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Metabolic syndrome, endothelial injury, and subclinical atherosclerosis in patients with systemic lupus erythematosus.
Scand J Rheumatol 2010; 39(1):42-9SJ

Abstract

OBJECTIVES

To study the link between metabolic syndrome (MetS), endothelial injury, and atherosclerosis in patients with systemic lupus erythematosus (SLE).

METHODS

Consecutive SLE patients without a history of arterial thrombosis were screened for atherosclerosis at the carotid and coronary arteries by B-mode ultrasound [intima-media thickness (IMT)] and multidetector computed tomography (MDCT) scan (Agatston calcium scores), respectively. Plasma levels of homocysteine, high-sensitivity C-reactive protein (hsCRP), soluble vascular cell adhesion molecule (sVCAM)-1, P-selectin, and soluble thrombomodulin (sTM) were assayed. Patients were stratified according to the National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III) criteria for MetS, using the Asian criteria for abdominal obesity. Risk factors for atherosclerosis were studied.

RESULTS

Of the 123 SLE patients (93% women; age 47.9+/-11 years; SLE duration 10.9+/-7.0 years) studied, 20 (16.3%) had MetS. The prevalence of MetS in the SLE patients was significantly higher than in 492 age- and sex-matched healthy controls (9.6%; p=0.03). Coronary calcification and abnormal carotid IMT were detected in 38 (31%) and 72 (59%) of SLE patients, respectively. Patients with MetS had a significantly higher Agatston score (69.5+/-95 vs. 16.4+/-57; p=0.03) and a numerically higher carotid IMT (p=0.43) than those without. In a logistic regression model, the MetS [odds ratio (OR) 3.11, 95% confidence interval (CI) 1.01-9.59, p=0.049] was associated with coronary atherosclerosis after adjustment for age and other risk factors. In addition, patients with MetS had significantly higher levels of hsCRP (p=0.002), homocysteine (p=0.03), and sTM (p=0.01).

CONCLUSIONS

The MetS is more prevalent in SLE patients than the general population and is associated with endothelial injury and coronary atherosclerosis. More aggressive control of risk factors is justified in these patients.

Authors+Show Affiliations

Department of Medicine, Tuen Mun Hospital, Hong Kong, SAR China. ccmok2005@yahoo.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

20132070

Citation

Mok, C C., et al. "Metabolic Syndrome, Endothelial Injury, and Subclinical Atherosclerosis in Patients With Systemic Lupus Erythematosus." Scandinavian Journal of Rheumatology, vol. 39, no. 1, 2010, pp. 42-9.
Mok CC, Poon WL, Lai JP, et al. Metabolic syndrome, endothelial injury, and subclinical atherosclerosis in patients with systemic lupus erythematosus. Scand J Rheumatol. 2010;39(1):42-9.
Mok, C. C., Poon, W. L., Lai, J. P., Wong, C. K., Chiu, S. M., Wong, C. K., ... Lam, C. S. (2010). Metabolic syndrome, endothelial injury, and subclinical atherosclerosis in patients with systemic lupus erythematosus. Scandinavian Journal of Rheumatology, 39(1), pp. 42-9. doi:10.3109/03009740903046668.
Mok CC, et al. Metabolic Syndrome, Endothelial Injury, and Subclinical Atherosclerosis in Patients With Systemic Lupus Erythematosus. Scand J Rheumatol. 2010;39(1):42-9. PubMed PMID: 20132070.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Metabolic syndrome, endothelial injury, and subclinical atherosclerosis in patients with systemic lupus erythematosus. AU - Mok,C C, AU - Poon,W L, AU - Lai,J P S, AU - Wong,C K, AU - Chiu,S M, AU - Wong,C K, AU - Lun,S W M, AU - Ko,G T C, AU - Lam,C W K, AU - Lam,C S, PY - 2010/2/6/entrez PY - 2010/2/6/pubmed PY - 2010/3/3/medline SP - 42 EP - 9 JF - Scandinavian journal of rheumatology JO - Scand. J. Rheumatol. VL - 39 IS - 1 N2 - OBJECTIVES: To study the link between metabolic syndrome (MetS), endothelial injury, and atherosclerosis in patients with systemic lupus erythematosus (SLE). METHODS: Consecutive SLE patients without a history of arterial thrombosis were screened for atherosclerosis at the carotid and coronary arteries by B-mode ultrasound [intima-media thickness (IMT)] and multidetector computed tomography (MDCT) scan (Agatston calcium scores), respectively. Plasma levels of homocysteine, high-sensitivity C-reactive protein (hsCRP), soluble vascular cell adhesion molecule (sVCAM)-1, P-selectin, and soluble thrombomodulin (sTM) were assayed. Patients were stratified according to the National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III) criteria for MetS, using the Asian criteria for abdominal obesity. Risk factors for atherosclerosis were studied. RESULTS: Of the 123 SLE patients (93% women; age 47.9+/-11 years; SLE duration 10.9+/-7.0 years) studied, 20 (16.3%) had MetS. The prevalence of MetS in the SLE patients was significantly higher than in 492 age- and sex-matched healthy controls (9.6%; p=0.03). Coronary calcification and abnormal carotid IMT were detected in 38 (31%) and 72 (59%) of SLE patients, respectively. Patients with MetS had a significantly higher Agatston score (69.5+/-95 vs. 16.4+/-57; p=0.03) and a numerically higher carotid IMT (p=0.43) than those without. In a logistic regression model, the MetS [odds ratio (OR) 3.11, 95% confidence interval (CI) 1.01-9.59, p=0.049] was associated with coronary atherosclerosis after adjustment for age and other risk factors. In addition, patients with MetS had significantly higher levels of hsCRP (p=0.002), homocysteine (p=0.03), and sTM (p=0.01). CONCLUSIONS: The MetS is more prevalent in SLE patients than the general population and is associated with endothelial injury and coronary atherosclerosis. More aggressive control of risk factors is justified in these patients. SN - 1502-7732 UR - https://www.unboundmedicine.com/medline/citation/20132070/Metabolic_syndrome_endothelial_injury_and_subclinical_atherosclerosis_in_patients_with_systemic_lupus_erythematosus_ L2 - http://www.tandfonline.com/doi/full/10.3109/03009740903046668 DB - PRIME DP - Unbound Medicine ER -