OBJECTIVE: To evaluate risk factors for subclinical atherosclerosis in a population of patients with pediatric systemic lupus erythematosus (SLE). METHODS: In a prospective multicenter study, a cohort of 221 patients underwent baseline measurements of carotid intima-media thickness (CIMT) as part of the Atherosclerosis Prevention in Pediatric Lupus Erythematosus (APPLE) trial. SLE disease measures, medications, and traditional risk factors for atherosclerosis were assessed. A standardized protocol was used to assess the thickness of the bilateral common carotid arteries and the mean maximal IMT of 12 segments. Univariable analysis identified potential associations with CIMT, which were examined in multivariable linear regression modeling. RESULTS: Based on the mean-mean common or the mean-max CIMT as the dependent variable, univariable analysis showed significant associations of the following variables with increased CIMT: increasing age, longer SLE duration, minority status, higher body mass index (BMI), male sex, increased creatinine clearance, higher lipoprotein(a) level, proteinuria, azathioprine treatment, and prednisone dose. In multivariable modeling, both azathioprine use (P=0.005 for the mean-mean model and P=0.102 for the mean-max model) and male sex (P<0.001) were associated with increases in the mean-max CIMT. A moderate dosage of prednisone (0.15-0.4 mg/kg/day) was associated with decreases in the mean-max CIMT (P=0.024), while high-dose and low-dose prednisone were associated with increases in the mean-mean common CIMT (P=0.021) and the mean-max CIMT (P=0.064), respectively. BMI (P<0.001) and creatinine clearance (P=0.031) remained associated with increased mean-mean common CIMT, while increasing age (P<0.001) and increasing lipoprotein(a) level (P=0.005) were associated with increased mean-max CIMT. CONCLUSION: Traditional as well as nontraditional risk factors were associated with increased CIMT in this cohort of patients in the APPLE trial. Azathioprine treatment was associated with increased CIMT. The relationship between CIMT and prednisone dose may not be linear.
OBJECTIVE: To evaluate risk factors for subclinical atherosclerosis in a population of patients with pediatric systemic lupus erythematosus (SLE). METHODS: In a prospective multicenter study, a cohort of 221 patients underwent baseline measurements of carotid intima-media thickness (CIMT) as part of the Atherosclerosis Prevention in Pediatric Lupus Erythematosus (APPLE) trial. SLE disease measures, medications, and traditional risk factors for atherosclerosis were assessed. A standardized protocol was used to assess the thickness of the bilateral common carotid arteries and the mean maximal IMT of 12 segments. Univariable analysis identified potential associations with CIMT, which were examined in multivariable linear regression modeling. RESULTS: Based on the mean-mean common or the mean-max CIMT as the dependent variable, univariable analysis showed significant associations of the following variables with increased CIMT: increasing age, longer SLE duration, minority status, higher body mass index (BMI), male sex, increased creatinine clearance, higher lipoprotein(a) level, proteinuria, azathioprine treatment, and prednisone dose. In multivariable modeling, both azathioprine use (P=0.005 for the mean-mean model and P=0.102 for the mean-max model) and male sex (P<0.001) were associated with increases in the mean-max CIMT. A moderate dosage of prednisone (0.15-0.4 mg/kg/day) was associated with decreases in the mean-max CIMT (P=0.024), while high-dose and low-dose prednisone were associated with increases in the mean-mean common CIMT (P=0.021) and the mean-max CIMT (P=0.064), respectively. BMI (P<0.001) and creatinine clearance (P=0.031) remained associated with increased mean-mean common CIMT, while increasing age (P<0.001) and increasing lipoprotein(a) level (P=0.005) were associated with increased mean-max CIMT. CONCLUSION: Traditional as well as nontraditional risk factors were associated with increased CIMT in this cohort of patients in the APPLE trial. Azathioprine treatment was associated with increased CIMT. The relationship between CIMT and prednisone dose may not be linear.
Authors: S Manzi; E N Meilahn; J E Rairie; C G Conte; T A Medsger; L Jansen-McWilliams; R B D'Agostino; L H Kuller Journal: Am J Epidemiol Date: 1997-03-01 Impact factor: 4.897
Authors: Sergio M A Toloza; América G Uribe; Gerald McGwin; Graciela S Alarcón; Barri J Fessler; Holly M Bastian; Luis M Vilá; Ruihua Wu; Yehuda Shoenfeld; Jeffrey M Roseman; John D Reveille Journal: Arthritis Rheum Date: 2004-12
Authors: Mieczyslaw Litwin; Elke Wühl; Claudia Jourdan; Justyna Trelewicz; Anna Niemirska; Kathrin Fahr; Katarzyna Jobs; Ryszard Grenda; Zbigniew T Wawer; Pawel Rajszys; Jörgen Tröger; Otto Mehls; Franz Schaefer Journal: J Am Soc Nephrol Date: 2005-03-16 Impact factor: 10.121
Authors: Allen Taylor; Leslee J Shaw; Zahi Fayad; Dan O'Leary; B Greg Brown; Steven Nissen; Daniel Rader; Paolo Raggi Journal: Atherosclerosis Date: 2005-05 Impact factor: 5.162
Authors: E H Stet; R A De Abreu; J P Bökkerink; H J Blom; L H Lambooy; T M Vogels-Mentink; A C de Graaf-Hess; B van Raay-Selten; F J Trijbels Journal: Biochem J Date: 1994-11-15 Impact factor: 3.857
Authors: Stacy P Ardoin; Laura Eve Schanberg; Christy I Sandborg; Huiman X Barnhart; Greg W Evans; Eric Yow; Kelly L Mieszkalski; Norman T Ilowite; Anne Eberhard; Lisa F Imundo; Yuki Kimura; Deborah Levy; Emily von Scheven; Earl Silverman; Suzanne L Bowyer; L Punaro; Nora G Singer; David D Sherry; Deborah K McCurdy; Marissa Klein-Gitelman; Carol Wallace; Richard M Silver; Linda Wagner-Weiner; Gloria C Higgins; Hermine I Brunner; Lawrence Jung; Jennifer B Soep; Ann M Reed; Susan D Thompson Journal: Ann Rheum Dis Date: 2013-02-22 Impact factor: 19.103