Intima media thickness measurement as a marker of subclinical atherosclerosis in SLE patient

Abstract

Aim. Accelerated atherosclerosis in systemic lupus erythematosus (SLE) is an important cause of morbidity and mortality. The pathophysiology of accelerated atherosclerosis in SLE is mediated by factors such as inflammatory processes in the vascular wall, specific antibodies, dyslipoproteinemia, endothelial dysfunction and the high prevalence of traditional risk factors for cardiovascular diseases. In this context, we evaluated the clinical significance of ultrasound examination of the carotic arteries in the early diagnosis of atherosclerosis. Methods. The study included 63 patients with SLE (female: male 53:10, mean age 38.4±12.7 years, mean disease duration 143.0 ±82.6 months), 24 patients had lupus nephritis. The control group consisted of 24 volunteers (female: male 20:4 mean age 31.04±8.59). Intima media thickness (IMT) was measured by ultrasound on both sides. The results were correlated with markers of lipid spectrum, anti-dsDNA, antinucleosomal and anticardiolipin antibodies, lupus anticoagulant and complement components. Clinical disease activity and damage were evaluated by SLEDAI and SLICC indices. Lifestyle and other important factors were examined per protocol and by questionnaire. Results. A significant difference of IMT (P≤0.03) was found between the lupus patients and sex-age adjusted healthy controls with an in mean IMT in SLE patients of 0.569±0.11 mm, in control group 0.495±0.05 mm. A significant correlation between IMT and disease duration, age, positivity of lupus anticoagulant, use of ACE inhibitors, glomerular filtration and serum creatinine were found. No difference in IMT was found between patients with or without lupus nephritis. Conclusion. IMT measurement could be used as a clinical predictor of risk of accelerated atherosclerosis in lupus patients.

Role of Osteopontin in Systemic Lupus Erythematosus

“…Our study found a significant correlation of CIMT as a marker of subclinical atherosclerosis with disease duration and serum cholesterol but no correlation with age, HDL or disease activity. This was agree with Andrea et al (26) who did study on 63 patients with SLE and reported that there was significant correlation between CIMT and disease duration, age. In the present study we found no significant correlation between CIMT and SLEDAI in SLE patients.…”

Prevalence and risk of metabolic syndrome in patients with systemic lupus erythematosus: A meta‐analysis

“…After reading titles or abstracts, 1846 records were removed because of duplication, irrelevance to SLE or our topic or review. Finally, 47 eligible studies which met the inclusion criteria were identified and included in this meta‐analysis . The detailed selection process is shown in Figure .…”

Relationship between protein-energy wasting in adults with chronic hemodialysis and the response to treatment with erythropoietin

“…The most commonly reported causes of lack of response to EPO treatment are iron deficiency, secondary hyperparathyroidism, chronic inflammatory processes, and malnutrition. Iron deficiency appears as the most frequent cause of failure to respond to treatment with EPO; however, it must not be forgotten that active inflammatory or infectious processes can temporarily block the response to iron therapy and therefore, to EPO [12–14]. That is why an evaluation of PEW is always relevant in this population.…”

“…The most common causes of EPO resistance, among other, are secondary hyperparathyroidism, chronic inflammatory processes, and malnutrition. While iron deficiency is the leading cause of failure to respond to treatment with EPO; it must not be forgotten that active inflammatory or infectious processes can temporarily block the response to iron therapy and, thereby, to EPO [12–14]. It is important to remember that the presence of anemia in the HD population, is considered one of the main causes of morbidity, closely related to a decrease in appetite and to a hypercatabolic state, all of which may induce a state of malnutrition and inflammation also known as protein-energy wasting (PEW) [15–17].…”