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Vorobyev A, Ludwig RJ. Forschung für die Praxis: Ernährung und Mikrobiom bei Autoimmunkrankheiten. J Dtsch Dermatol Ges 2023; 21:958-963. [PMID: 37700405 DOI: 10.1111/ddg.15101_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 03/17/2023] [Indexed: 09/14/2023]
Abstract
ZusammenfassungDie Häufigkeit von Autoimmunerkrankungen in Industrieländern hat während der letzten Jahrzehnte ständig zugenommen. Diese Erkrankungen führen zu erhöhter Sterblichkeit sowie anhaltender Beeinträchtigung der Lebensqualität der Patienten und bedeuten eine große medizinische Belastung. Die Behandlung von Autoimmunkrankheiten beruht häufig auf unspezifischer Immunsuppression, was das Risiko von Infektionskrankheiten und Krebsmanifestationen erhöht. Die Pathogenese von Autoimmunerkrankungen ist komplex und umfasst nicht nur genetische Faktoren, sondern auch Umwelteinflüsse, die als Grund für die Zunahme von Autoimmunerkrankungen angesehen werden. Zahlreiche Umweltfaktoren wie Infektionen, Rauchen, Medikamente oder Ernährung können das Auftreten von Autoimmunität entweder fördern oder verhindern. Die Mechanismen der Beeinflussung durch Umwelteinflüsse sind jedoch komplex und derzeit noch nicht eindeutig geklärt. Die Entschlüsselung dieser Wechselwirkungen könnte unser Verständnis der Autoimmunität verbessern und neue Behandlungsmöglichkeiten für die Patienten eröffnen.
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Affiliation(s)
- Artem Vorobyev
- Abteilung für Dermatologie, Allergologie und Venerologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
- Lübecker Institut für experimentelle Dermatologie, Lübeck
| | - Ralf J Ludwig
- Abteilung für Dermatologie, Allergologie und Venerologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
- Lübecker Institut für experimentelle Dermatologie, Lübeck
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Vorobyev A, Ludwig RJ. Research in practice: Diet and microbiome in autoimmune diseases. J Dtsch Dermatol Ges 2023; 21:958-962. [PMID: 37235511 DOI: 10.1111/ddg.15101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 03/06/2023] [Accepted: 03/17/2023] [Indexed: 05/28/2023]
Abstract
The incidence of autoimmune diseases in industrialized countries is constantly increasing over past decades. These diseases lead to increased mortality and persistent reduction in quality of life of the patients, posing a severe medical burden. Treatment of autoimmune diseases is often based on unspecific immune suppression, increasing the risk of infectious diseases as well as cancer manifestation. Pathogenesis of autoimmune conditions is complex and includes not only genetic factors, but also environmental influence, which is considered to be the reason for the rise of incidence of autoimmune diseases. Environmental factors comprise numerous elements, such as infections, smoking, medication, diet etc., which can either promote or prevent the onset of autoimmunity. However, the mechanisms of environmental influence are complex and for this moment not clearly understood. Deciphering of these interactions could enhance our comprehension of autoimmunity and provide some novel treatment options for the patients.
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Affiliation(s)
- Artem Vorobyev
- Department of Dermatology, Allergology and Venereology, University Hospital Schleswig-Holstein, Campus Lübeck, Germany
- Lübeck Institute of Experimental Dermatology, Lübeck, Germany
| | - Ralf J Ludwig
- Department of Dermatology, Allergology and Venereology, University Hospital Schleswig-Holstein, Campus Lübeck, Germany
- Lübeck Institute of Experimental Dermatology, Lübeck, Germany
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Akhil A, Bansal R, Anupam K, Tandon A, Bhatnagar A. Systemic lupus erythematosus: latest insight into etiopathogenesis. Rheumatol Int 2023:10.1007/s00296-023-05346-x. [PMID: 37226016 DOI: 10.1007/s00296-023-05346-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 05/15/2023] [Indexed: 05/26/2023]
Abstract
Systemic lupus erythematosus (SLE) is a complex autoimmune disorder of unknown etiology. Multifactorial interaction among various susceptible factors such as environmental, hormonal, and genetic factors makes it more heterogeneous and complex. Genetic and epigenetic modifications have been realized to regulate the immunobiology of lupus through environmental modifications such as diet and nutrition. Although these interactions may vary from population to population, the understanding of these risk factors can enhance the perception of the mechanistic basis of lupus etiology. To recognize the recent advances in lupus, an electronic search was conducted among search engines such as Google Scholar and PubMed, where we found about 30.4% publications of total studies related to genetics and epigenetics, 33.5% publications related to immunobiology and 34% related to environmental factors. These outcomes suggested that management of diet and lifestyle have a direct relationship with the severity of lupus that influence via modulating the complex interaction among genetics and immunobiology. The present review emphasizes the knowledge about the multifactorial interactions between various susceptible factors based on recent advances that will further update the understanding of mechanisms involved in disease pathoetiology. Knowledge of these mechanisms will further assist in the creation of novel diagnostic and therapeutic options.
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Affiliation(s)
- Akhil Akhil
- Department of Biochemistry, BMS-Block II, South Campus, Panjab University, Chandigarh, 160014, India
| | - Rohit Bansal
- Department of Biochemistry, BMS-Block II, South Campus, Panjab University, Chandigarh, 160014, India
| | - Kumari Anupam
- Department of Pathology, Saint Louis University, St. Louis, MO, 63103, USA
| | - Ankit Tandon
- Department of Endocrinology, PGIMER, Chandigarh, 160012, India
| | - Archana Bhatnagar
- Department of Biochemistry, BMS-Block II, South Campus, Panjab University, Chandigarh, 160014, India.
