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Luo Q, Zhang Y, Yang X, Qin L, Wang H. Hypertension in connective tissue disease. J Hum Hypertens 2024; 38:19-28. [PMID: 35505225 DOI: 10.1038/s41371-022-00696-8] [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: 05/26/2021] [Revised: 02/23/2022] [Accepted: 04/12/2022] [Indexed: 11/10/2022]
Abstract
It is well documented that connective tissue disease (CTD) is a type of autoimmune disease characterized by chronic inflammation, which can occur across various organ systems throughout the whole body. Although the clinical manifestations of CTD are different, studies have shown that different CTD diseases have similar pathogenesis, implying that different CTD diseases may have similar clinical outcomes. Recent population-based studies have demonstrated an increased risk of cardiovascular disease (CVD) in patients with CTD compared with the control group, which is partially attributed to traditional cardiovascular risk factors, such as hypertension (HT), and that controlling the patients' blood pressure (BP) still constitutes one of the most effective means to prevent CVD. Although many studies have shown that the prevalence of HT in patients with CTD is higher than that in the general population, there is a lack of adequate data on the possible pathogenesis of HT. Also, the factors that promote the rise of BP, especially the relationship between connective tissue disease- hypertension (CTD-HT) and traditional cardiovascular risk factors (aging, sex, race, dyslipidemia, diabetes mellitus, smoking, obesity, etc.), have not been fully confirmed. In this review, we explore the mechanisms that might lead to elevated BP in patients with CTD and the factors that contribute to elevated BP and the management of CTD-HT, and we focus on whether traditional cardiovascular risk factors, the disease, and the presence of related therapeutic drugs are associated with an increased risk of HT in patients with CTD.
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Affiliation(s)
- Qiang Luo
- Department of Cardiology, Affiliated Hospital of Southwest Jiaotong University, The Third People's Hospital of Chengdu, 82 Qinglong St., Chengdu, Sichuan, China
| | - Yiwen Zhang
- Department of Cardiology, Affiliated Hospital of Southwest Jiaotong University, The Third People's Hospital of Chengdu, 82 Qinglong St., Chengdu, Sichuan, China
| | - Xiaoqian Yang
- Department of Cardiology, Affiliated Hospital of Southwest Jiaotong University, The Third People's Hospital of Chengdu, 82 Qinglong St., Chengdu, Sichuan, China
| | - Li Qin
- Department of Cardiology, Affiliated Hospital of Southwest Jiaotong University, The Third People's Hospital of Chengdu, 82 Qinglong St., Chengdu, Sichuan, China
| | - Han Wang
- Department of Cardiology, Affiliated Hospital of Southwest Jiaotong University, The Third People's Hospital of Chengdu, 82 Qinglong St., Chengdu, Sichuan, China.
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Zafar A, Wajid B, Shabbir A, Gohar Awan F, Ahsan M, Ahmad S, Wajid I, Anwar F, Mazhar F. Unearthing Insights into Metabolic Syndrome by Linking Drugs, Targets, and Gene Expressions Using Similarity Measures and Graph Theory. Curr Comput Aided Drug Des 2024; 20:773-783. [PMID: 37592790 DOI: 10.2174/1573409920666230817101913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 06/13/2023] [Accepted: 07/05/2023] [Indexed: 08/19/2023]
Abstract
AIMS AND OBJECTIVES Metabolic syndrome (MetS) is a group of metabolic disorders that includes obesity in combination with at least any two of the following conditions, i.e., insulin resistance, high blood pressure, low HDL cholesterol, and high triglycerides level. Treatment of this syndrome is challenging because of the multiple interlinked factors that lead to increased risks of type-2 diabetes and cardiovascular diseases. This study aims to conduct extensive in silico analysis to (i) find central genes that play a pivotal role in MetS and (ii) propose suitable drugs for therapy. Our objective is to first create a drug-disease network and then identify novel genes in the drug-disease network with strong associations to drug targets, which can help in increasing the therapeutical effects of different drugs. In the future, these novel genes can be used to calculate drug synergy and propose new drugs for the effective treatment of MetS. METHODS For this purpose, we (i) investigated associated drugs and pathways for MetS, (ii) employed eight different similarity measures to construct eight gene regulatory networks, (iii) chose an optimal network, where a maximum number of drug targets were central, (iv) determined central genes exhibiting strong associations with these drug targets and associated disease-causing pathways, and lastly (v) employed these candidate genes to propose suitable drugs. RESULTS Our results indicated (i) a novel drug-disease network complex, with (ii) novel genes associated with MetS. CONCLUSION Our developed drug-disease network complex closely represents MetS with associated novel findings and markers for an improved understanding of the disease and suggested therapy.
