A comparative study of clinical profile & investigative parameters of systemic lupus erythematosus patients with & without metabolic syndrome
Abstract
Introduction: The Metabolic Syndrome (MetS) often contributes to increased cardiovascular risk in patients with systemic lupus erythematosus (SLE) especially in younger age group. Determining the contribution of SLE phenotype and therapeutic exposures to the development of MetS in SLE patients would yield important insights into pathophysiology of cardiovascular events and help in Coronary Heart Disease (CHD) risk stratification.
Objective: We aimed to get prevalence of metabolic syndrome in SLE patients & to correlate its presence with demographic, socioeconomic, clinical manifestations, serological parameters, pharmacological treatment, disease activity, disease duration & damage index.
Method: A total 104 patients of SLE diagnosed as per American College of Rheumatology (ACR) criteria were enrolled during the study. Metabolic Syndrome was defined according to the American Heart Association & National Heart, Lung & Blood Institute modified National Cholesterol Education Programme Adult Treatment Panel III criteria (AHA/NHLBI modified NCEP/ATP III).
Result: Out of 104 enrolled patients, MetS was present in 35 patients (33.7%). Higher mean age (32.8 vs 27 years), Higher Body Mass Index (26.65 vs 21.07kg/m2), Increased triceps skin fold thickness (20.46 vs 15.80 mm), longer disease duration (223.9wk vs 64.78 wk), the presence of lupus nephritis, hypertriglyceridemia, positive anti-ds DNA, higher serum creatinine, higher damage index & higher cumulative dose of steroids were associated MetS in SLE patients.
Conclusion: Screening for metabolic syndrome in patients with SLE will be helpful to minimize morbidity and mortality.
Downloads
References
Dall’era M, Wofsy D. Clinical features of Systemic Lupus Erythematosus. Kelly’s Book of Rheumatology . 9th Edition, Philadelphia. Saunders Elsevier; 2012, P 1283-1303. eBook ISBN: 9781455737673.
Urowitz MB, Bookman AA, Koehler BE, et al. The bimodal mortality pattern of systemic lupus erythematosus. Am J Med. 1976 Feb;60(2):221-5.
Gladman DD, Urowitz MB. Morbidity in systemic lupus erythematosus. J Rheumatol Suppl. 1987 Jun;14 Suppl 13:223-6.
Petri M, Perez-Gutthann S, Spence D, et al. Risk factors for coronary artery disease in patients with systemic lupus erythematosus. Am J Med. 1992 Nov;93(5):513-9.
Doria A, Iaccarino L, Sarzi-Puttini P, et al. Cardiac involvement in systemic lupus erythematosus. Lupus. 2005;14(9):683-6. DOI: https://doi.org/10.1191%2F0961203305lu2200oa.
Manzi S, Meilahn EN, Rairie JE, et al. Age-specific incidence rates of myocardial infarction and angina in women with systemic lupus erythematosus: comparison with the Framingham Study. Am J Epidemiol. 1997 Mar 1;145(5):408-15.
Petri MA, Kiani AN, Post W, et al. Lupus Atherosclerosis Prevention Study (LAPS). Ann Rheum Dis. 2011 May;70(5):760-5. doi: http://dx.doi.org/10.1136/ard.2010.136762. Epub 2010 Dec 21.
Ahmad Y, Shelmerdine J, Bodill H, et al. Subclinical atherosclerosis in systemic lupus erythematosus (SLE): the relative contribution of classic risk factors and the lupus phenotype. Rheumatology (Oxford). 2007 Jun;46(6):983-8. Epub 2007 Mar 23.
Roman MJ, Shankar BA & et al. Prevalence and correlates of accelerated atherosclerosis in Systemic Lupus Erythematosus. N Engl J Med. 2003 Dec 18;349(25):2399-406. doi: https://doi.org/10.1056/NEJMoa035471.
El-Magadmi, Bodill H & et al. Systemic Lupus Erythematosus: an independent risk factor for endothelial dysfunction in women. Circulation. 2004 Jul 27;110(4):399-404. Epub 2004 Jul 19. doi: https://doi.org/10.1161/01.CIR.0000136807.78534.50.
Reilly MP, Rader DJ. The metabolic syndrome: more than the sum of its parts? Circulation. 2003 Sep 30;108(13):1546-51. DOI: https://doi.org/10.1161/01.CIR.0000088846.10655.E0
Parker B, Bruce IN. The Metabolic Syndrome in Systemic Lupus Erythematosus. Rheumatic Dis Clin North Am. 2010 Feb;36(1):81-97, viii. doi: https://doi.org/10.1016/j.rdc.2009.12.004.
Bultink IE, Turkstra F, Diamant M, et al. Prevalence of and risk factors for the metabolic syndrome in women with systemic lupus erythematosus. Clin Exp Rheumatol. 2008 Jan-Feb;26(1):32-8.
Negron AM, Molina MJ & et al. Factors associated with metabolic syndrome in patients with metabolic syndrome in patients with Systemic Lupus Erythematosus from Puerto Rico. Lupus. 2008 Apr;17(4):348-54. doi: https://doi.org/10.1177%2F0961203307086645.
Sabio JM, Zamora-Pasadas M, Jiménez-Jáimez J, et al. Metabolic syndrome in patients with systemic lupus erythematosus from Southern Spain. Lupus. 2008 Sep;17(9):849-59. doi: https://doi.org/10.1177%2F0961203308093554.
Chung CP, Avalos I, Oeser A, et al. High prevalence of the metabolic syndrome in patients with systemic lupus erythematosus: association with disease characteristics and cardiovascular risk factors. Ann Rheum Dis. 2007 Feb;66(2):208-14. Epub 2006 Aug 10.
Simrad JF, Costenbader KH. Epidemiology & Classification of Systemic Lupus Erythematosus. In: Hochberg MC, Silman AJ, Smolen JS, Weinblatt ME, Welsman MH, editors. Rheumatology . 5th Edition . Philadelphia. Mosby Elsevier; 2011, p 1301-1306.
Gladman DD, Ibañez D, Urowitz MB. Systemic lupus erythematosus disease activity index 2000. J Rheumatol. 2002 Feb;29(2):288-91.
Gladman DD, Urowitz MB & et al. The relitability of Systemic lupus International Collabrating Clinic/ American College of rheumatology Damage Index in patients with Systemic Lupus Erythematosus. Arthritis Rheum.1997; 40: 809-13. DOI: https://doi.org/10.1002/art.1780400506.
Grundy SM, Cleeman JI, Daniels SR, et al. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation. 2005 Oct 25;112(17):2735-52. Epub 2005 Sep 12. DOI: https://doi.org/10.1161/CIRCULATIONAHA.105.169404.
Parker B, Urowitz MB & et al. Clinical association of Metabolic Syndrome in systemic lupus Erythematosus: Data from the international inception cohort. Ann Rheum Dis 2013; 72:1308-14 doi: http://dx.doi.org/10.1136/annrheumdis-2012-202106. Epub 2012 Sep 3.
Cobble M, Bale B. Carotid intima-media thickness: knowledge and application to everyday practice. Postgrad Med. 2010 Jan;122(1):10-8. doi: https://doi.org/10.3810/pgm.2010.01.2091.
OAI - Open Archives Initiative