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Nutritional Approaches to Modulate Cardiovascular Disease Risk in Systemic Lupus Erythematosus: A Literature Review. Nutrients 2023; 15:nu15041036. [PMID: 36839394 PMCID: PMC9958972 DOI: 10.3390/nu15041036] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 02/15/2023] [Accepted: 02/17/2023] [Indexed: 02/22/2023] Open
Abstract
Systemic lupus erythematosus (SLE) is a chronic pathology characterized by a bimodal mortality pattern attributed to clinical disease activity and cardiovascular disease (CVD). A complex interaction between traditional CVD risk factors such as obesity, dyslipidemia, smoking, insulin resistance, metabolic syndrome, and hypertension, as well as the presence of non-traditional CVD risk factors such as hyperhomocysteinemia, pro-inflammatory cytokines, and C-reactive protein levels, has been suggested as a cause of the high prevalence of CVD in SLE patients. On the other hand, environmental factors, such as nutritional status, could influence the disease's prognosis; several nutrients have immunomodulators, antioxidants, and anti-cardiometabolic risk properties which could reduce SLE severity and organ damage by decreasing the development of traditional and non-traditional CVD risk factors. Therefore, this critical literature review discusses the therapeutic potential of nutritional approaches that could modulate the development of the main comorbidities related to CVD risk in SLE patients.
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Pesqueda-Cendejas K, Parra-Rojas I, Mora-García PE, Montoya-Buelna M, Ruiz-Ballesteros AI, Meza-Meza MR, Campos-López B, Rivera-Escoto M, Vizmanos-Lamotte B, Cerpa-Cruz S, de la Cruz-Mosso U. CRP Serum Levels Are Associated with High Cardiometabolic Risk and Clinical Disease Activity in Systemic Lupus Erythematosus Patients. J Clin Med 2022; 11:jcm11071849. [PMID: 35407457 PMCID: PMC8999239 DOI: 10.3390/jcm11071849] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 03/05/2022] [Accepted: 03/24/2022] [Indexed: 02/06/2023] Open
Abstract
Systemic lupus erythematosus (SLE) patients have a higher frequency of cardiovascular risk factors such as high C-reactive protein (CRP) levels than the general population. CRP is considered a cardiovascular disease marker that could be related to SLE clinical disease activity. This study aimed to assess the association between CRP with cardiometabolic risk and clinical disease activity in SLE patients. A comparative cross-sectional study was conducted in 176 female SLE patients and 175 control subjects (CS) with median ages of 38 and 33 years, respectively; SLE patients were classified by the 1997 SLE-ACR criteria, and the clinical disease activity by the Mexican-SLEDAI (Mex-SLEDAI). CRP and lipid profile (triglycerides, cholesterol, HDL-C, and LDL-C) were quantified by turbidimetry and colorimetric-enzymatic assays, respectively. SLE patients had higher CRP levels than CS (SLE: 5 mg/L vs. CS = 1.1 mg/L; p < 0.001). In SLE patients, CRP levels ≥ 3 mg/L were associated with a higher risk of cardiometabolic risk status assessed by LAP index (OR = 3.01; IC: 1.04−8.7; p = 0.04), triglycerides/HDL-C index (OR = 5.2; IC: 2.1−12.8; p < 0.001), Kannel index (OR = 3.1; IC: 1.1−8.1; p = 0.03), Castelli index (OR = 6.6; IC: 2.5−17.8; p < 0.001), and high clinical disease activity (OR = 2.5: IC: 1.03−6.2; p = 0.04; and β coefficient = 5.8; IC: 2.5−9.4; R2 = 0.15; p = 0.001). In conclusion, high CRP levels were associated with high cardiometabolic risk and clinical disease activity in SLE patients.
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Affiliation(s)
- Karen Pesqueda-Cendejas
- Proyecto Inmunonutrición y Genómica Nutricional en las Enfermedades Autoinmunes, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico; (K.P.-C.); (I.P.-R.); (P.E.M.-G.); (M.M.-B.); (A.I.R.-B.); (M.R.M.-M.); (B.C.-L.); (M.R.-E.); (B.V.-L.)
- Instituto de Nutrigenética y Nutrigenómica Traslacional, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico
| | - Isela Parra-Rojas
- Proyecto Inmunonutrición y Genómica Nutricional en las Enfermedades Autoinmunes, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico; (K.P.-C.); (I.P.-R.); (P.E.M.-G.); (M.M.-B.); (A.I.R.-B.); (M.R.M.-M.); (B.C.-L.); (M.R.-E.); (B.V.-L.)
- Laboratorio de Investigación en Obesidad y Diabetes, Facultad de Ciencias Químico-Biológicas, Universidad Autónoma de Guerrero, Chilpancingo de los Bravo 39087, Mexico
| | - Paulina E. Mora-García
- Proyecto Inmunonutrición y Genómica Nutricional en las Enfermedades Autoinmunes, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico; (K.P.-C.); (I.P.-R.); (P.E.M.-G.); (M.M.-B.); (A.I.R.-B.); (M.R.M.-M.); (B.C.-L.); (M.R.-E.); (B.V.-L.)
