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

Abstract

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.

High Prevalence of Metabolic Syndrome in Patients with Discoid Lupus Erythematosus: A Cross-Sectional, Case-Control Study

“…We found a statistically higher number of smokers among DLE patients than among controls and the number of cigarettes smoked daily was higher in patients with DLE, as found in other case-control reports. In previous studies, it has been determined by Negrón et al that smoking status in SLE patients with MetS did not show any significance when compared to the control group while Mederios et al reported that SLE patients with MetS were higher smokers when compared to the patients without MetS [12, 13]. In our study, no significance was observed in terms of smoking habits between the DLE patients with and without MetS.…”

“…Unsurprisingly, it was an expected result to find lower ratio of arterial HT in DLE patients with MetS when compared to the SLE patients with MetS. In the previous studies, older age in SLE patients has been notified with MetS similar to our DLE patients; however, different from our study, as can be interpreted as higher inflammation burden in SLE, higher BMI, longer disease duration, and higher disease activity have been found in SLE patients with MetS when compared to the patients without MetS [13, 14]. …”

“…Nonetheless, patients with the MetS are at twice the risk of developing CVD over the next 5 to 10 years as individuals without the syndrome. The risk over a lifetime undoubtedly is even higher [9–13, 20]. Similarly, the ratio of generalized lesion distribution, the mean total CLASI activity, and damage scores were higher in our DLE patients with MetS than in those without MetS, but such values did not reach a statistical significance.…”

“…Similarly, the ratio of generalized lesion distribution, the mean total CLASI activity, and damage scores were higher in our DLE patients with MetS than in those without MetS, but such values did not reach a statistical significance. The notion that antimalarials are protective against MetS, CVD, and general mortality in SLE patients is endorsed by some authors [13, 15], but not by others [6, 14]. Singh et al found that there was no difference in total cholesterol between CLE patients who had or never used antimalarials [6].…”

Alterações metabólicas em síndrome antissintetase

“…Com base em fatores relacionados aos mecanismos inflamatórios no lúpus eritematoso sistêmico e ao uso prolongado de glicocorticoides, infere-se que a prevalência de SM parece ser aumentada na população com lúpus eritematoso sistêmico que na população geral. Entretanto os achados são controversos, por um lado trabalhos anteriores descrevem maior prevalência de SM em lúpus eritematoso sistêmico, outros por sua vez apontaram achados sem significância estatística quando comparados com grupo controle saudável (Medeiros et al, 2016).…”