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Affiliation(s)
- Alwaz Zafar
- Ibn Sina Research & Development Division, Sabz-Qalam, Lahore, 54000, Pakistan
| | - Bilal Wajid
- Ibn Sina Research & Development Division, Sabz-Qalam, Lahore, 54000, Pakistan
- Department of Electrical Engineering, University of Engineering and Technology, Lahore, 54000, Pakistan
| | - Ans Shabbir
- Ibn Sina Research & Development Division, Sabz-Qalam, Lahore, 54000, Pakistan
| | - Fahim Gohar Awan
- Department of Electrical Engineering, University of Engineering and Technology, Lahore, 54000, Pakistan
| | - Momina Ahsan
- Ibn Sina Research & Development Division, Sabz-Qalam, Lahore, 54000, Pakistan
| | - Sarfraz Ahmad
- Ibn Sina Research & Development Division, Sabz-Qalam, Lahore, 54000, Pakistan
| | - Imran Wajid
- Ibn Sina Research & Development Division, Sabz-Qalam, Lahore, 54000, Pakistan
- Department of Social Sciences, Istanbul Commerce University, Istanbul, Turkey
| | - Faria Anwar
- Outpatient Department, Mayo Hospital, Lahore, 54000, Pakistan
| | - Fazeelat Mazhar
- Department of Biomedical, Electrical and System Engineering, University of Bologna, Cesena Campus, Bologna, Italy
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Muñoz-Grajales C, Yilmaz EB, Svenungsson E, Touma Z. Systemic lupus erythematosus and damage: What has changed over the past 20 years? Best Pract Res Clin Rheumatol 2023; 37:101893. [PMID: 37993371 DOI: 10.1016/j.berh.2023.101893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 10/27/2023] [Indexed: 11/24/2023]
Abstract
The young age of onset and chronic/relapsing nature of systemic lupus erythematosus (SLE) make SLE patients prone to develop and accrue organ damage as a result of long-standing disease activity and side effects of treatment. There is a growing interest in objectifying damage and identifying its risk factors. Still, the lack of therapeutic alternatives has led to difficulties in avoiding immunosuppressives particularly corticosteroids, which have been implicated in a large spectrum of organ damage in SLE patients. Moreover, it continues to be very challenging to determine what actually causes damage in different organ-systems. Cardiovascular disease continues to be one of the leading types of damage in patients with SLE, reported as early as 1976. Since then, many researchers have focused on identifying SLE or treatment-related and traditional risk factors. The same considerations are valid for other conditions, such as the occurrence of metabolic syndrome, osteoporosis, avascular necrosis, susceptibility to infections, etc. On the other hand, diverse risk factors contribute to the development of chronic kidney disease (CKD) in SLE. Most evidence suggests that high initial levels of serum creatinine, hypocomplementemia, nephrotic range proteinuria, concomitant uncontrolled hypertension, Black and Hispanic ancestry, non-adherence to treatment, and biopsy findings such as diffuse proliferative lupus nephritis (LN), a high chronicity index, tubular atrophy, and tubulointerstitial inflammation are risk factors for progression to end stage renal disease (ESRD) in LN. While cardiovascular disease, CKD and infections are leading causes of mortality in patients with SLE, hospitalizations are caused mostly by SLE disease flares and infections. Cognitive impairment and mood disorders are common in SLE but continue to impose a challenge on how to measure, manage and decipher the underlying pathogenesis. Nevertheless, they have a great impact on SLE patients' health-related quality of life (HRQoL) and social functioning. Also, skin manifestations, such as alopecia and scaring, cataracts, and sicca symptoms result in a significant decrease in HRQoL. In light of recent developments in SLE treatment, we can expect to enter a period of new-age targeted therapies that will enable us to reduce disease activity and glucocorticoid usage further and positively alter the trajectory of damage development and accrual in SLE.