- Instituto de Nutrigenética y Nutrigenómica Traslacional, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico
| | - Margarita Montoya-Buelna
- Proyecto Inmunonutrición y Genómica Nutricional en las Enfermedades Autoinmunes, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico; (K.P.-C.); (I.P.-R.); (P.E.M.-G.); (M.M.-B.); (A.I.R.-B.); (M.R.M.-M.); (B.C.-L.); (M.R.-E.); (B.V.-L.)
- Laboratorio de Inmunología, Departamento de Fisiología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico
| | - Adolfo I. Ruiz-Ballesteros
- Proyecto Inmunonutrición y Genómica Nutricional en las Enfermedades Autoinmunes, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico; (K.P.-C.); (I.P.-R.); (P.E.M.-G.); (M.M.-B.); (A.I.R.-B.); (M.R.M.-M.); (B.C.-L.); (M.R.-E.); (B.V.-L.)
- Instituto de Nutrigenética y Nutrigenómica Traslacional, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico
| | - Mónica R. Meza-Meza
- Proyecto Inmunonutrición y Genómica Nutricional en las Enfermedades Autoinmunes, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico; (K.P.-C.); (I.P.-R.); (P.E.M.-G.); (M.M.-B.); (A.I.R.-B.); (M.R.M.-M.); (B.C.-L.); (M.R.-E.); (B.V.-L.)
- Instituto de Nutrigenética y Nutrigenómica Traslacional, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico
| | - Bertha Campos-López
- Proyecto Inmunonutrición y Genómica Nutricional en las Enfermedades Autoinmunes, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico; (K.P.-C.); (I.P.-R.); (P.E.M.-G.); (M.M.-B.); (A.I.R.-B.); (M.R.M.-M.); (B.C.-L.); (M.R.-E.); (B.V.-L.)
- Instituto de Nutrigenética y Nutrigenómica Traslacional, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico
| | - Melissa Rivera-Escoto
- Proyecto Inmunonutrición y Genómica Nutricional en las Enfermedades Autoinmunes, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico; (K.P.-C.); (I.P.-R.); (P.E.M.-G.); (M.M.-B.); (A.I.R.-B.); (M.R.M.-M.); (B.C.-L.); (M.R.-E.); (B.V.-L.)
- Instituto de Nutrigenética y Nutrigenómica Traslacional, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico
| | - Barbara Vizmanos-Lamotte
- Proyecto Inmunonutrición y Genómica Nutricional en las Enfermedades Autoinmunes, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico; (K.P.-C.); (I.P.-R.); (P.E.M.-G.); (M.M.-B.); (A.I.R.-B.); (M.R.M.-M.); (B.C.-L.); (M.R.-E.); (B.V.-L.)
- Instituto de Nutrigenética y Nutrigenómica Traslacional, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico
| | - Sergio Cerpa-Cruz
- Departamento de Reumatología, O.P.D. Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara 44280, Mexico;
| | - Ulises de la Cruz-Mosso
- Proyecto Inmunonutrición y Genómica Nutricional en las Enfermedades Autoinmunes, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico; (K.P.-C.); (I.P.-R.); (P.E.M.-G.); (M.M.-B.); (A.I.R.-B.); (M.R.M.-M.); (B.C.-L.); (M.R.-E.); (B.V.-L.)
- Instituto de Nutrigenética y Nutrigenómica Traslacional, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico
- Correspondence: or ; Tel.: +52-1-331-744-15-75
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Goessler KF, Gualano B, Nonino CB, Bonfá E, Nicoletti CF. Lifestyle Interventions and Weight Management in Systemic Lupus Erythematosus Patients: A Systematic Literature Review and Metanalysis. J Lifestyle Med 2022; 12:37-46. [PMID: 35300036 PMCID: PMC8918379 DOI: 10.15280/jlm.2022.12.1.37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 01/05/2022] [Indexed: 11/22/2022] Open
Abstract
Background We aimed to identify and describe different types of lifestyle interventions primarily or secondarily focused on weight loss in SLE patients. Methods A systematic search of controlled trials published until June 2021 that assigned adults patients after dietary or exercise intervention resulted in 248 studies initially screened. Results Six studies with seven interventions (3 dietary and 4 exercise training programs) fulfilled the eligibility criteria and were included in the meta-analysis with a median of age 35.8 (31.3 to 49.0 years); median of BMI 26.6 (25.2 to 33.6 kg/m2). After six to twelve weeks of diet or exercise program, no differences were observed in body weight [-1.539 (-4.482 to 1.405) kg (CI 95%), p = 0.306]. Also, a subgroup analysis also revelated no body weight difference following dietary intervention [-3.561 (-9.604 to 2.481) kg (CI 95%), p = 0.248] or exercise intervention [-0.910 (-4.279 to 2.460) kg (CI 95%), p = 0.597]. Conclusion The results showed that different protocols of exercise intervention or diets were not effective to reduce body weight in patients with SLE. However, only one of the selected trials had a specific study design and protocol focusing on weight loss management.
