Low physical activity is associated with proinflammatory high‐density lipoprotein and increased subclinical atherosclerosis in women with systemic lupus erythematosus

Abstract

Objective. To investigate the association between physical activity, functional activity of high-density lipoprotein (HDL), and subclinical cardiovascular disease in patients with systemic lupus erythematosus (SLE). Results. Number of METS per week spent performing strenuous exercise was negatively correlated with IMT (r ‫؍‬ ؊0.4, P ‫؍‬ 0.002) and number of plaques (r ‫؍‬ ؊0.30, P ‫؍‬ 0.0001). Physical function as assessed by the SF-36 was also negatively correlated with IMT (r ‫؍‬ ؊0.14, P ‫؍‬ 0.03) and number of plaques (r ‫؍‬ ؊0.14, P ‫؍‬ 0.04). In multivariate analyses, number of strenuous exercise METS was significantly associated with IMT (t ‫؍‬ ؊2.2, P ‫؍‬ 0.028) and number of plaques (t ‫؍‬ ؊2.5, P ‫؍‬ 0.014) when controlling for markers of SLE disease activity and damage, but not after controlling for traditional cardiac risk factors. Low physical activity, defined as <225 total METS per week, was associated with the presence of proinflammatory HDL (P ‫؍‬ 0.03). Conclusion. Low physical activity is associated with increased subclinical atherosclerosis and proinflammatory HDL in patients with SLE. Increased strenuous exercise may reduce the risk of atherosclerosis in SLE.

Intima media thickness measurement as a marker of subclinical atherosclerosis in SLE patient

“…A large number of studies report a high prevalence of hypertension in SLE patients; in some cohorts in up in 74% of those aged between 18-74 years of age, the prevalence is 36.3%, while among young healthy women between 20 and 44 years of age it is 2.7 to 14% only 33,34 . In Volkman's study, a sedentary lifestyle was associated with higher IMT and the presence of atherosclerotic plaques, with proinflammatory HDL, representing a crucial disharmony in protective mechanisms 35 . The presence of preclinical atherosclerosis could be measured by several methods including invasive examinations such as coronarography, highly specific and sensitive, but unsuitable for prevention trials.…”

Physical Activity Program Is Helpful for Improving Quality of Life in Patients with Systemic Lupus Erythematosus

“…According to current literature, patients with SLE may benefit from exercise through prevention of cardiovascular and cerebrovascular diseases (Cronin 1988;Ayan and Martin 2007;Mancuso et al 2011). Exercise increases plasma levels of high-density lipoprotein cholesterol and reduces triglyceride levels, thereby preventing the occurrence of hypercholesterolemia, which is an important factor in the development of atherosclerosis (Urowitz et al 2008;Volkmann et al 2010). By reducing the obesity of the stomach region i.e.…”

“…Although physical activity reduces the patients' fear of disability, there is still a great difference of opinion about the time of onset, type and intensity of that activity. Knowing the physiology of physical activity will be reasonable to apply it during treatment or as an early prevention of the disease's sequelae (Krupp et al 1991;Gustafsson et al 2009;Volkmann et al 2010). It is unknown which type and intensity of physical activity contributes most to the treatment.…”

“…Although physical activity can prevent long-term consequences of SLE such as obesity, osteoporosis and premature cardiovascular and cerebrovascular diseases risk (Petri et al 1992;Svenungsson et al 2001;Bruce et al 2003;Oeser et al 2005;Goldberg et al 2009;Gustafsson et al 2009;Urowitz et al 2008;Volkmann et al 2010), in John Hopkins Lupus Cohort, 70% of patients reported a sedentary lifestyle (Petri et al 1992). Although physical activity reduces the patients' fear of disability, there is still a great difference of opinion about the time of onset, type and intensity of that activity.…”

Subclinical Atherosclerosis in Systemic Autoimmune Disorders

“…Peroxidised HDLs (piHDLs) are unable to reverse cholesterol transport which normally clears oxLDL from the subendothelial space promoting endothelial injury. piHDLs occur in a larger proportion of patients with SLE compared to RA and are associated with carotid artery plaque formation, documented CV disease and low physical activity (McMahon, Grossman et al 2006;McMahon, Grossman et al 2009;Volkmann, Grossman et al 2010). Apart from HDL, LDL can be also modified in SLE; Frostergard et al disclosed higher levels of oxidized epitopes on LDL in lupus patients compared to controls, which were associated with arterial disease and renal manifestations (Frostegard, Svenungsson et al 2005).…”