4.7 Article

Clinical associations of the metabolic syndrome in systemic lupus erythematosus: data from an international inception cohort

期刊

ANNALS OF THE RHEUMATIC DISEASES
卷 72, 期 8, 页码 1308-1314

出版社

BMJ PUBLISHING GROUP
DOI: 10.1136/annrheumdis-2012-202106

关键词

Systemic Lupus Erythematosus; Cardiovascular Disease; Inflammation; Epidemiology

资金

  1. Canadian Institutes of Health Research [93695]
  2. Arthritis Research UK (Arthritis Research UK Epidemiology Unit core support programme grant)
  3. National Institute for Health Research Biomedical Research Unit funding scheme
  4. NIHR Manchester Biomedical Research Centre
  5. NIH [UL1 RR025741, P60AR 30692, K24 AR 002138]
  6. Arthritis Research clinical research fellowship
  7. Hopkins Lupus Cohort NIH [RD-1 43727]
  8. Department of Education, Universities and Research, Basque Government
  9. Singer Family Fund for Lupus Research
  10. National Institute for Health Research [NF-SI-0512-10105] Funding Source: researchfish
  11. Versus Arthritis [18845] Funding Source: researchfish

向作者/读者索取更多资源

Background The metabolic syndrome (MetS) may contribute to increased cardiovascular risk in systemic lupus erythematosus (SLE). We aimed to examine the association of demographic factors, lupus phenotype and therapy exposure with the presence of MetS. Methods The Systemic Lupus International Collaborating Clinics Registry for Atherosclerosis inception cohort enrolled recently diagnosed (<15months) SLE patients from 30 centres across 11 countries from 2000. Clinical, laboratory and therapeutic data were collected according to a standardised protocol. MetS was defined according to the 2009 consensus statement from the International Diabetes Federation. Univariate and backward stepwise multivariate logistic regression were used to assess the relationship of individual variables with MetS. Results We studied 1686 patients, of whom 1494 (86.6%) had sufficient data to determine their MetS status. The mean (SD) age at enrolment and disease duration was 35.2years (13.4) and 24.1weeks (18.0), respectively. MetS was present at the enrolment visit in 239 (16%). In backward stepwise multivariable regression analysis, higher daily average prednisolone dose (mg) (OR 1.02, 95% CI 1.00 to 1.03), older age (years) (OR 1.04, 95% CI 1.03 to 1.06), Korean (OR 6.33, 95% CI 3.68 to 10.86) and Hispanic (OR 6.2, 95% CI 3.78 to 10.12) ethnicity, current renal disease (OR 1.79, 95% CI 1.14 to 2.80) and immunosuppressant use (OR 1.81, 95% CI 1.18 to 2.78) were associated with MetS. Conclusions Renal lupus, higher corticosteroid doses, Korean and Hispanic ethnicity are associated with MetS in SLE patients. Balancing disease control and minimising corticosteroid exposure should therefore be at the forefront of personalised treatment decisions in SLE patients.

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