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Affiliation(s)
- Karla F. Goessler
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, Faculdade de Medicina FMUSP, Sao Paulo, Brazil
| | - Bruno Gualano
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, Faculdade de Medicina FMUSP, Sao Paulo, Brazil
- Rheumatology Division, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Sao Paulo, Brazil
| | - Carla B. Nonino
- Department of Health Science, Ribeirão Preto School of Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | - Eloisa Bonfá
- Rheumatology Division, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Sao Paulo, Brazil
| | - Carolina Ferreira Nicoletti
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, Faculdade de Medicina FMUSP, Sao Paulo, Brazil
- Rheumatology Division, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Sao Paulo, Brazil
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Campos-López B, Meza-Meza MR, Parra-Rojas I, Ruiz-Ballesteros AI, Vizmanos-Lamotte B, Muñoz-Valle JF, Montoya-Buelna M, Cerpa-Cruz S, Bernal-Hernández LE, De la Cruz-Mosso U. Association of cardiometabolic risk status with clinical activity and damage in systemic lupus erythematosus patients: A cross-sectional study. Clin Immunol 2020; 222:108637. [PMID: 33232825 DOI: 10.1016/j.clim.2020.108637] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 11/17/2020] [Accepted: 11/19/2020] [Indexed: 11/29/2022]
Abstract
Cardiometabolic status is a key factor in mortality by cardiovascular disease (CVD) in systemic lupus erythematosus (SLE). This study evaluated the association of cardiometabolic risk status with clinical activity and damage in SLE patients. A cross-sectional study was conducted in 158 SLE patients and 123 healthy subjects (HS). Anthropometry, glucose, hs-CRP, lipid profile, oxLDL, sCD36, anti-oxLDL antibodies, and cardiometabolic indexes were evaluated. SLE patients had dyslipidemia, higher sCD36, anti-oxLDL antibodies, hs-CRP, and risk (OR > 2) to present Castelli score ≥ 4.5, HDL-C < 40 mg/dL and LDL-C ≥ 100 mg/dL. Disease evolution time was correlated with glucose and BMI, damage with TG, and clinical activity with TG, TG/HDL-C ratio, and Kannel index. Active SLE patients had risk (OR > 2) to present a Castelli score ≥ 4.5, Kannel score ≥ 3, TG/HDL-C ratio ≥ 3 and HDL-C < 40 mg/dL. In conclusion, SLE patients have high cardiometabolic risk to CVD related to disease evolution time, and clinical activity.
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Affiliation(s)
- Bertha Campos-López
- Grupo de Inmunonutrición y Genómica Nutricional en las Enfermedades Autoinmunes, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara Jalisco 44340, Mexico; Instituto de Investigación en Ciencias Biomédicas, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara Jalisco 44340, Mexico
| | - Mónica R Meza-Meza
- Grupo de Inmunonutrición y Genómica Nutricional en las Enfermedades Autoinmunes, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara Jalisco 44340, Mexico; Instituto de Investigación en Ciencias Biomédicas, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara Jalisco 44340, Mexico; Programa de Doctorado en Ciencias Biomédicas Inmunología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara Jalisco 44340, Mexico
| | - Isela Parra-Rojas
- Laboratorio de Investigación en Obesidad y Diabetes, Facultad de Ciencias Químico-Biológicas, Universidad Autónoma de Guerrero, Chilpancingo, de los Bravo, Guerrero 39087, Mexico
| | - Adolfo I Ruiz-Ballesteros
- Grupo de Inmunonutrición y Genómica Nutricional en las Enfermedades Autoinmunes, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara Jalisco 44340, Mexico; Instituto de Investigación en Ciencias Biomédicas, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara Jalisco 44340, Mexico; Programa de Doctorado en Ciencias de la Nutrición Traslacional, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara Jalisco 44340, Mexico
| | - Barbara Vizmanos-Lamotte
- Instituto de Nutrigenética y Nutrigenómica Traslacional, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara Jalisco 44340, Mexico
| | - José Francisco Muñoz-Valle
- Instituto de Investigación en Ciencias Biomédicas, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara Jalisco 44340, Mexico
| | - Margarita Montoya-Buelna
- Laboratorio de Inmunología, Departamento de Fisiología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara Jalisco 44340, Mexico
| | - Sergio Cerpa-Cruz
- Departamento de Reumatología, O.P.D. Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara, Jalisco 44280, Mexico
| | - Luis E Bernal-Hernández
- Grupo de Inmunonutrición y Genómica Nutricional en las Enfermedades Autoinmunes, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara Jalisco 44340, Mexico; Instituto de Investigación en Ciencias Biomédicas, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara Jalisco 44340, Mexico
| | - Ulises De la Cruz-Mosso
- Grupo de Inmunonutrición y Genómica Nutricional en las Enfermedades Autoinmunes, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara Jalisco 44340, Mexico; Instituto de Investigación en Ciencias Biomédicas, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara Jalisco 44340, Mexico; Programa de Doctorado en Ciencias Biomédicas Inmunología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara Jalisco 44340, Mexico; Programa de Doctorado en Ciencias de la Nutrición Traslacional, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara Jalisco 44340, Mexico.
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Islam MA, Khandker SS, Kotyla PJ, Hassan R. Immunomodulatory Effects of Diet and Nutrients in Systemic Lupus Erythematosus (SLE): A Systematic Review. Front Immunol 2020; 11:1477. [PMID: 32793202 PMCID: PMC7387408 DOI: 10.3389/fimmu.2020.01477] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 06/05/2020] [Indexed: 12/16/2022] Open
Abstract
Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by multiple organ involvement, including the skin, joints, kidneys, lungs, central nervous system and the haematopoietic system, with a large number of complications. Despite years of study, the etiology of SLE remains unclear; thus, safe and specifically targeted therapies are lacking. In the last 20 years, researchers have explored the potential of nutritional factors on SLE and have suggested complementary treatment options through diet. This study systematically reviews and evaluates the clinical and preclinical scientific evidence of diet and dietary supplementation that either alleviate or exacerbate the symptoms of SLE. For this review, a systematic literature search was conducted using PubMed, Scopus and Google Scholar databases only for articles written in the English language. Based on the currently published literature, it was observed that a low-calorie and low-protein diet with high contents of fiber, polyunsaturated fatty acids, vitamins, minerals and polyphenols contain sufficient potential macronutrients and micronutrients to regulate the activity of the overall disease by modulating the inflammation and immune functions of SLE.
