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Study of Prevalence of Metabolic Syndrome in Systemic Lupus Erythematosus Patients in Western India


Affiliations
1 Seth GS Medical College and KEM Hospital, Mumbai, India
     

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Systemic lupus erythematosus (SLE), a systemic autoimmune disease and Metabolic Syndrome (MetS), both confer a proinflammatory and pro-thrombotic state with role in coronary artery disease, hence, focussed CHD risk assessment is required in such patients. Establishing the contribution of SLE phenotype and therapeutic exposure to the development of MetS in SLE patients will yield important insights into pathophysiology of cardiovascular event and help in CHD risk stratification.

Method: It is a cross-sectional observational study with 104 SLE patients in a tertiary care center. Having obtained appropriate permission and written informed consent; personal data, clinical history, general anthropometric and systemic examination are entered in the record form. Serological tests in the management of SLE and MetS are performed. Using appropriate statistical tests, association between presence of MetS and SLE and its variation with various parameters are determined.

Results: Of the 104 SLE patients, 35 had MetS as per modified NCEP/ATP III criteria, higher the age more the risk. Longer disease duration and presence of lupus nephritis are significantly associated with MetS. Patients with MetS had higher disease accrual as measured by SLICC/ACR damage index. Positive anti-dsDNA and higher serum creatinine at presentation were associated with risk of MetS; whereas low C3 and high ESR were more frequent in patients without MetS. Patients with MetS had higher carotid artery intima-media thickness. Higher cumulative doses of steroids (IV pulse MPS and oral both) was associated with MetS.

Conclusions: Screening for risk factors of MetS in SLE will help in identifying the risk for premature atherosclerotic cardiovascular disease for early intervention.


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  • Dall’eraM, Wofsy D. Clinical features of Systemic Lupus Erythematosus. In: Firestein GS, Budd RC, GabrielSE, McInnesIB, O’Dell JR, editors. Kelley’s textbook of rheumatology. 9th edition. Philadelphia. Saunders Elsevier; 2012, p 1283-1303

  • GladmanDD,Urowitz MB. Mortality in Systemic Lupus Erythematosus. J Rheumatol. 1987; 14 (Suppl 13) : 223-26

  • Petri M, Perez- Gutthan S, Spence D, Hochberg MC. Risk factors for coronary artery disease in patients with systemic lupus erythematosus. Am J Med. 1992; 93: 513-19

  • Doria A, IaccarinoL,Sarzi-Puttini P, Atzeni F, Turriel M, Petri M. Cardiac involvement in systemic lupus erythematosus. Lupus. 2005; 14: 683-86

  • El- Magadmi M, Bodill H, Ahmad Y, Durrington PN, Mackness M, Walker M et al. Systemic Lupus Erythematosus: an independent risk factor for endothelial dysfunction in women. Circulation 2004; 110: 399-404

  • Reilly MP, Rader DJ. The metabolic syndrome: more than the sum of its parts Circulation 2003; 108: 1546-51

  • Gami AS, Witt BJ, Howard DE, Erwin Pj, Gami LA, Somers VK et al. Metabolic Syndrome and risk of incident cardiovascular events and death: a systematic review and meta-analysis of longitudinal studies. J Am CollCardiol. 2007; 49: 403-14

  • Expert Panel on Detection, Evaluation and Treatment of High Blood cholesterol in Adults. Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation and treatment of high blood cholesterol in adults (Adult Treatment Panel III). JAMA. 2001; 285(19): 2486-97

  • Bultink IEM, Turkstra F, Diamant M, Dijkmans BAC, Voskuyl AE. Prevalence of and risk factors for the metabolic syndrome in women with systemic lupus erythematosus. ClinExpRheumatol. 2008; 26:32-38

  • Sabio JM, Zamora-Pasadas M, Jimenez-Jaimez J, Albadalejo F, Vargas-Hitos J, Rodriguez del Aguila MD et al. Metabolic syndrome in patients with Systemic Lupus Erythematosus from Southern Spain. Lupus. 2008;17:849-59

  • Chung CP, Avalos I, Oeser A, Gebretsadik T, ShintaniA, Raggi P et al. High prevalence of the metabolic syndrome in patients with systemic lupus erythematosus: association with disease characteristics and cardiovascular risk factors. Ann Rheum Dis. 2007;66:208-14

  • Parker B, Bruce IN. The metabolic syndrome in systemic lupus erythematosus. Rheum Dis Clin North Am. 2010; 36:81-97 13. Negron AM, Molina MJ, Mayor AM, Rodriguez VE, Vila LM. Factors associated with metabolic syndrome in patients with systemic lupus erythematosus from Puerto Rico. Lupus. 2008; 17: 348-54

  • Simard JF, Costenbader KH. Epidemiology and classification of systemic lupus erythematosus. In: Hochberg MC, Silman AJ, Smolen JS, Weinblatt ME, Welsman MH, editors. Rheumatology. 5th edition. Philadelphia. Mosby Elsevier; 2011, p 1301-1306

  • Gladman DD, Urowitz MB, Goldsmith CH, Fortin P, Ginzler E, Gordon C et al. The reliability of the Systemic Lupus International Collaborating Clinics/ American College of Rheumatology Damage Index in patients with systemic lupus erythematosus. Arthritis Rheum. 1997;40:809-13

  • Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA et al. American Heart Association/ National Heart, Lung and Blood Institute. Diagnosis and management of the metabolic syndrome: an American Heart Association/ National Heart, Lung and Blood Institute Scientific Statement Circulation 2005; 112:2735-52

  • Parker B, Urowitz MB, Gladman DD, Lunt M, Bae SC, Sanchez-Guerrero J et al. Clinical associations of the metabolic syndrome in systemic lupus erythematosus: data from an international inception cohort. Ann Rheum Dis 2013; 72: 1308-14.


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  • Study of Prevalence of Metabolic Syndrome in Systemic Lupus Erythematosus Patients in Western India

Abstract Views: 210  |  PDF Views: 3

Authors

S. Mangalgi
Seth GS Medical College and KEM Hospital, Mumbai, India
A. G. Rajadhyaksha
Seth GS Medical College and KEM Hospital, Mumbai, India

Abstract


Systemic lupus erythematosus (SLE), a systemic autoimmune disease and Metabolic Syndrome (MetS), both confer a proinflammatory and pro-thrombotic state with role in coronary artery disease, hence, focussed CHD risk assessment is required in such patients. Establishing the contribution of SLE phenotype and therapeutic exposure to the development of MetS in SLE patients will yield important insights into pathophysiology of cardiovascular event and help in CHD risk stratification.

Method: It is a cross-sectional observational study with 104 SLE patients in a tertiary care center. Having obtained appropriate permission and written informed consent; personal data, clinical history, general anthropometric and systemic examination are entered in the record form. Serological tests in the management of SLE and MetS are performed. Using appropriate statistical tests, association between presence of MetS and SLE and its variation with various parameters are determined.

Results: Of the 104 SLE patients, 35 had MetS as per modified NCEP/ATP III criteria, higher the age more the risk. Longer disease duration and presence of lupus nephritis are significantly associated with MetS. Patients with MetS had higher disease accrual as measured by SLICC/ACR damage index. Positive anti-dsDNA and higher serum creatinine at presentation were associated with risk of MetS; whereas low C3 and high ESR were more frequent in patients without MetS. Patients with MetS had higher carotid artery intima-media thickness. Higher cumulative doses of steroids (IV pulse MPS and oral both) was associated with MetS.

Conclusions: Screening for risk factors of MetS in SLE will help in identifying the risk for premature atherosclerotic cardiovascular disease for early intervention.


References