AB0725 The metabolic syndrome in women with systemic lupus erythematosus: Association with disease characteristics and atherosclerosis:
Authors: T.A. Panafidina, T.V. Popkova, D.S. Novikova, E.N. Alexandrova, E.V. Gerasimova, Z.S. Alekberova, E.L. Nasonov
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Patients with Systemic lupus erythematosus (SLE) have an increased risk for cardiovascular disease (CVD) and develop early atherosclerosis. A possible explanation could be the metabolic syndrome likely associated with a combination of factors, including traditional risk factors, disease and its therapy related factors, proinflammatory mediators (C-reactive protein (CRP), interleukin-6 (IL-6), interleukin-18 (IL-18), soluble receptor type 1 of tumor necrosis factor-α (sTNF-R1). <h3>Objectives</h3> To evaluate metabolic syndrome (MetS) prevalence and it's association with subclinical atherosclerosis, inflammatory mediators of atherosclerosis (CRP, IL-6, IL-18, sTNF-R1) and SLE-related factors in patients with SLE. <h3>Methods</h3> We observed 154 women (mean age 35 (27-43) years), fulfilling ≥4 ACR criteria for SLE, and 69 controls (women without any rheumatic and infectious diseases, matched for age 36 (30-48) years). We considered the CVD, traditional cardiovascular risk factors and SLE-related factors (age at onset, duration of SLE, clinical features, SLE Disease Activity Index (SLEDAI-2K) and the Systemic Lupus International Collaborating Clinics damage index (SLICC), treatment with steroids). The MetS was assessed using NCEP ATP III definitions.Carotid intima-media wall thickness (IMT) was measured by high resolution B-mode ultrasound. A plaque was defined as a local intimal-medial thickening with a thickness ≥1,2 mm, normal IMT&lt;0,9 mm. The levels of CRP, IL-6, IL-18 and sTNF-R1 were determined in serum samples by the highly sensitive particle-enhanced immunonephelometric assay. <h3>Results</h3> The mean disease duration of SLE patients was 99 (43-204) months, SLEDAI-2K score - 8 (4,0-16), SLICC/ACR damage index score - 2 (0-3), duration of steroid treatment - 72 (26-141) months, cumulative steroid doses - 22 (9-63) g. The SLE patients had significantly higher prevalence of MetS (19% vs 7% in controls, d=0,02), hypertension (51% vs 20%, p&lt;0,00001), higher concentration of TG level (1,4 (0,9-2,0) vs 0,5(0,3-0,8) mmol/l, p&lt;0,05). The frequency of CVD was 14% in patients and 2% in controls p&lt;0,01, the carotid plaque had observed in 15% patients and 4% controls p&lt;0,05. The CRP level was higher in women with SLE than in control: 2,2 (0,9-4,5) vs 0,6 (0,2-2,0) mg/l respectively (p&lt;0,05). We divided SLE patients on two groups: with MetS and without MetS. SLE women with MetS was older, they had a higher SLEDAI-2K and SLICC score, higher prevalence of subclinical atherosclerosis, concentration of CRP, IL-6, IL-18, sTNF-R1 (* p&lt;0,05 in all cases) (Table 1). <h3>Conclusions</h3> The prevalence of metabolic syndrome was higher in women with SLE than control. MetS was associated with subclinical atherosclerosis, SLE activity, damage index and inflammatory mediators of atherosclerosis (CRP, IL-6, IL-18, sTNF-R1) in SLE women. <h3>Disclosure of Interest</h3> None Declared