A Calorie by Any Name Is Still a Calorie

Abstract

If we analyze 15-year survival rates according to aPL status, there is a trend toward decreased survival in aPLpositive patients (0.77 vs 0.89), which did not reach statistical significance (P = .37). Regarding specific antibodies, anticardiolipin (aCL)-positive patients showed similar figures (0.77 vs 0.9; P = .37); however, patients with lupus anticoagulant (LA) had a significantly lower survival rate (0.58 vs 0.91; P = .008). Similar results were obtained using Cox proportional hazards models. Only LA remained an independent predictor for mortality (odds ratio, 5.0; 95% confidence interval, 1.8-14.0), while aPL and aCL showed nonsignificant trends toward increased mortality. These results support the idea that LA is a more powerful predictor of thrombosis than is aCL. 2 It is mentioned in our article that anticoagulation was not offered to many patients with APS before 1995. As a result, this variable lacks any statistical or clinical significance in our series.In summary, these additional results show that, despite their intrinsic variability, the presence of aPL-particularly LA-is an adverse prognostic factor in patients with SLE, even before thrombosis and full APS have developed. This strengthens the indication for primary prophylaxis of thrombosis in SLE patients with aPL positivity. 3

Environmental Perspective

“…Our group and others have suggested that low carbohydrate diets work primarily by decreasing food choice in diets where fat and carbohydrate are so tightly associated [41][42][43]50 . Also there is a suggestion that there is increased satiety with low carbohydrate diets 41,51 .…”