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Affiliation(s)
- Carolina Muñoz-Grajales
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Division of Rheumatology, University of Toronto, Toronto, Canada; University of Toronto Lupus Clinic, Centre for Prognosis Studies in Rheumatic Diseases, Toronto Western Hospital Lupus Clinic, Toronto, Canada
| | - Esin Beste Yilmaz
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Elisabet Svenungsson
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Zahi Touma
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Division of Rheumatology, University of Toronto, Toronto, Canada; University of Toronto Lupus Clinic, Centre for Prognosis Studies in Rheumatic Diseases, Toronto Western Hospital Lupus Clinic, Toronto, Canada.
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Bello N, Meyers KJ, Workman J, Hartley L, McMahon M. Cardiovascular events and risk in patients with systemic lupus erythematosus: Systematic literature review and meta-analysis. Lupus 2023; 32:325-341. [PMID: 36547368 PMCID: PMC10012401 DOI: 10.1177/09612033221147471] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 12/07/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Systemic lupus erythematosus (SLE) is an autoimmune disease that typically affects women aged 16-55 years. Cardiovascular disease (CVD) is a well-recognized complication of SLE. This systematic literature review and meta-analysis evaluated the relative risk (RR; compared with non-SLE controls), absolute risk (AR; as incidence proportion, n/N), and incidence rate (IR) of CVD events (including stroke, myocardial infarction [MI], and CVD [composite or undefined]) in adult patients with SLE. The RR of CV risk factors (including hypertension, diabetes, and metabolic syndrome [MetS]) was also examined. METHODS PubMed and Embase were searched on September 10, 2020. Observational studies published between January 2010 and September 2020 that reported RR, AR, and/or IR of CVD events, or RR of CV risk factors, were eligible. Pooled risk estimates were calculated using a random-effects model. RESULTS Forty-six studies (16 cross-sectional, 15 retrospective cohort, 14 prospective cohort, and 1 case-control) were included in meta-analyses. Most studies were considered high quality (Critical Appraisal Skills Programme checklists). Compared with adults without SLE, patients with SLE had statistically significantly higher RRs (95% CIs) of stroke (2.51 [2.03-3.10]; 12 studies), MI (2.92 [2.45-3.48]; 11 studies), CVD (2.24 [1.94-2.59]; 8 studies), and hypertension (2.70 [1.48-4.92]; 7 studies). RRs of diabetes (1.24 [0.78-1.96]; 3 studies) and MetS (1.49 [0.95-2.33]; 7 studies) were elevated but not significant. RRs of stroke and MI were generally higher in younger versus older patients with SLE. In patients with SLE, the pooled estimate of AR (95% CI) was 0.03 (0.02-0.05), 0.01 (0.00-0.02), and 0.06 (0.03-0.10) for stroke (7 studies), MI (6 studies), and CVD (8 studies), respectively. The pooled estimate of IR per 1000 person-years (95% CI) was 4.72 (3.35-6.32), 2.81 (1.61-4.32), and 11.21 (8.48-14.32) for stroke (10 studies), MI (6 studies), and CVD (8 studies), respectively. Although heterogeneity (based on I2 value) was high in most analyses, sensitivity analyses confirmed the robustness of the pooled estimates. CONCLUSIONS This meta-analysis found an increased risk of stroke, MI, CVD, and hypertension in patients with SLE compared with the general population, despite substantial heterogeneity across the included studies.
