients diagnosed with systemic sclerosis according to the 2013 ACR-EULAR classification criteria and 35 age- and sex-matched healthy controls without autoimmune or cardiovascular diseases. Patients must be over 18 years old, and both genders will be included. Controls will be recruited from hospital staff and volunteers. Exclusion criteria eliminate any confounding factors affecting serum catestatin, including other autoimmune diseases, comorbid cardiovascular conditions unrelated to SSc, diabetes, chronic kidney disease, and obesity.