Serum Lipoprotein(a) Level and its Clinical Significance in Patients with Systemic Lupus Erythematosus

Sari, Refik Ali; Polat, Murat; Taysı, Seyithan; Bakan, Ebubekîr; Capoglu, Ilyas

doi:10.1007/s100670200127

Cited by 31 publications

(27 citation statements)

References 21 publications

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“…Cross-sectional studies of patients with differing degrees of disease activity and steroid dosages have generally demonstrated elevated mean triglyceride levels, while total cholesterol levels have been either normal or elevated. Similar variability in low-density lipoprotein (LDL) cholesterol and HDL cholesterol levels have been seen (13,16,23,24,27,(31)(32)(33). None of the studies published thus far have reported longitudinal data on lipid levels at fixed time points or evaluated large numbers of pediatric patients at presentation and at times of differing disease activity in order to better differentiate the effects of disease activity and steroid treatment.…”

mentioning

confidence: 76%

The complex nature of the interaction between disease activity and therapy on the lipid profile in patients with pediatric systemic lupus erythematosus

Sarkissian¹,

Beyenne²,

Feldman³

et al. 2006

Arthritis & Rheumatism

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Objective. To determine the prevalence of lipid abnormalities at different times and to determine the influence of both the disease and corticosteroid therapy on lipid abnormalities in pediatric patients with systemic lupus erythematosus (SLE).Methods. Lipid measurements were obtained in an inception cohort of 139 pediatric patients with SLE (114 females). Fasting levels of total cholesterol, triglycerides, low-density lipoprotein (LDL) cholesterol, and highdensity lipoprotein (HDL) cholesterol in the SLE patients were compared with those in age-and sex-matched control subjects. Disease activity levels and medication dosages were obtained at the time of lipid measurements.Results. At the time of diagnosis, the mean levels of total cholesterol, LDL cholesterol, and triglycerides were highest, whereas the mean levels of HDL cholesterol were lowest. The percentage of patients with abnormal triglyceride values was highest at diagnosis, decreased at year 1, and then remained relatively constant thereafter. The mean total cholesterol and LDL cholesterol levels decreased at year 1 as compared with the time of diagnosis and then remained relatively constant. The lowest mean HDL cholesterol levels were found at the time of diagnosis, and these values rose with time. Comparison of lipid levels at different prednisone dosages and disease activity levels revealed that changes in triglyceride levels were mainly associated with changes in disease activity, changes in both total cholesterol and LDL cholesterol levels were associated with changes in the prednisone dosage and not disease activity, and low levels of HDL cholesterol were associated with active SLE, whereas the prednisone dosage was associated with increased levels of HDL cholesterol.Conclusion. Factors intrinsic to SLE appear to alter lipid levels. Control of SLE may be the most important factor in improving abnormal lipid profiles, and paradoxically, prednisone therapy may improve abnormal lipid levels.

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mentioning

confidence: 76%

The complex nature of the interaction between disease activity and therapy on the lipid profile in patients with pediatric systemic lupus erythematosus

Sarkissian¹,

Beyenne²,

Feldman³

et al. 2006

Arthritis & Rheumatism

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“…Dyslipidemia with decreased highdensity lipoprotein (HDL) and elevated triglycerides, LDL, and lipoprotein(a) has been associated with cumulative SLE disease activity and disease damage [35,36]. Lipoprotein(a), a cholesterol-rich lipoprotein, has been identifi ed as an independent risk factor for CVD [37].…”

Section: Dyslipidemia Increased Oxidative Stress and Impaired Antiomentioning

confidence: 99%

“…Lipoprotein(a), a cholesterol-rich lipoprotein, has been identifi ed as an independent risk factor for CVD [37]. It has been shown to be signifi cantly elevated in SLE patients compared with healthy controls (P < 0.01) [36]. Lipoprotein(a) has also been found to be associated with coronary artery calcifi cation in SLE patients [14,36,38].…”

Section: Dyslipidemia Increased Oxidative Stress and Impaired Antiomentioning

confidence: 99%

“…It has been shown to be signifi cantly elevated in SLE patients compared with healthy controls (P < 0.01) [36]. Lipoprotein(a) has also been found to be associated with coronary artery calcifi cation in SLE patients [14,36,38]. Dyslipidemia in SLE may be related to the development of CVD through the action of cytokines.…”

Section: Dyslipidemia Increased Oxidative Stress and Impaired Antiomentioning

confidence: 99%

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Atherosclerosis risk factors in systemic lupus erythematosus

Agarwal¹,

Elliott²,

Manzi

2009

Curr Rheumatol Rep

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Cardiovascular disease (CVD) has emerged as a leading cause of morbidity and mortality in patients with systemic lupus erythematosus (SLE). Growing evidence suggests that inflammation plays a key role in the pathogenesis of atherosclerosis from initial endothelial dysfunction to rupture of atheromatous plaques. The increased frequency of atherosclerosis in SLE is likely due to a complex interplay among traditional risk factors, disease-related factors such as medications and disease activity, and inflammatory and immunogenic factors. Identification of these novel risk factors will lead to a better understanding of CVD pathogenesis and may also provide targets for potential treatment strategies. When caring for SLE patients, clinicians should be aware of the increased CVD risk and treat the known modifiable risk factors in addition to controlling disease activity and inflammation.

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“…Adults and children with cardiovascular disease without underlying inflammatory disease like SLE also have elevated cytokines and autoantibodies to oxidized LDL components. Most cardiovascular risk factors are common to both groups, such as elevated Lp(a) [40], homocysteine, lupus anticoagulant [4], the traditional Framingham risk factors, and others.…”

Section: Causes Of Dyslipoproteinemia In Systemic Lupus Erythematosusmentioning

confidence: 99%

Dyslipoproteinemia and premature atherosclerosis in pediatric systemic lupus erythematosus

Schanberg

Sandborg²

2004

Curr Rheumatol Rep

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While modern treatments for systemic lupus erythematosus (SLE) have resulted in greatly improved long term outcome in children and adults, complications of atherosclerosis have become a major cause of morbidity and mortality. Although children and adolescents with SLE rarely experience adverse cardiovascular events before adulthood, dyslipoproteinemia and early evidence of premature atherosclerosis is present much earlier. Accelerated atherogenesis in SLE is multifactorial, most likely reflecting vascular, immune, and inflammatory changes along with medication effects. The long term complications of cardiovascular disease in childhood lupus present a particularly important target for intervention because of the potential return on investment by significantly lengthening life and improving quality of life over many decades. An ongoing multi-center, randomized, controlled trial, Atherosclerosis Prevention in Pediatric Lupus Erythematosus (APPLE), testing the efficacy of statins in preventing premature atherosclerosis in children and adolescents with SLE will guide future therapeutic intervention.

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Serum Lipoprotein(a) Level and its Clinical Significance in Patients with Systemic Lupus Erythematosus

Cited by 31 publications

References 21 publications

The complex nature of the interaction between disease activity and therapy on the lipid profile in patients with pediatric systemic lupus erythematosus

The complex nature of the interaction between disease activity and therapy on the lipid profile in patients with pediatric systemic lupus erythematosus

Atherosclerosis risk factors in systemic lupus erythematosus

Dyslipoproteinemia and premature atherosclerosis in pediatric systemic lupus erythematosus

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