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Affiliation(s)
- Md Asiful Islam
- Department of Haematology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Malaysia
| | - Shahad Saif Khandker
- Department of Biochemistry and Molecular Biology, Jahangirnagar University, Dhaka, Bangladesh
| | - Przemysław J Kotyla
- Department of Internal Medicine, Rheumatology and Clinical Immunology, Medical Faculty in Katowice, Medical University of Silesia, Katowice, Poland
| | - Rosline Hassan
- Department of Haematology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Malaysia
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Correa-Rodríguez M, Pocovi-Gerardino G, Callejas Rubio JL, Ríos Fernández R, Martín Amada M, Cruz Caparrós M, Ortego-Centeno N, Rueda-Medina B. The impact of obesity on disease activity, damage accrual, inflammation markers and cardiovascular risk factors in systemic lupus erythematosus. Panminerva Med 2020; 62:75-82. [PMID: 32515571 DOI: 10.23736/s0031-0808.19.03748-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND We aimed to evaluate the relationships between obesity metrics including Body Mass Index (BMI), waist to height ratio (WtHR) and fat mass percentage, and disease activity, damage accrual, inflammation markers and traditional cardiovascular risk factors in SLE patients. METHODS A cross-sectional study was conducted on a sample of 275 patients (90.5% females; mean age 46.37±13.85 years). Disease activity was assessed with the SLE disease activity index (SLEDAI-2K), and disease-related organ damage was assessed using the SLICC/ACR damage index (SDI). Biochemical variables of lipids profile, high-sensitivity C-reactive protein (hs-CRP), homocysteine (Hcy), anti-dsDNA titers and complement components C3 and C4 serum levels were measured. Blood pressure and ankle-brachial index (ABI) were also calculated. RESULTS Significant differences were observed between normal-weight, overweight and obese patients in SLEDAI (2.60±2.48 vs. 2.71±2.65 vs. 3.84±3.02; P=0.004), SDI (0.76±1.10 vs. 1.09±1.24 vs. 1.57±1.54; P=0.002), hsCRP (2.15±2.93 vs. 3.24±3.63 vs. 5.30±5.63 mg/dL; P<0.001), complement C3 level (99.92±24.45 vs. 111.38±27.41 vs. 123.16±28.96 mg/dL; P<0.001), triglycerides serum levels (85.99±41.68 vs. 102.35±50.88 vs. 129.12±61.59 mg/dL; P<0.001) and systolic blood pressure (112.28±16.35 vs. 124.25±17.94 vs. 132.78±16.71 mmHg; P=0.001) after adjusting for age and sex. CONCLUSIONS Patients with SLE who are obese have worse disease activity and damage accrual, higher levels of inflammation markers hs-CRP and C3 complement, increased triglycerides serum levels and systolic blood pressure levels in comparison with overweight or normal weight SLE patients, supporting that optimizing weight in SLE patients should be a potential target to improve SLE outcomes.
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Affiliation(s)
- María Correa-Rodríguez
- Institute of Biomedical Research (IBS), Granada, Spain.,Nursing Department, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Gabriela Pocovi-Gerardino
- Institute of Biomedical Research (IBS), Granada, Spain - .,Faculty of Health Sciences, University of Granada, Granada, Spain
| | - José-Luis Callejas Rubio
- Institute of Biomedical Research (IBS), Granada, Spain.,Systemic Autoimmune Diseases Unit, San Cecilio University Hospital, Granada, Spain
| | - Raquel Ríos Fernández
- Institute of Biomedical Research (IBS), Granada, Spain.,Systemic Autoimmune Diseases Unit, San Cecilio University Hospital, Granada, Spain
| | | | | | - Norberto Ortego-Centeno
- Institute of Biomedical Research (IBS), Granada, Spain.,Systemic Autoimmune Diseases Unit, San Cecilio University Hospital, Granada, Spain
| | - Blanca Rueda-Medina
- Institute of Biomedical Research (IBS), Granada, Spain.,Nursing Department, Faculty of Health Sciences, University of Granada, Granada, Spain
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10
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Relationship of Excess Weight with Clinical Activity and Dietary Intake Deficiencies in Systemic Lupus Erythematosus Patients. Nutrients 2019; 11:nu11112683. [PMID: 31698711 PMCID: PMC6893805 DOI: 10.3390/nu11112683] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 10/28/2019] [Accepted: 10/29/2019] [Indexed: 12/14/2022] Open
Abstract
Obesity and nutrients intake deficiencies may contribute to the clinical manifestations and inflammatory processes in systemic lupus erythematosus (SLE). The aim of this study was to assess the relationship between nutritional status and dietary intake with clinical variables in Mexican-mestizo SLE patients. A cross-sectional study was conducted in 130 female SLE patients, classified by the 1997 SLE American College of Rheumatology (ACR) criteria; the clinical activity was evaluated by the Mexican-Systemic Lupus Erythematosus-Disease Activity Index (Mex-SLEDAI); body mass index (BMI) by the World Health Organization (WHO) criteria; the energy calculation and nutritional intake were performed by Nutritionist Pro Diet software. SLE patients with excess weight (BMI > 25 kg/m2) showed a higher score of clinical activity (Mex-SLEDAI = 2; p = 0.003), higher clinical activity prevalence (40.9%; p = 0.039) and a significant association for high clinical activity (odds ratio (OR) = 2.52; 95% confidence interval (CI) = 1.08-5.9; p = 0.033), in comparison with patients without excess weight (BMI < 25 kg/m2). In particular, the excess weight increased the Mex-SLEDAI score (β coefficient = 1.82; R2 = 0.05; p = 0.005). Also, the SLE patients presented a high prevalence (%) of deficient consumption (cut-off point: <67% of dietary adequacy) of vitamin E (100%), iodine (96%), omega 3 (93.44%), biotin (78%), vitamin K (73.33%), iron (67%), vitamin D (63.3%), potassium (59%), folic acid (56.67%), pantothenic acid (43.3%), vitamin A (41.67%) and zinc (32%). In conclusion, in SLE patients the excess weight was associated with increased clinical activity and to the presence of deficiencies in some essential nutrients ingested.
