Background High prolactin (PRL) levels have been reported in systemic lupus erythematosus (SLE) patients to be associated with disease activity; they have also been described in patients with chronic diseases like chronic renal failure and chronic liver disease. To our knowledge, an association between disease damage and PRL levels in SLE patients has not been previously evaluated. Objectives To determine whether PRL levels are independently associated with disease damage in SLE patients. Methods This cross-sectional study was conducted in consecutive SLE patients seen in our Rheumatology Department from January to December 2012. An interview, chart review, physical examination and laboratory tests were performed. SLE was defined using the revised and updated ACR criteria; disease activity was ascertained using the SLEDAI and disease damage with the SLICC/ACR damage index (SDI). Use of steroids was recorded as current dose of prednisone and time of exposure. Chronic liver disease was defined as the presence of cirrhosis or chronic hepatitis. The association between PRL levels and SDI was evaluated using Spearman’s correlation. Subsequently, a linear regression model was performed to evaluate the association between PRL levels and SDI, adjusting for age, gender, disease duration, disease activity, thyroid-stimulating hormone (TSH), use of steroids, chronic liver disease and serum creatinine level. Results 130 patients were evaluated, 119 (91.5%) were female; their average (SD) age was 42.6 (13.2) years. Disease duration was 7.3 (6.1) years; almost all patients were mestizo. The mean SLEDAI was 5.9 (4.6), the SDI was 0.9 (1.3), 57 (43.8%) patients had at least one point in the SDI. Mean current prednisone dose was 7.8 (4.6) mg/d, and time of exposure to steroids was 7.1 (6.0) years. Mean creatinine level was 1.3 (1.8) mg/dl, 3 (2.3%) patients had chronic liver disease. TSH was 5.2 (10.5) mIU/l, 37 (28.5%) had TSH above upper normal limit. Mean PRL level was 20.0 (14.4) ng/ml, 38 (29.2%) had a PRL level above upper normal limit. In univariate analysis, PRL level was associated with a higher SDI (Rho: 0.29, p: 0.001). In the adjusted model, PRL level remained associated with SDI (β: 0.37, p<0.001). Conclusions In our SLE patients, we found a positive association between the prolactin level and SDI, independently of age, gender, disease duration, disease activity, TSH, use of steroids, chronic liver disease and creatinine level. Longitudinal studies are needed to sort out the role of this variable in disease damage in lupus. Disclosure of Interest: None Declared

Background Chronic inflammatory diseases such as Rheumatoid Arthritis (RA) and periodontal disease (PD) havebeen associated with accelerated cardiovascular disease and Metabolic Syndrome (MS) is also strongly associatedwith this condition. No previous study, to our knowledge, has investigated if more severe PD influences the emergence of MS in RA. Objectives To demonstrate that a more severe PD is independently associated with MS in RA population. Methods A cross sectional study. All subjects met the ACR criteria, had no other autoimmune disease. We excluded patients with less than 4 teeth, serious or local ongoing infections, oral cancer or precancerous lesion, hospitalized, pregnant, local antibiotics (previous 3 months) or drugs associated with gingival hyperplasia. A personal interview, physical examination, auxiliary tests and medical chart review were performed. Diagnosis and severity of PD were defined according to the American Academy of Periodontology criteria. Severity was categorized on the basis of the amount of clinical attachment loss as mild, moderate or severe. Alldental assessments were interpreted by three odolontologist blind to clinical patient condition. MS was defined according to International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity.2009. Statistical analysis: First an univariated x2 analysis was performed to evaluatethe association between MS and PD severity, then a logistic binary regression model adjusted to age, tobacco, gender, rheumatoid factor (RF), disease duration (DD), socioeconomic level (Graffar scale), disease activity (DAS28CRP), functional status (MDHAQ), body fat distribution by DXA(trunk-to-leg fat ratio), percentage of body fat by DXA, body mass index(BMI) and current dose of glucocorticoids was done to assess the persistence of the association. Statistical package SPSSv16.0 was used. Results 165 patients were evaluated, all mestizos, 90.3% were women, average (SD) age was 58.96 (12.51) years, DD: 15.47(11.43) years, socioeconomic status was more frequently medium, (middle Class: 36.2%), 89.7% were RF(+), and the DAS28CRP was 4.06 (1.19); 17% were current or past smokers. Mean BMI was 27.91(4.89)kg/m2. Current dose of prednisone: 4.92 (3.43) mg/d;124 patients (75.2%) had PD, mostly moderate (43.6%). A MS was identified in 37.6% patients. In the adjusted model a higher PD severity was independently associated with MS (OR: 2.92; p=0.006). Conclusions In our RA patients, more severe PD correlates with MS independently of other known associated factors. Prospective studies to explore cardiovascular risk in RA patients with PD are necessary to establish the impact of this condition. Disclosure of Interest None Declared

Background There is a connection between periodontal disease (PD) and a higher incidence and severity of rheumatoid arthritis (RA) but to our knowledge there is no reported study evaluating the impact of PD in joint damage (JD). In our country, the prevalence of PD is 95%. Objectives To demonstrate that a more severe PD is independently associated with higher Sharp/van der Heijde radiologic scores(Sharp VDH) in RA patients. Methods A cross sectional study. All subjects met the ACR criteria for RA, had no other autoimmune disease and were older than 18 years at the diagnosis. We excluded patients with less than 4 teeth, serious or local ongoing infections, oral cancer or precancerous lesion, hospitalized, pregnant, or gingival hyperplasia induced by drugs. We applied a personal interview, physical examination, laboratory analysis and review of medical charts to assess factors associated with JD. Diagnosis and severity of PD were defined according to the American Academy of Periodontology criteria. Severity was categorized on the basis of the amount of clinical periodontal attachment loss (as mild, moderate or severe). All dental assessments and radiographs were interpreted by three odolontologist blinded to JD. A blinded investigator to clinical RA and PD status determined JD score according to Sharp VDH method. Statistical analysis: An univariated linear regression model to determine association between PD and JD was applied. Then, a multiple linear regression model adjusted for age, tobacco, gender, rheumatoid factor (RF), disease duration (DD), diagnosis delay, socioeconomic status (Graffar scale), disease activity (DAS 28CRP), functional status (MDHAQ) and comorbidities (Charlson index) was performed in order to determine persistence of the association. SPSSv16.0 statistical package was used. Results 157 patients were evaluated, 88.5% were women, average (SD) age was 59.00 (12.73) years, DD: 17.60 (11.28) years, socioeconomic status were more frequent medium / medium low (34.4% and 30.6%), 89.2% were RF (+), the mean CRP: 12.78 (17.18) mg/L and the DAS28CRP: 3.94 (1.14). Erosion, joint narrowing space and total Sharp VDH score were 40.21 (48.28), 66.02 (43.85) and106.23 (89.12) respectively. 139 patients (88.5%) had PD, mostly moderate (54.1%). In multivariate analysis PD was independently associated with a higher score for erosion (B: 0.27, P = 0.002), joint space narrowing (B: 0.25, P = 0.003) and total SharpVDH scores (B: 0.27, P = 0.001). Conclusions A more severe PD is associated with joint damage independently of other known associated factors. A more strict periodontal evaluation and follow-up could be useful for better outcomes with less disease progression in RA patients. Disclosure of Interest None Declared