Chylomicron metabolism is markedly altered in systemic lupus erythematosus

Abstract

Objective. To verify the in vivo status of chylomi-cron metabolism in systemic lupus erythematosus (SLE) since there is a high incidence of atherosclerosis in this disease and chylomicrons may have an important role in atherogenesis. Methods. A chylomicron-like emulsion labeled with 14 C-cholesteryl esters and 3 H-triglycerides was injected intravenously into 10 female patients with inactive SLE and 10 healthy age-and sex-matched control subjects to determine the plasma kinetics of the emulsion lipids from consecutive plasma samples taken at regular intervals for 1 hour. Lipolytic activity was determined in vitro after incubation of the labeled emulsion with postheparin plasma. Results. The decay curves for the emulsion were markedly slowed in SLE. Chylomicron lipolysis, indicated by the fractional clearance rate (FCR) of emulsion 3 H-triglyceride, was 2-fold smaller in SLE patients than in controls (mean SD 0.023 0.011 versus 0.047 0.015 minute 1 ; P 0.010). Chylomicron removal, indicated by emulsion 14 C-cholesteryl ester FCR, was 3-fold smaller in SLE patients than in controls (0.007 0.007 versus 0.023 0.011 minute 1 ; P 0.009). In vitro lipolysis in SLE patients was nearly half that of the controls (mean SD 10,199 2,959 versus 6,598 2,215; P 0.014). Higher levels of very-low-density lipoprotein cholesterol and triglycerides and lower levels of high-density lipoprotein cholesterol and apoli-poprotein A-I were also observed in the SLE patients. Conclusion. SLE patients have disturbances in chylomicron metabolism that are characterized by decreased lipolysis and chylomicron remnant removal from the plasma. This finding, together with other alterations in lipid profiles that were confirmed in the present study, is largely accountable for the accelerated atherosclerotic process of the disease.

Antibodies to high‐density lipoprotein and β2‐glycoprotein I are inversely correlated with paraoxonase activity in systemic lupus erythematosus and primary antiphospholipid syndrome

“…In SLE, prolonged steroid treatment seems to be the major cause in that it induces an atherogenic lipid profile, characterized by increased levels of very lowdensity lipoprotein and LDL and decreased levels of HDL, together with hypertension and diabetes (25). In the present study, HDL was reduced in SLE patients compared with controls, as has been reported previously (26). This reduction was quite significant for the HDL 2 subfraction.…”

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

“…Premature atherosclerosis, as demonstrated by the presence of abnormal carotid intima-media thickness and flow-mediated dilation, has been reported both in adult and pediatric patients with SLE (6,(9)(10)(11)(12)(13)(14)(15)(16). Although both traditional and nontraditional factors are important in the development of premature atherosclerosis in patients with SLE, dyslipoproteinemia, which is present in 30-73% of adult patients with SLE, plays a role in the development of atherosclerosis (2,10,(17)(18)(19)(20)(21)(22)(23)(24). To date, there have been few comprehensive lipid studies in pediatric patients with SLE (5,6,16,(25)(26)(27).…”

Subclinical Atherosclerosis in Systemic Autoimmune Disorders

“…The classical pattern of dyslipoproteinemia in SLE is characterized by elevated levels of very-low-density lipoprotein cholesterol (VLDL), triglycerides and LDL and low levels of HDL (Borba, Bonfa et al 2000), although HDL qualitative abnormalities such as peroxidation have been also described, often in association with active disease. Peroxidised HDLs (piHDLs) are unable to reverse cholesterol transport which normally clears oxLDL from the subendothelial space promoting endothelial injury.…”