Dyslipidemia in systemic lupus erythematosus: just another comorbidity?

Tselios, Konstantinos; Koumaras, Charalambos; Gladman, Dafna D.; Urowitz, Murray B.

doi:10.1016/j.semarthrit.2015.10.010

Cited by 87 publications

(79 citation statements)

References 102 publications

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“…Most studies reveal that relative risk of myocardial infarction exceeds 5 to 8 times compared to general population 4. Studies have shown that the prevalence of dyslipidemia in lupus patients ranges from 36% at diagnosis to 60% or even higher after 3 years 5. Patients with SLE have an elevated plasma TG, LDL- C, Apoprotein B, and decreased HDL-C 6.…”

Section: Introductionmentioning

confidence: 99%

Frequency of Dyslipidemia in patients with Lupus Nephritis

et al. 2017

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Objective:To determine the frequency of dyslipidemia in patients with lupus nephritis and its association with the degree of proteinuria.Methods:This cross-sectional analytic study included 65 patients who fulfilled the ACR (American College of Rheumatology) criteria for SLE and had renal involvement, presenting to the Division of Rheumatology, Fatima Memorial Hospital (FMH), and Lahore from 21st Sep 2016 to 20th Dec 2016. After 12 hours overnight fast their blood samples were assessed for total cholesterol (TC), triglycerides (TG), high density lipoprotein (HDL) and low density lipoprotein (LDL). Patient demographic variables (age, sex) and disease characteristics (disease duration, degree of proteinuria, steroid dose) were noted. Patients were categorized into two groups on the basis of degree of proteinuria: having proteinuria >1gm or ≤ 1gm. Data was analyzed using SPSS version 22. Individual lipid profiles were correlated with the degree of proteinuria.Results:Most common lipid abnormality found in our study was hypertriglyceridemia (58.5%). Total Cholesterol and LDL-C was high in 55.4% and 30.8% subjects respectively. Low HDL was found in 21.5% subjects. Increased frequency of dyslipidemia was noticed in those subjects who had proteinuria >1gm (P value < 0.05).Conclusion:Dyslipidemia was observed in a high frequency in patients with lupus nephritis and was strongly associated with their degree of proteinuria.

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Section: Introductionmentioning

confidence: 99%

Frequency of Dyslipidemia in patients with Lupus Nephritis

et al. 2017

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“…44 Or rather, it could be due to a combination of both the former and latter. 15,16 The effects of HCQ in contributing to this less atherogenic profile have been postulated through different mechanisms. It has been suggested through rat hepatocyte isolates that chloroquine affects the cholesterol biosynthetic pathway outside of the cytosolic acetylcoA.…”

Section: Discussionmentioning

confidence: 99%

“…13,14 Yet these patients have been difficult to risk stratify, and the current cardiac risk scores only take into account traditional risk factors for atherosclerotic disease such as hypertension, diabetes mellitus, and smoking. 15 Szabo et al reported that accelerated atherosclerosis is also related to non-traditional, disease-related factors of SLE. 16 According to a 3-year international inception cohort study of patients with SLE, the prevalence of coronary artery disease has been noted to be as high as 60% after 3 years of disease burden.…”

Section: Introductionmentioning

confidence: 99%

Favorable effects of hydroxychloroquine on serum low density lipid in patients with systemic lupus erythematosus: A systematic review and meta‐analysis

et al. 2017

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Aims: Hydroxychloroquine (HCQ) has shown to have significant immunomodulatory effects in the treatment of systemic lupus erythematosus (SLE). Current studies show favorable effects of HCQ on traditional cardiac risk factors in patients with SLE. This review examined the effects of HCQ on serum low-density lipoprotein (LDL) level in patients with SLE.Methods: A systematic search of seven major literature search databases from their inception until 3 April, 2017 identified nine studies. Random-effects pooled mean difference with corresponding 95% confidence intervals (CI) were estimated. Heterogeneity was measured by I 2 . Publication bias was assessed by visual inspection of funnel plots. Sensitivity analysis examined whether HCQ effect on serum total cholesterol level was similar to the main analysis. The Grading of Recommendations Assessment, Development, and Evaluation system was used to assess the overall quality of evidence.Results: Pooled study participants were 559 patients from eight observation studies (two before-after studies; six case-control studies) examining the effects of HCQ on serum LDL. Pooled study participants' characteristics were as follows: mean age 45.719, female 95.262%, and prednisone use 58.366%. HCQ reduced mean LDL levels by 24.397 mg/dL (95% CI 8.921-39.872; P = 0.002). The number of studies identifying statin use was too few to perform meta-regression analysis of statin use. Heterogeneity was extensive (I 2 = 94.739%). Symmetrical funnel plot visualized no evidence of publication bias.Conclusion: HCQ was associated with serum LDL level reduction by mean 24.397 mg/dL in patients with SLE. Future prospective studies are need to fully characterize the treatment effect.

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“…(27) In SLE, a described pattern of dyslipidemia is characterized by increased VLDL and triglycerides, and decreased HDL. (29) This pattern is often seen at time of diagnosis and correlates to SLE activity. (30) Oxidized LDL/β2glycoprotein 1 immune complexes have also been described,(31) which bind oxidized LDL (oxLDL) and are phagocytosed by macrophages, promoting foam cell formation.…”

Section: Endothelial Dysfunction and Aberrant Metabolic Pathways In Slementioning

confidence: 99%

Update on cardiovascular disease in lupus

Lewandowski

Kaplan

2016

Current Opinion in Rheumatology

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Purpose of Review Atherosclerotic cardiovascular disease confers significant morbidity and mortality in patients with systemic lupus erythematosus (SLE) and cannot be fully explained by traditional cardiovascular risk factors. Recent immunologic discoveries have outlined putative pathways in SLE that may also accelerate the development of atherosclerosis. Recent findings Aberrant innate and adaptive immune responses implicated in lupus pathogenesis may also contribute to the development of accelerated atherosclerosis in these patients. Defective apoptosis, abnormal lipoprotein function, autoantibodies, aberrant neutrophil responses and a dysregulated type I interferon pathway likely contribute to endothelial dysfunction. SLE macrophages have an inflammatory phenotype that may drive progression of plaque. Summary Recent discoveries have placed increase emphasis on the immunology of atherosclerotic cardiovascular disease. Understanding the factors that drive the increase risk for CVD in SLE patients may provide selective therapeutic targets for reducing inflammation and improving outcomes in atherosclerosis.

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Dyslipidemia in systemic lupus erythematosus: just another comorbidity?

Cited by 87 publications

References 102 publications

Frequency of Dyslipidemia in patients with Lupus Nephritis

Frequency of Dyslipidemia in patients with Lupus Nephritis

Favorable effects of hydroxychloroquine on serum low density lipid in patients with systemic lupus erythematosus: A systematic review and meta‐analysis

Update on cardiovascular disease in lupus

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