Priscila B S Medeiros1,2, Roberta G Salomão3, Sara R Teixeira4, Diane M Rassi5, Luciana Rodrigues1, Davi C Aragon1, Priscila G Fassini6, Fábio V Ued3, Rita C Tostes5, Jacqueline P Monteiro1,3, Virgínia P L Ferriani1,2, Luciana M de Carvalho7,8,9. 1. Department of Pediatrics, University of São Paulo, Av. Bandeirantes, 3900, Ribeirão Preto, São Paulo, 14049-900, Brazil. 2. Division of Pediatric Rheumatology, University of São Paulo, Ribeirão Preto, São Paulo, Brazil. 3. Division of Nutrition and Metabolism, Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil. 4. Department of Medical Imaging, Oncology and Hematology, University of São Paulo, Ribeirão Preto, São Paulo, Brazil. 5. Department of Pharmacology, University of São Paulo, Ribeirão Preto, São Paulo, Brazil. 6. Department of Internal Medicine, Division of Nutrology, University of São Paulo, Ribeirão Preto, São Paulo, Brazil. 7. Department of Pediatrics, University of São Paulo, Av. Bandeirantes, 3900, Ribeirão Preto, São Paulo, 14049-900, Brazil. lucianamartinscarvalho@usp.br. 8. Division of Pediatric Rheumatology, University of São Paulo, Ribeirão Preto, São Paulo, Brazil. lucianamartinscarvalho@usp.br. 9. Clinical Hospital of Ribeirão Preto Medical School, University of São Paulo, Av. Bandeirantes, 3900, Ribeirão Preto, SP, 14049-900, Brazil. lucianamartinscarvalho@usp.br.
Abstract
BACKGROUND: Systemic lupus erythematosus (SLE) is an independent risk factor for cardiovascular events. The present study determined the prevalence of subclinical atherosclerosis in childhood-onset SLE using the carotid intima-media thickness (CIMT) measurement and investigated associations between traditional and nontraditional risk factors for atherosclerosis, such as medications, SLE Disease Activity Index - SLEDAI-2 K and SLICC-ACR damage index and CIMT. METHODS: Cross-sectional prospective study between 2017 and 2018. CIMT was assessed by ultrasonography. Data were collected by chart review, nutritional evaluation and laboratory tests and analyzed by Fisher, Wilcoxon-Mann-Whitney tests, multiple linear and log binomial regression. RESULTS: Twenty-eight patients (mean age 13.9 years, SD 3) were enrolled. The prevalence of subclinical atherosclerosis was 32% (95% CI 14.8, 49.4). The mean CIMT was 0.43 ± 0.035 mm. The most common traditional risk factors observed were dyslipidemia (82.1%), uncontrolled hypertension (14.2%), obesity (14.3%), and poor diet (78.6%). Uncontrolled hypertension (p = 0.04), proteinuria (p = 0.02), estimated glomerular filtration rate < 75 ml /min/1.73 m2 (p = 0.02) and SLEDAI-2 K > 5 (P = 0.04) were associated with subclinical atherosclerosis. SLEDAI-2 K > 5 maintained association with CIMT after adjusting for control variables. CONCLUSION: Subclinical atherosclerosis is frequently observed in cSLE, mainly in patients with moderate to severe disease activity.
BACKGROUND:Systemic lupus erythematosus (SLE) is an independent risk factor for cardiovascular events. The present study determined the prevalence of subclinical atherosclerosis in childhood-onset SLE using the carotid intima-media thickness (CIMT) measurement and investigated associations between traditional and nontraditional risk factors for atherosclerosis, such as medications, SLE Disease Activity Index - SLEDAI-2 K and SLICC-ACR damage index and CIMT. METHODS: Cross-sectional prospective study between 2017 and 2018. CIMT was assessed by ultrasonography. Data were collected by chart review, nutritional evaluation and laboratory tests and analyzed by Fisher, Wilcoxon-Mann-Whitney tests, multiple linear and log binomial regression. RESULTS: Twenty-eight patients (mean age 13.9 years, SD 3) were enrolled. The prevalence of subclinical atherosclerosis was 32% (95% CI 14.8, 49.4). The mean CIMT was 0.43 ± 0.035 mm. The most common traditional risk factors observed were dyslipidemia (82.1%), uncontrolled hypertension (14.2%), obesity (14.3%), and poor diet (78.6%). Uncontrolled hypertension (p = 0.04), proteinuria (p = 0.02), estimated glomerular filtration rate < 75 ml /min/1.73 m2 (p = 0.02) and SLEDAI-2 K > 5 (P = 0.04) were associated with subclinical atherosclerosis. SLEDAI-2 K > 5 maintained association with CIMT after adjusting for control variables. CONCLUSION: Subclinical atherosclerosis is frequently observed in cSLE, mainly in patients with moderate to severe disease activity.
Authors: Laura E Schanberg; Christy Sandborg; Huiman X Barnhart; Stacy P Ardoin; Eric Yow; Gregory W Evans; Kelly L Mieszkalski; Norman T Ilowite; Anne Eberhard; Deborah M Levy; Yukiko Kimura; Emily von Scheven; Earl Silverman; Suzanne L Bowyer; Lynn Punaro; Nora G Singer; David D Sherry; Deborah McCurdy; Marissa Klein-Gitelman; Carol Wallace; Richard Silver; Linda Wagner-Weiner; Gloria C Higgins; Hermine I Brunner; Lawrence Jung; Jennifer B Soep; Ann Reed Journal: Arthritis Rheum Date: 2009-05
Authors: Elaine M Urbina; Richard V Williams; Bruce S Alpert; Ronnie T Collins; Stephen R Daniels; Laura Hayman; Marc Jacobson; Larry Mahoney; Michele Mietus-Snyder; Albert Rocchini; Julia Steinberger; Brian McCrindle Journal: Hypertension Date: 2009-09-03 Impact factor: 10.190