AB0563 Metabolic syndrome predicts new damage in systemic lupus erythematosus patients
Authors: C. Reátegui-Sokolova, R.V. Gamboa-Cárdenas, M. Medina, F. Zevallos, C. Elera-Fitzcarrald, V.R. Pimentel-Quiroz, J.M. Cucho-Venegas, J.L. Alfaro-Lozano, Z.J. Rodriguez-Bellido, C.A. Pastor-Asurza, R.A. Perich-Campos, G.S. Alarcón, M.F. Ugarte Gil
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> The metabolic syndrome (MetS) is a complex of interrelated risk factors for the occurrence of cardiovascular disease and diabetes, and it is now both a public health and a clinical problem(.<sup>1</sup> The MetS has also been reported to be associated with new organ damage, vascular events and mortality in Systemic Lupus Erythematosus (SLE) patients.<sup>2</sup> <h3>Objectives</h3> To determine whether the MetS predicts damage accrual in SLE patients. <h3>Methods</h3> This prospective study was conducted in a cohort of consecutive SLE patients seen since 2012 at one single institution. Patients had a baseline visit and follow-up visits every 6 months. Patients with ≥2 visits were included. Evaluations included interview, medical records review, physical examination and laboratory tests. Damage accrual was ascertained with the SLICC/ACR damage index (SDI) and disease activity with the SLEDAI. The MetS was defined if the patient fulfilled 3 of 5 criteria according to Alberti et al.<sup>1</sup> Survival univariable and multivariable Cox-regression models were carried out to determine the risk of developing new damage. The multivariable model was adjusted for age at diagnosis, disease duration, socioeconomic status, SLEDAI, baseline SDI, the Charlson Comorbidity Index, baseline use of prednisone (PDN), antimalarials and immunosuppressive drugs. <h3>Results</h3> Two hundred and forty-nine patients were evaluated; 232 were females and 17 males. Their mean (SD) age at diagnosis was 35.8 (13.1) years; nearly all patients were mestizo. Disease duration was 7.4 (6.6) years. The SLEDAI was 5.2 (4.3) and the SDI 0.9 (1.3). The average daily dose of PDN was 7.3 (6.4) mg/d and the time of exposure to PDN was 6.9 (6.2) years. One hundred and eight patients (43.4%) had MetS at baseline. During follow-up, 116 (46.6%) patients accrued at least one new point in the SDI damage index. In multivariable analyses, the presence of MetS was a predictor of development of new damage; with a Hazard Ratio (HR) 1.54 (1.05–2.26); p:&lt;0.029. <h3>Conclusions</h3> The presence of MetS predicts the development of new damage in SLE patients, despite of other well-known risk factors for such occurrence. <h3>References</h3> [1] Alberti KGMM, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA, et al. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation [Internet]. 2009Oct 20 [cited 2018 Jan 27];120(16):1640–5. Available from: http://www.ncbi.nlm.nih.gov/pubmed/19805654 [2] Mok CC, Tse SM, Chan KL, Ho LY. Effect of the metabolic syndrome on organ damage and mortality in patients with systemic lupus erythematosus: a longitudinal analysis. Clin Exp Rheumatol [Internet]. 2017Oct 18 [cited 2018 Jan 27]; Available from: http://www.ncbi.nlm.nih.gov/pubmed/29148424 <h3>Disclosure of Interest</h3> None declared