Metabolic syndrome and insulin resistance comorbidity in systemic lupus erythematosus

Gheita, Tamer A.; Raafat, H.; Sayed, Safaa; El-Fishawy, Hussein S.; Nasrallah, M. M.; Abdel-Rasheed, Enas

doi:10.1007/s00393-012-1058-9

Cited by 49 publications

(22 citation statements)

References 33 publications

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“…The increased IMT in SLE in the present study has been confirmed in several studies [24][25][26]. Furthermore, in other studies on Egyptian SLE patients, the IMT was found to be significantly increased [11,12,27].…”

Section: Discussionsupporting

confidence: 91%

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Intima-media thickness in secondary anti-phospholipid syndrome patients: Impact of disease activity

Raafat

Fawzy

Fishawy

2015

The Egyptian Rheumatologist

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Aim of the work: To assess the carotid intima-media thickness (IMT) and plaque formation in systemic lupus erythematosus (SLE) patients with and without antiphospholipid syndrome (APS) by doppler ultrasonography and to correlate it with the clinical features, disease activity and damage.Patients and methods: Thirty-six female SLE patients with secondary APS and another 36 without were included. Thirty-six matching healthy volunteers were included as control. In patients, the disease activity and damage were assessed using the SLE Disease Activity Index (SLEDAI) and Systemic Lupus International Collaborating Clinics (SLICC) index, respectively. Doppler ultrasound was carried out for patients and control and the IMT was measured.Results: The demographic and clinical characteristics of patients are presented. The disease activity was significantly higher in SLE patients with APS (19.7 ± 7.9) compared to SLE only patients (15.1 ± 9.2) (p = 0.03). The low density lipoprotein (LDL) was significantly increased in APS patients (p = 0.04). The IMT was comparable between both groups (0.83 ± 0.15 mm) vs (0.86 ± 0.2 mm) (p = 0.55) and both were significantly increased compared to the control (0.61 ± 0.11 mm) (p < 0.0001). The dyslipidemia present in the patients showed a significant difference in the measured lipid profile parameters (p < 0.0001). The IMT significantly correlated with the SLEDAI in both groups (p < 0.002 and <0.001 respectively).Conclusion: The increased IMT as a marker of atherosclerosis is confirmed in SLE patients with no obvious difference in those with secondary APS. The link between the increased IMT and disease activity favors the role of disease-specific potential risk factors, in addition to the traditional conventional ones, in the development of atherosclerosis.

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Section: Discussionsupporting

confidence: 91%

“…The IMT has been found to be increased in many rheumatic diseases such as rheumatoid arthritis [10], SLE [11,12], Behcets disease [13] and osteoarthritis [14]. Together with classical conventional risk factors, other mechanisms (disease-specific factors) promote accelerated atherosclerosis in SLE.…”

Section: Introductionmentioning

confidence: 98%

Intima-media thickness in secondary anti-phospholipid syndrome patients: Impact of disease activity

Raafat

Fawzy

Fishawy

2015

The Egyptian Rheumatologist

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“…Icli et al [11] and Ammirati et al [23] showed that cIMT values were higher in SLE patients compared to control individuals. Gheito et al [24] demonstrated that cIMT levels were higher in SLE patients than in their control group and that it showed a correlation with SLEDAI. Batún Garrido et al [5] reported the strong correlation between SLE activity and dyslipidemia.…”

Section: Discussionmentioning

confidence: 95%

Plasma Atherogenic Index is an Independent Indicator of Subclinical Atherosclerosis in Systemic Lupus Erythematosus

