Lipid and lipoprotein levels in premenopausal systemic lupus erythematosus patients

Abstract

The purpose of this study was to assess the prevalence of dyslipoproteinemia and to analyze the clinical variables that are associated with it in a sample of premenopausal systemic lupus erythematosus (SLE) patients. We studied 53 premenopausal (34.5 y) SLE outpatients and 45 controls. Clinical variables studied included patient age, weight, height, body mass index (BMI), age at disease onset, disease duration, clinical activity of SLE, renal involvement and drug therapy. Total cholesterol (TC), high- and low-density lipoprotein cholesterol (HDL-C and LDL-C), and triglycerides were measured using standard enzymatic techniques. Apolipoproteins (apo) A-I and B were determined by radial immunodiffusion. Twenty-nine patients (55%) and 14 controls (30%) had dyslipoproteinemia. An increase in TC, triglycerides, HDL3-C, apo A-I and apo B, and a decrease in HDL2-C and HDL-C/TC index was found in SLE patients in comparison with controls. TC (P = 0.007), apo B (P = 0.02), LDL-C (P = 0.03) and triglycerides (P = 0.0001) were significantly correlated with proteinuria. Patients on prednisone therapy had higher triglycerides levels (P = 0.03) than untreated patients. TC (P = 0.01), LDL-C (P = 0.006) and triglycerides (P = 0.04) were also correlated with the dose of prednisone. Dyslipoproteinemia is a common feature in adult SLE premenopausal patients which is characterized by an increase in TC, triglycerides and apo B, and an abnormal distribution of HDL subclasses. Corticosteroid therapy and proteinuria are the best predictors of dyslipoproteinemia in these patients.

Recent corticosteroid use and recent disease activity: Independent determinants of coronary heart disease risk factors in systemic lupus erythematosus?

“…Some previous studies reported positive associations between corticosteroid use and traditional coronary risk factors, such as total plasma cholesterol (7-9,12,13,17,31), systolic BP (7), triglycerides (12)(13)(14)17,32,33), LDL cholesterol (13,14,31), Apo B (10), and hyperinsulinemia (33). However, most of these studies did not adjust for disease activity, which in our cohort was correlated both with corticosteroid dose (r ϭ 0.32) and with most CHD risk factors, and therefore may act as a confounder.…”

Changes in Lipid Profile Between Flare and Remission of Patients with Systemic Lupus Erythematosus: A Prospective Study

“…However, in SLE these ratios, representing athero-genic indexes of important prognostic markers for cardiovascular disease, have been underevaluated 7,10,22,26,42 . Blood levels of TC and other lipid fractions have been used widely to predict CHD in patients with SLE, but there are few studies evaluating the ratios in such patients 7,43,44 .…”

Lupus eritematoso sistêmico: novo fator de risco para aterosclerose?

“…The elevation of circulating lipid levels in SLE can be explained by several mechanisms. The long-term use of corticosteroids is known to be responsible for the elevation of total cholesterol, triglycerides and apolipoprotein B levels and for promoting an abnormal distribution of highdensity lipoprotein subclasses 26 . On the other hand, inflammation is associated with the atherosclerosis, and therefore, steroid therapy could have a protective effect.…”