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11
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Lee YX, Kwan YH, Lim KK, Tan CS, Lui NL, Phang JK, Chew EH, Ostbye T, Thumboo J, Fong W. A systematic review of the association of obesity with the outcomes of inflammatory rheumatic diseases. Singapore Med J 2019; 60:270-280. [PMID: 31243460 DOI: 10.11622/smedj.2019057] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
This was a systematic review of the literature on the association between obesity and the outcome of inflammatory rheumatic diseases. We conducted a literature search using PubMed®, Embase and PsycINFO®. Articles were classified into three categories based on the effects of obesity on the outcomes of inflammatory rheumatic diseases. The subject population, country, type of studies, number of patients, measurement of obesity and outcomes assessed were presented. Quality was appraised using Kmet et al's criteria. 4,331 articles were screened and 60 were relevant to the objective. Obesity had a negative, positive and neutral association with outcomes of inflammatory rheumatic diseases in 38 (63.3%) studies with 57,612 subjects, 11 (18.3%) studies with 3,866 subjects, and 11 (18.3%) studies with 3,834 subjects, respectively. In most studies, the disease population had been diagnosed with rheumatoid arthritis (RA). Tumour necrosis factor-α inhibitors were mostly associated with negative outcomes. More studies examining subjects outside Europe and North America and diseases other than RA are warranted.
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Affiliation(s)
- Yi Xuan Lee
- Department of Pharmacy, National University of Singapore, Singapore
| | - Yu Heng Kwan
- Programme in Health Services and Systems Research, Duke-NUS Medical School, Singapore
| | - Ka Keat Lim
- Programme in Health Services and Systems Research, Duke-NUS Medical School, Singapore
| | - Chuen Seng Tan
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Nai Lee Lui
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore
| | - Jie Kie Phang
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore
| | - Eng Hui Chew
- Department of Pharmacy, National University of Singapore, Singapore
| | - Truls Ostbye
- Programme in Health Services and Systems Research, Duke-NUS Medical School, Singapore
| | - Julian Thumboo
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore
| | - Warren Fong
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore
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12
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Salomão RG, de Carvalho LM, Izumi C, Czernisz ÉS, Rosa JC, Antonini SRR, Bueno AC, Almada MORDV, Coelho-Landell CDA, Jordão AA, Ferriani VPL, Monteiro JP. Homocysteine, folate, hs-C-reactive protein, tumor necrosis factor alpha and inflammatory proteins: are these biomarkers related to nutritional status and cardiovascular risk in childhood-onset systemic lupus erythematosus? Pediatr Rheumatol Online J 2018; 16:4. [PMID: 29316941 PMCID: PMC5761099 DOI: 10.1186/s12969-017-0220-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Accepted: 12/21/2017] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Childhood-onset systemic lupus erythematosus (c-SLE) is a chronic autoimmune disease which increases cardiovascular risk factors (CRF) such as elevated homocysteine, TNF-α, and hs-C reactive protein. METHODS We evaluated BMI, waist circumference (WC), 24-h recalls, SLEDAI-2 K, SLICC/ACR-DI, serum levels of homocysteine, folate, TNF-α, hs-C reactive protein, lipid profile, proteomic data, and duration of corticosteroid therapy in 19 c-SLE and 38 healthy volunteers. Physiological and anthropometric variables of c-SLE and healthy controls were compared by ANCOVA. k-cluster was used to separate c-SLE into two different groups with the best and the worst metabolic profile according to previous analysis showing some metabolites that were statistically different from controls, such as homocysteine, TNF-α, hs-CRP and folate levels. These two clusters were again compared with the control group regarding nutritional parameters, lipid profile and also proteomic data. RESULTS Individuals with c-SLE presented higher BMI, WC, homocysteine, triglycerides, TNF-α, hs-CRP and lower folate levels when compared to controls. We found 10 proteins whose relative abundances were statistically different between control group and lupus clusters with the best (LCBMP) and the worst metabolic profile (LCWMP). A significant positive correlation was found between TNF-α and triglycerides and between hs-CRP and duration of corticosteroid therapy. CONCLUSION Cardiovascular disease (CVD) risk parameters were worse in c-SLE. A less protective CVD proteomic profile was found in LCWMP.
