Metabolic syndrome in Argentinean patients with systemic lupus erythematosus

Abstract

The objective was to determine the prevalence of the metabolic syndrome (MS) in patients with systemic lupus erythematosus (SLE) in Argentina, to assess the factors associated to it, and to compare the results with a control group with non-inflammatory disorders. The study included 147 patients with SLE and 119 controls. MS was defined according to criteria by the American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI) Scientific Statement. Demographic characteristics, Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) and Systemic Lupus International Collaborating Clinics/ACR Damage Index (SDI) were assessed as well as administration, maximum dose and cumulative dose of prednisone and hydroxychloroquine (HCQ). MS prevalence was 28.6% (CI 95%: 21.4-36.6) in patients with SLE and 16% in controls (P = 0.0019). Patients with SLE presented higher arterial hypertension frequency compared with controls (43 vs 25%, P = 0.007). When comparing lupus patients with MS (n = 41) and without MS (n = 106), no significant differences were observed regarding duration of the disease, SLEDAI or cumulative prednisone dose. Cumulative damage was associated independently with MS (OR 1.98; P = 0.021), whereas HCQ use was found to be protective (OR 0.13; P = 0.015). Patients with lupus presented higher MS prevalence than controls with non-inflammatory disorders, and occurrence of arterial hypertension was also higher. MS was associated with cumulative damage; the use of HCQ showed to be protective against presence of MS.

Excess weight and associated risk factors in patients with systemic lupus erythematosus

“…On the other hand, the study by Oeser et al and the LUMINA study did not show this association between the damage index and BMI [2,3]. Studies that have compared cumulative damage in patients with and without the presence of metabolic syndrome have identified a significant and independent correlation between the presence of metabolic syndrome and a higher damage index [26,27]. Therefore, other studies need to be undertaken to adequately assess this possible association.…”

Prevalence of metabolic syndrome in a cohort of systemic lupus erythematosus patients from Northeastern Brazil: association with disease activity, nephritis, smoking, and age

“…The MetS components such as hypertension, diabetes, and hypertriglyceridemia were associated with increased serum levels of C-reactive protein (CRP), interleukin-18 (IL- 18), and TNF-α, a characteristic finding in IR and endothelial dysfunction, which in turn have been implicated in the development of CVD and MetS in the general population [8,9]. Based on factors related to inflammatory mechanisms in chronic SLE and prolonged use of corticosteroids, the prevalence of MetS might be expected to be higher in SLE patients than in the general population, but this has not been clearly established: While some authors have reported higher prevalences of MetS in SLE patients than in healthy controls [10][11][12][13][14], others have found the difference to be nonsignificant [15]. Studies without control groups [16][17][18][19][20][21] do not allow to ascertain whether the prevalence of MetS is increased in SLE compared to the general population.…”

“…In the literature, the prevalence of MetS in SLE ranges from 16 to 41.4 % [10][11][12][13][14][15][16][17][18][19][20][21][22][23]. Three Brazilian studies conducted in geographically different regions reported prevalences of 20, 32.1, and 41.4 % [10,14,20].…”

Risk Factors in Cardiovascular Disease in Systemic Lupus Erythematosus

“…In addition to the cardiovascular risk factors that comprise the metabolic syndrome, there is a strong relationship with inflammation [19,20]. Several studies have shown that the prevalence of MetS is increased in SLE [21][22][23][24][25].…”