medigraphic.com
Colegio de Medicina Interna de México.

2017, Number 4

<< Back Next >>

Med Int Mex 2017; 33 (4)

Metabolic syndrome and disease activity in patients with systemic lupus erythematosus

Batún-Garrido JAJ, García-Padrón OA, Hernández-Núñez E, Olán F, Salas- Magaña M

Language: Spanish
References: 28
Page: 443-451
PDF size: 206.30 Kb.


ABSTRACT

Objetive: To determine the frequency of metabolic syndrome in a cohort of patients with systemic lupus erythematous and its relationship with disease activity and cardiovascular risks factors.
Material and Method: A descriptive, cross-sectional and observational study including patients diagnosed with systemic lupus erythematous according to the SLICC 2012 criteria, disease activity was evaluated through SLEDAI 2K from June 2015 to June 2016. The presence of metabolic syndrome was established according to the NECP ATP III criteria. Categorical variables were compared with χ2 and the continuous ones with Mann-Withney U or Student t. Finally, a logistic regression multivariate model was used to determine the association of the studied variables and the metabolic syndrome.
Results: One hundred two patients were included; from which 41% of the patients presented with metabolic syndrome (60% of men and 39% of women). The main alterations were hypoalphalipoproteinemia (75.5%), elevated abdominal circumference (63%) and hypertriglyceridemia (60%). It was observed that with a higher number of components of the metabolic syndrome a major disease activity existed. An SLEDAI 2K index ≥4 was associated independently with the presence of metabolic syndrome (RR 2.89; IC 1.21-6.89; p=0.017). Hydroxicloroquine use was associated in an independent manner with the absence of the metabolic syndrome (RR 0.48; IC 0.19-0.39; p=0.14). Statistic significance was found between disease activity and hypoalphalipoproteinemia (p=0.007) and hypertriglyceridemia (p=0.035).
Conclusion: There is a high frequency of metabolic syndrome in patients with systemic lupus erythematous, which is associated with disease activity.


REFERENCES

  1. Chung CP, Avalos I, Oeser A, Gebretsadik T, 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.

  2. Lakka HM, Laaksonen DE, Lakka TA, Niskanen LK, et al. The metabolic syndrome and total and cardiovascular disease mortality in middle-aged men. JAMA 2002;288:2709-16.

  3. Jonkers IJ, Mohrschladt MF, Westendorp RG, van der LA, Smelt AH. Severe hypertriglyceridemia with insulin resistance is associated with systemic inflammation: reversal with bezafibrate therapy in a randomized controlled trial. Am J Med 2002;112:275-80.

  4. Aaksonen DE, Niskanen L, Nyyssönen K, Punnonen K, et al. C-reactive protein and the development of metabolic syndrome and diabetes in middle-aged men. Diabetologia 2004;47:1403-10.

  5. Bengtsson AA, Trygg J, Wuttge DM, Sturfelt G, et al. Metabolic Profiling of systemic lupus erythematosus and comparison with primary Sjögren’s syndrome and systemic sclerosis. Plos One 2016;11:e0159384.

  6. Erdozain JG, Irastorza GR. Síndrome metabólico en pacientes con lupus eritematoso sistémico: causas y consecuencias. Med Clin (Barc) 2015;144:309-11.

  7. Parker B, Ahmad Y, Shelmerdine J, Edlin H, et al. An analysis of the metabolic syndrome phenotype in systemic lupus erythematosus. Lupus 2011;20:1459-65.

  8. Demir S, Artim-Esen B, Şahinkaya Y, Pehlivan Ö, et al. Metabolic syndrome is not only a risk factor for cardiovascular diseases in systemic lupus erythematosus but is also associated with cumulative organ damage: a cross-sectional analysis of 311 patients. Lupus 2016;25:177-84.

  9. Castejon R, Jimenez-Ortiz C, Rosado S, Tutor-Ureta P, et al. Metabolic syndrome is associated with decreased circulating endothelial progenitor cells and increased arterial stiffness in systemic lupus erythematosus. Lupus 2016;25:129-36.

  10. Westerweel PE, Luijten RK, Hoefer IE, et al. Haematopoietic and endothelial progenitor cells are deficient in quiescent systemic lupus erythematosus. Ann Rheum Dis 2007;66:865-70.