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Affiliation(s)
- Roberta Garcia Salomão
- Department of Pediatrics, Ribeirão Preto Medical School, University of São Paulo, Av. Bandeirantes, 3900, 14049-900, Ribeirão Preto, São Paulo, Brasil.
| | - Luciana Martins de Carvalho
- Department of Pediatrics, Ribeirão Preto Medical School, University of São Paulo, Av. Bandeirantes, 3900, 14049-900, Ribeirão Preto, São Paulo, Brasil
| | - Clarice Izumi
- Protein Chemistry Center, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brasil
| | - Érika Silva Czernisz
- Protein Chemistry Center, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brasil
| | - José César Rosa
- Protein Chemistry Center, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brasil
| | - Sonir Roberto Rauber Antonini
- Department of Pediatrics, Ribeirão Preto Medical School, University of São Paulo, Av. Bandeirantes, 3900, 14049-900, Ribeirão Preto, São Paulo, Brasil
| | - Ana Carolina Bueno
- Department of Pediatrics, Ribeirão Preto Medical School, University of São Paulo, Av. Bandeirantes, 3900, 14049-900, Ribeirão Preto, São Paulo, Brasil
| | - Maria Olímpia Ribeiro do Vale Almada
- Department of Pediatrics, Ribeirão Preto Medical School, University of São Paulo, Av. Bandeirantes, 3900, 14049-900, Ribeirão Preto, São Paulo, Brasil
| | - Carolina de Almeida Coelho-Landell
- Department of Pediatrics, Ribeirão Preto Medical School, University of São Paulo, Av. Bandeirantes, 3900, 14049-900, Ribeirão Preto, São Paulo, Brasil
| | - Alceu Afonso Jordão
- Department of Medical Clinical, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brasil
| | - Virgínia Paes Leme Ferriani
- Department of Pediatrics, Ribeirão Preto Medical School, University of São Paulo, Av. Bandeirantes, 3900, 14049-900, Ribeirão Preto, São Paulo, Brasil
| | - Jacqueline Pontes Monteiro
- Department of Pediatrics, Ribeirão Preto Medical School, University of São Paulo, Av. Bandeirantes, 3900, 14049-900, Ribeirão Preto, São Paulo, Brasil
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Hrycek E, Banasiewicz‐Szkróbka I, Żurakowski A, Buszman P, Hrycek A. Accelerated Atherosclerosis in Patients with Systemic Lupus Erythematosus and the Role of Selected Adipocytokines in This Process. Lupus 2017. [DOI: 10.5772/68016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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14
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Shi H, Guo X, Zhang Q, Wu H, Du H, Liu L, Wang C, Xia Y, Liu X, Li C, Sun S, Wang X, Zhou M, Jia Q, Zhao H, Song K, Wei D, Niu K. Serum Immunoglobulin M Concentration Varies with Triglyceride Levels in an Adult Population: Tianjin Chronic Low-Grade Systemic Inflammation and Health (TCLSIHealth) Cohort Study. PLoS One 2015; 10:e0124255. [PMID: 25915947 PMCID: PMC4411052 DOI: 10.1371/journal.pone.0124255] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Accepted: 03/11/2015] [Indexed: 12/11/2022] Open
Abstract
Persistent low-grade inflammation is thought to underlie the pathogenesis of many chronic diseases, such as cardiovascular diseases and metabolic syndrome. Autoimmunity is correlated with increased levels of chronic low-grade inflammation, and immunoglobulin M (IgM) is reactive to autoantigens and believed to be important for autoimmunity. Triglyceride (TG) is fatty acid carrier and initiator of oxidative stress, and it has been hypothesized that TG stimulates B cells to secrete IgM. However, few studies have investigated the relationship between TG and IgM in human populations. We designed a cross-sectional and prospective cohort study to evaluate how serum TG levels are related to IgM concentration. Participants were recruited from Tianjin Medical University General Hospital-Health Management Centre. Both a baseline cross-sectional (n = 10,808) and a prospective assessment (n = 2,615) were performed. Analysis of covariance was used in the cross-sectional analysis. After multiple adjustments for confounding factors, serum IgM level in the highest quartile of TG in males was significantly higher than levels in lower quartiles (P <0.05). There was no significant difference between the four quartiles in females (P = 0.91). In follow-up analysis, a multiple linear regression model showed a significant and positive correlation between changes in IgM levels and changes of TG concentration in males (P = 0.04, standard β coefficient = 0.882). This cross-sectional and cohort study is the first to show that serum concentration of IgM varies with TG levels in adult male populations. Further research is needed to explore the mechanism by which TG leads to increased IgM concentration.
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Affiliation(s)
- Hongbin Shi
- The Second Hospital of Tianjin Medical University, Tianjin, China
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Xiaoyan Guo
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Qing Zhang
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Hongmei Wu
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Huanmin Du
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Li Liu
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Chongjin Wang
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Yang Xia
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Xing Liu
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Chunlei Li
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Shaomei Sun
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Xing Wang
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Ming Zhou
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Qiyu Jia
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Honglin Zhao
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Kun Song
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Dianjun Wei
- The Second Hospital of Tianjin Medical University, Tianjin, China
- * E-mail: (DW); (KN)
| | - Kaijun Niu
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
- * E-mail: (DW); (KN)
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15
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Amaya-Amaya J, Montoya-Sánchez L, Rojas-Villarraga A. Cardiovascular involvement in autoimmune diseases. BIOMED RESEARCH INTERNATIONAL 2014; 2014:367359. [PMID: 25177690 PMCID: PMC4142566 DOI: 10.1155/2014/367359] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/23/2014] [Accepted: 05/01/2014] [Indexed: 12/15/2022]
Abstract
Autoimmune diseases (AD) represent a broad spectrum of chronic conditions that may afflict specific target organs or multiple systems with a significant burden on quality of life. These conditions have common mechanisms including genetic and epigenetics factors, gender disparity, environmental triggers, pathophysiological abnormalities, and certain subphenotypes. Atherosclerosis (AT) was once considered to be a degenerative disease that was an inevitable consequence of aging. However, research in the last three decades has shown that AT is not degenerative or inevitable. It is an autoimmune-inflammatory disease associated with infectious and inflammatory factors characterized by lipoprotein metabolism alteration that leads to immune system activation with the consequent proliferation of smooth muscle cells, narrowing arteries, and atheroma formation. Both humoral and cellular immune mechanisms have been proposed to participate in the onset and progression of AT. Several risk factors, known as classic risk factors, have been described. Interestingly, the excessive cardiovascular events observed in patients with ADs are not fully explained by these factors. Several novel risk factors contribute to the development of premature vascular damage. In this review, we discuss our current understanding of how traditional and nontraditional risk factors contribute to pathogenesis of CVD in AD.