et al. 2017

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Objective: Systemic lupus erythematosus (SLE) is characterized by chronic inflammation. Plasma atherogenic index (PAI) is a valuable marker for the cardiovascular disease and cardiac risk. The aim of this study was to evaluate the role and clinical use of PAI in atherosclerosis and the cardiac risk in SLE patients. Materials and Methods:We included 56 female SLE patients who were selected according to the American College of Rheumatology (1997) diagnosis criteria. Furthermore, we selected age-and body mass index (BMI)-matched 56 female healthy individuals. PAI was measured as a logarithmic value of triglyceride to high-density cholesterol ratio. We used carotid intima media thickness (cIMT) as an inflammatory marker because of its widespread use. The lipid and other biochemical parameters of patient and control groups were examined.Results: The PAI and cIMT values of SLE patients were 0.04±0.23 and 0.78±0.18 mm, respectively. Besides, for the control group, the PAI value was −0.09±0.20 and cIMT value was 0.50±0.15 mm (p=0.002, p<0.001; respectively). There was a strong correlation between cIMT and PAI (r=0.273, p=0.003). According to the multiple logistic regression analysis, we found that PAI value is an independent factor for cIMT in SLE patients (odds ratio: 2.6, 95 % confidence interval; 1.506-4.374; p=0.029). Conclusions:We determined that PAI can be used as an independent indicator for subclinical atherosclerosis in SLE patients.Keywords: Plasma atherogenic index, carotid intima-media thickness, systemic lupus erythematosus, atherosclerosis ÖZ Amaç: Sistemik lupus eritematozus (SLE), kronik inflamasyon ile karakterize bir hastalıktır. Plazma aterojenik indeks (PAI), kardiyovasküler hastalık ve kardiyak risk için değerli bir belirteçtir. Bu çalışmanın amacı PAI'in SLE hastalarında aterosklerozu ve kardiyak riski değerlendirmekteki rolü ve klinik kullanılabilirliliğini araştırmaktır.Gereç ve Yöntem: Amerikan Romatoloji Koleji (1997) tanı kriterlerine göre değerlendirilen 56 kadın SLE hastası dahil edildi. Ayrıca yaş ve vucüt kitle indeksi uyumlu 56 kadın sağlıklı kişi seçildi. PAI, trigliserit'in yüksek yoğunluklu kolesterole oranı logartimik ölçümüdür. Karotis intima medya kalınlığı (KIMK) inflamatuvar belirteç olarak yaygın olarak kullanıldığından, bu işareti bu çalışmada kullandık. Hasta ve kontrol gruplarının lipid ve diğer biyokimyasal parametreleri incelendi.Bulgular: Hasta grubunda PAI 0,04±0,23, KIMK 0,78±0,18 mm, kontrol grubunda PAI -0,09±0,20, KIMK 0,50±0,15 mm olduğu tespit edildi. Hasta grubunda PAI ve KIMK'ın kontrol grubuna kıyasla yüksek olduğu görüldü (sırasıyla p=0,002, p<0,001). SLE hastaları içerisine KIMK ile PAI arasında pozitif korelasyon olduğu görüldü (r=0,273, p=0,003). Multipl logistik regresyon analize göre PAI, KIMK için bağımsız risk faktörü olarak değerlendirildi (Olasılık oranı: 2,6, Güven aralığı %95 1,506-4,374, p=0,029).Sonuç: Bu çalışma bize PAI'nın SLE hastalarında subklinik aterosklerozun değerlendirilmesinde kullanılabilecek bağımsız bir belirteç olabileceğini d...

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“…In Negrón et al [17], SLAM-R-scored SLE activity was independently associated with MetS (OR 1.14; 95 % CI 1.00-1.30). In Gheita et al [32], SLEDAI and SLICC were significantly increased in SLE patients, especially those with MetS, and the carotid intima-media thickness correlated with disease activity. However, since all the studies evaluating this relation were cross-sectional, they were limited to establishing associations between variables, not causality.…”

Section: Discussionmentioning

confidence: 96%

“…Age and disease duration are clearly positively associated with MetS since the likelihood of developing this condition increases over time of exposure to disease-specific inflammatory and metabolic mechanisms and therapy. Damage has been associated with MetS in several studies [17,18,[20][21][22]32]. A meta-analysis by Sun et al [33] including 56,691 individuals from the general population and 8688 cases of MetS showed that active smoking increased the risk of MetS by 26 %.…”

Section: Discussionmentioning

confidence: 97%

Prevalence of metabolic syndrome in a cohort of systemic lupus erythematosus patients from Northeastern Brazil: association with disease activity, nephritis, smoking, and age

2015

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Systemic lupus erythematosus (SLE), an autoimmune inflammatory disease, is associated with an increased prevalence of accelerated atherosclerosis and cardiovascular events. Metabolic syndrome (MetS) is a set of cardiovascular risk factors in SLE patients, which may lead to a proinflammatory condition and increased morbidity and mortality. The objective of this study was to evaluate the prevalence of MetS in a cohort of SLE patients versus healthy controls, and to analyze the association of clinical and demographic factors. SLE patients (n = 146) treated at a Northeast Brazilian university hospital were evaluated with regard to demographic, clinical, laboratory, and anthropometric parameters and compared to controls (n = 101). MetS was diagnosed according to the definition of 2005 NCEP/ATP III. The average age of SLE patients was 41.7 ± 12.5 years, and 91.8 % were female. MetS was significantly more prevalent in SLE patients (45.2 %) than in controls (32.7 %; p = 0.04). The MetS components such as hypertension, diabetes, and hypertriglyceridemia were significantly more prevalent in SLE. In the univariate analysis, MetS in SLE patients was associated with age, disease duration, Systemic Lupus International Collaborating Clinics/American College of Rheumatology damage index, smoking, menopause, nephritis, cyclophosphamide use, prednisone dose, and chloroquine use, which appeared to have a protective effect. In the logistic regression analysis, age, disease activity, nephritis, and smoking were statistically significant. The prevalence of MetS observed in our cohort of SLE patients from Northeastern Brazil is higher than controls. MetS components should be routinely investigated to minimize the occurrence of MetS and associated cardiovascular morbidity and mortality.

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Metabolic syndrome and insulin resistance comorbidity in systemic lupus erythematosus

Cited by 49 publications

References 33 publications

Intima-media thickness in secondary anti-phospholipid syndrome patients: Impact of disease activity

Intima-media thickness in secondary anti-phospholipid syndrome patients: Impact of disease activity

Plasma Atherogenic Index is an Independent Indicator of Subclinical Atherosclerosis in Systemic Lupus Erythematosus

Prevalence of metabolic syndrome in a cohort of systemic lupus erythematosus patients from Northeastern Brazil: association with disease activity, nephritis, smoking, and age

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