AB1008 METABOLIC DISORDERS IN CHILDREN WITH SYSTEMIC LUPUS ERYTHEMATOSUS
Authors: I. Chyzheuskaya, A. Vishnevskaya, I. Arher, T. Matsushko
Journal: Annals of the Rheumatic Diseases (2020)

Background: Systemic lupus erythematosus (SLE) is the most common pathology from the group of systemic diseases of the connective tissue. Currently, the problem of deadly complications in patients with SLE is progressively shifting towards vascular catastrophes, such as strokes and heart attacks. If a few years ago, patients mainly died at a young age from renal failure as a complication of lupus nephritis, now thromboses of various localization are in first place. Objectives: The purpose of the study was to determine the state of lipid peroxidation and antioxidant protection, the main indicators of the lipid spectrum and the state of hemostasis in children with SLE. Methods: 25 children with SLE and 20 healthy children were examined in the rheumatology department of the 4th city children’s clinical hospital in Minsk. The lipid spectrum, lipid peroxidation (LPO) and serum ACL, ACW were determined in the Central Research Laboratory of the Belarusian Medical Academy of Postgraduate Education. Results: In children with SLE a significant increase in the content of total cholesterol (5.56±0.36 mmol/l) and a decrease in HDL-cholesterol levels (0.94±0.18 mmol/l) were found in comparison with the control group (3.71±0 69 mmol/L and 1.29±0.33 mmol/l, respectively). A significant (p &lt;0.05) decrease in the concentration of ApoA (85.1 [59.8; 94.9] mg/dl), ApoE (2.1 [1.2; 3, 7] mg/dl) and an increase in ApoB (59.8 [51.9; 67.8] mg/dl) in children with SLE were found compared with the control group (127.2 [122.1; 132.3] mg/dl, 3, 2 [2.3; 5.9] mg/dl and 32.1 [19.9; 50.8] mg/dl, respectively). ApoB / ApoA&gt; 1 was established in 7 (28%) children with SLE. The study found a significant (p &lt;0.05) increase in the level of intermediate (DK233, DK278) and final (MDA) LPO products in the blood serum of children with SLE in comparison with the control group, which indicates the activation of LPO processes in these patients. During the correlation analysis, a positive correlation was established between the levels of DK233, DK278 in blood serum and CRP (r s = 0.87, p &lt;0.001). When studying the main indicators of the blood lipid spectrum in children with SLE, a significant increase in the serum concentration of total lipids (p &lt;0.01) and triglycerides (p &lt;0.001) was revealed when compared with the control group. When determining indicators of coagulation hemostasis, in children with SLE, a predominance of hypercoagulation was detected, accompanied by a significant increase in serum fibrinogen level (5.08 ± 0.14 g/l) and an increase in platelet level (479.57 ± 8.01*10 9 /l) in peripheral blood compared with the control group (3.24 ± 0.07 g / l and 294.23 ± 5.39*10 9 /l, respectively). These indicators correlated with serum CRP concentration (rS = 0.62; p &lt;0.01) and ESR level (r s = 0.73; p &lt;0.01). A relationship was established between elevated serum levels of fibrinogen and disease activity indicators (r s =0.74; p &lt;0.01). Conclusion: The atherogenic orientation of the blood lipid spectrum, characterized by hyperlipidemia, hypertriglyceridemia, hypercholesterolemia and dyslipoproteinemia in the form of a decrease in HDL-cholesterol and an increase in LDL-cholesterol, as well as an increase in ApoB/ApoA ratio&gt; 1 and a decrease in ApoE, the activation of LPO processes and a significant decrease in ACW and ACL in the serum of children with SLE are cardiovascular events risk factors (pulmonary thromboembolism, myocardial infarction and brain). Acknowledgments: This study would not have been possible without the collaboration of numerous Belarusian pediatric rheumatologists, patients and their parents. Disclosure of Interests: None declared