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Affiliation(s)
- Jenny Amaya-Amaya
- Center for Autoimmune Diseases Research (CREA), School of Medicine and Health Sciences, Universidad del Rosario, Carrera 24 No. 63C-69, 11001000 Bogotá, Colombia
- Mederi, Hospital Universitario Mayor, Calle 24 No. 29-45, 11001000 Bogotá, Colombia
| | - Laura Montoya-Sánchez
- Center for Autoimmune Diseases Research (CREA), School of Medicine and Health Sciences, Universidad del Rosario, Carrera 24 No. 63C-69, 11001000 Bogotá, Colombia
- Mederi, Hospital Universitario Mayor, Calle 24 No. 29-45, 11001000 Bogotá, Colombia
| | - Adriana Rojas-Villarraga
- Center for Autoimmune Diseases Research (CREA), School of Medicine and Health Sciences, Universidad del Rosario, Carrera 24 No. 63C-69, 11001000 Bogotá, Colombia
- Mederi, Hospital Universitario Mayor, Calle 24 No. 29-45, 11001000 Bogotá, Colombia
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16
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Amaya-Amaya J, Sarmiento-Monroy JC, Caro-Moreno J, Molano-González N, Mantilla RD, Rojas-Villarraga A, Anaya JM. Cardiovascular disease in latin american patients with systemic lupus erythematosus: a cross-sectional study and a systematic review. Autoimmune Dis 2013; 2013:794383. [PMID: 24294522 PMCID: PMC3835818 DOI: 10.1155/2013/794383] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2013] [Accepted: 08/26/2013] [Indexed: 12/24/2022] Open
Abstract
Objective. This study was performed to determine the prevalence of and associated risk factors for cardiovascular disease (CVD) in Latin American (LA) patients with systemic lupus erythematosus (SLE). Methods. First, a cross-sectional analytical study was conducted in 310 Colombian patients with SLE in whom CVD was assessed. Associated factors were examined by multivariate regression analyses. Second, a systematic review of the literature on CVD in SLE in LA was performed. Results. There were 133 (36.5%) Colombian SLE patients with CVD. Dyslipidemia, smoking, coffee consumption, and pleural effusion were positively associated with CVD. An independent effect of coffee consumption and cigarette on CVD was found regardless of gender and duration of disease. In the systematic review, 60 articles fulfilling the eligibility criteria were included. A wide range of CVD prevalence was found (4%-79.5%). Several studies reported ancestry, genetic factors, and polyautoimmunity as novel risk factors for such a condition. Conclusions. A high rate of CVD is observed in LA patients with SLE. Awareness of the observed risk factors should encourage preventive population strategies for CVD in patients with SLE aimed at facilitating the suppression of cigarette smoking and coffee consumption as well as at the tight control of dyslipidemia and other modifiable risk factors.
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Affiliation(s)
- Jenny Amaya-Amaya
- Center for Autoimmune Diseases Research (CREA), School of Medicine and Health Sciences,
Universidad del Rosario, Carrera 24 No. 63C-69, 111221 Bogotá, Colombia
| | - Juan Camilo Sarmiento-Monroy
- Center for Autoimmune Diseases Research (CREA), School of Medicine and Health Sciences,
Universidad del Rosario, Carrera 24 No. 63C-69, 111221 Bogotá, Colombia
| | - Julián Caro-Moreno
- Center for Autoimmune Diseases Research (CREA), School of Medicine and Health Sciences,
Universidad del Rosario, Carrera 24 No. 63C-69, 111221 Bogotá, Colombia
| | - Nicolás Molano-González
- Center for Autoimmune Diseases Research (CREA), School of Medicine and Health Sciences,
Universidad del Rosario, Carrera 24 No. 63C-69, 111221 Bogotá, Colombia
| | - Rubén D. Mantilla
- Center for Autoimmune Diseases Research (CREA), School of Medicine and Health Sciences,
Universidad del Rosario, Carrera 24 No. 63C-69, 111221 Bogotá, Colombia
| | - Adriana Rojas-Villarraga
- Center for Autoimmune Diseases Research (CREA), School of Medicine and Health Sciences,
Universidad del Rosario, Carrera 24 No. 63C-69, 111221 Bogotá, Colombia
| | - Juan-Manuel Anaya
- Center for Autoimmune Diseases Research (CREA), School of Medicine and Health Sciences,
Universidad del Rosario, Carrera 24 No. 63C-69, 111221 Bogotá, Colombia
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