Background: Systemic lupus erythematosus (SLE) is a complex autoimmune disease. Cardiovascular manifestations are common in SLE, which may have a wide range of severity and one of the major causes of morbidity and mortality. Diabetes mellitus (DM) is one of the most common metabolic diseases. One of the major risk factor for cardiovascular diseases is DM, which is the most common cause of death among diabetic patients. Aim of the Work: evaluation of subclinical atherosclerosis as a predictor for CVD in patients with SLE and DM. Methods: 50 SLE patients, 50 T2DM patients, 50 diabetic SLE patients and 50 healthy controlled subjects were enrolled in this study. They were undergone to Doppler examination of the extra-cranial portion of the carotid and femoral arteries measuring the intima-media thickness. Result: In SLE the subclinical atherosclerosis was present in 22% of patients and was significantly associated with older age (p˂0,001), high blood pressure (p=0,023), overweight (p=0,004), proteinuria (p˂0,001), total cholesterol (p=0,004), active disease (p=0,007), high SLEDAI score (p˂0,001) and long duration of SLE (p˂0,001); whereas in diabetic patients the subclinical atherosclerosis was documented in 24% and was significantly associated with older age (p˂0,001), overweight (p˂0,001), proteinuria (p˂0,001), low hemoglobin (p=0,041), total cholesterol (p=0,001), LDL (p˂0,001), uncontrolled diabetes (p=0,005) and long duration of diabetes (p=0,001) but in SLE diabetic patients the subclinical atherosclerosis was documented in 44% of patients. Conclusion: Subclinical atherosclerosis is frequent in patients with SLE and increases with increased disease activity. Subclinical atherosclerosis in SLE diabetic patients was significantly more than that in SLE or diabetic patients.
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