  11. Moonen JR, de Leeuw K, van Seijen XJ, et al. Reduced number and impaired function of circulating progenitor cells in patients with systemic lupus erythematosus. Arthritis Res Ther 2007;9:R84.

  12. Chironi G, Walch L, Pernollet MG, Gariepy J, et al. Decreased number of circulating CD34þKDRþ cells in asymptomatic subjects with pre-clinical atherosclerosis. Atherosclerosis 2007;191:115-20.

  13. Petri M, Orbai AM, Alarcón GS, Gordon C, et al. Derivation and validation of the Systemic Lupus International Collaborating Clinics classification criteria for systemic lupus erythematosus. Arthritis Rheum 2012;64:2677-86.

  14. Grundy S, Brewer H, Cleeman J, Smith S, Lenfant C. For the Conference Participants. Definition of metabolic syndrome. Report of the National Heart, Lung, and Blood Institute/ American Heart Association Conference on Scientific Issues Related to Definition. Circulation 2004;109:433-8.

  15. Ibáñez D, Gladman D, Urowitz M. Summarizing disease features over time: II. Variability measures of SLEDAI-2K. J Rheumatol 2007;34:336-40.

  16. Negrón AM, Molina MJ, Mayor AM, Rodriguez VE, Vilá LM. Factors associated with metabolic syndrome in patients with systemic lupus erythematosus from Puerto Rico. Lupus 2008;17:348-54.

  17. Ormseth MJ, Swift LL, Fazio S, Linton MF, et al. Free fatty acids are associated with metabolic syndrome and insulin resistance, but not inflammation in SLE patients. Lupus 2013;22:26-33.

  18. Bellomio V, Spindler A, Lucero E, Berman A, et al. Metabolic syndrome in Argentinean patients with systemic lupus erythematosus. Lupus 2009;18:1019-25.

  19. Telles RW, Lanna CC, Ferreira GA, Ribeiro AL. Metabolic syndrome in patients with systemic lupus erythematosus: association with traditional risk factors for coronary heart disease and lupus characteristics. Lupus 2010;19:803-9.

  20. Chagas MM, Mont I, Oliveira X, Mendes AT. Prevalence of metabolic syndrome in a cohort of systemic lupus erythematosus patients from Northeastern Brazil: association with disease activity, nephritis, smoking, and age. Rheumatol Int 2015. DOI 10.1007/s00296-015-3316-z.

  21. Batún-Garrido JAJ, Radillo-Alba HA, Hernández-Núñez E, Olán F. Dislipidemia y riesgo aterogénico en pacientes con lupus eritematoso sistémico. Med Clin (Barc) 2016;147:61-6.

  22. Escobedo J, Pérez R, Schargrodsky H, Champagne B. Prevalencia de dislipidemias en la ciudad de México y su asociación con otros factores de riesgo cardiovascular. Resultados del estudio CARMELA. Gac Med Me x 2014;150:128-36.

  23. Parker B, Urowitz MB, Gladman DD, Lunt M, et al. Impact of early disease factors on metabolic syndrome in systemic lupus erythematosus: data from an international inception cohort. Ann Rheum Dis 2015;74:1530-36.

  24. Parker B, Urowitz BM, Gladman DD, Lunt M, 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.

  25. García-Villegas EA, Lerman-Garber I, Flores-Suárez LF, Aguilar-Salinas C, et al. Prognostic value of metabolic syndrome for the development of cardiovascular disease in a cohort of premenopausal women with systemic lupus erythematosus. Med Clin (Barc) 2015;144:289-96.

  26. Magro-Checa C, Salvatierra J, Rosales-Alexander JL, RayaÁlvarez E. Riesgo cardiovascular en el lupus eritematoso sistémico: factores implicados y métodos para su valoración. Semin Fund Esp Reumatol 2012;13:95-102.

  27. Gómez R, Conde J, Gómez J, Lago F, Gualillo O. Las adipocinas: mediadores emergentes de la respuesta inmune y de la inflamación. Reumatol Clin 2009;5:6-12.

  28. Beyen A, van der Molen A, Geelen M. Inhibition of hepatic cholesterol biosynthesis by chloroquine. Lipids 1981;16:472-4.




2020     |     www.medigraphic.com