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Affiliation(s)
| | | | | | | | - Maureen McMahon
- Division of Rheumatology, Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
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Lin YJ, Chien CC, Ho CH, Chen HA, Chen CY. Increased risk of type 2 diabetes in patients with systemic lupus erythematosus: A nationwide cohort study in Taiwan. Medicine (Baltimore) 2022; 101:e32520. [PMID: 36595866 PMCID: PMC9794330 DOI: 10.1097/md.0000000000032520] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Data on the risk of developing diabetes in patients with systemic lupus erythematosus (SLE) are limited and have yielded mixed results. We conducted a nationwide cohort study to investigate the risk of subsequent type 2 diabetes in patients with SLE compared with matched non-SLE controls. Data were collected from the Taiwan National Health Insurance Research Database. Adult patients newly diagnosed with SLE between 2003 to 2010 were identified as the study cohort. The non-SLE group was matched for age, gender, and date of initial diagnosis as the comparison cohort. A total of 6159 SLE patients (87.90% female, mean age 38.79 years) were identified during this period. Of these, 206 (3.34%) developed type 2 diabetes. The 3-year incidence of type 2 diabetes was significantly higher in the SLE cohort than in the control group (130.26 vs 101.18 cases per 10,000 person-years), with an adjusted hazard ratio of 1.22 (95% confidence interval [CI] 1.04-1.44), after adjusting for age, gender, underlying comorbidities, and monthly income. Stratified analyses showed that women with SLE and low-income SLE patients (monthly income < 20,000 New Taiwan Dollar) had a higher risk of type 2 diabetes than non-SLE controls, with adjusted hazard ratios of 1.21 (95% CI 1.01-1.45) and 1.36 (95% CI 1.10-1.69), respectively. Patients with newly diagnosed SLE had a 22% increased risk of developing type 2 diabetes during the 3-year follow-up period compared with matched controls.
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Affiliation(s)
- Yeong-Jang Lin
- Department of Allergy, Immunology and Rheumatology, Chi-Mei Medical Center, Yung Kang District, Tainan City, Taiwan
- * Correspondence: Yeong-Jang Lin, Department of Allergy, Immunology and Rheumatology, Chi-Mei Medical Center, 901 Jung-Hua Road, Yung Kang District, Tainan City 710, Taiwan (e-mail: )
| | - Chih-Chiang Chien
- Department of Nephrology, Chi-Mei Medical Center, Yung Kang District, Tainan City, Taiwan
| | - Chung-Han Ho
- Department of Medical Research, Chi-Mei Medical Center, Yung Kang District, Tainan City, Taiwan
| | - Hung-An Chen
- Department of Allergy, Immunology and Rheumatology, Chi-Mei Medical Center, Yung Kang District, Tainan City, Taiwan
| | - Chao-Yu Chen
- Department of Allergy, Immunology and Rheumatology, Chi-Mei Medical Center, Yung Kang District, Tainan City, Taiwan
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Chen J, Liao S, Pang W, Guo F, Yang L, Liu HF, Pan Q. Life factors acting on systemic lupus erythematosus. Front Immunol 2022; 13:986239. [PMID: 36189303 PMCID: PMC9521426 DOI: 10.3389/fimmu.2022.986239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 08/31/2022] [Indexed: 11/25/2022] Open
Abstract
Systemic lupus erythematosus (SLE) is a highly heterogeneous autoimmune disease that primarily affects women. Currently, in the search for the mechanisms of SLE pathogenesis, the association of lifestyle factors such as diet, cigarette smoking, ultraviolet radiation exposure, alcohol and caffeine-rich beverage consumption with SLE susceptibility has been systematically investigated. The cellular and molecular mechanisms mediating lifestyle effects on SLE occurrence, including interactions between genetic risk loci and environment, epigenetic changes, immune dysfunction, hyper-inflammatory response, and cytotoxicity, have been proposed. In the present review of the reports published in reputable peer-reviewed journals and government websites, we consider the current knowledge about the relationships between lifestyle factors and SLE incidence and outline directions of future research in this area. Formulation of practical measures with regard to the lifestyle in the future will benefit SLE patients and may provide potential therapy strategies.
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Affiliation(s)
| | | | | | | | | | | | - Qingjun Pan
- *Correspondence: Hua-feng Liu, ; Qingjun Pan,
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Prevalence of Findings in Routine Abdominal Ultrasound in Patients with Systemic Autoimmune Rheumatic Diseases and Their Impact on Therapeutic Decision Making. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12020851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Patients with systemic autoimmune rheumatic diseases (SARD) often receive abdominal ultrasound examinations to screen for organ involvement; yet, the spectrum of findings and their clinical relevance are poorly understood. We conducted a retrospective chart review of inpatients from a rheumatological referral centre with an abdominal ultrasound between 1 January2006 and 31 December 2015, examining 1092 SARD patients with a total of 1695 inpatient stays. The mean age was 55.1 years (range: 17–90 years, SD: 15.8), and the mean disease duration was 6.4 years (range: 0.0–52.8 years, SD: 9.1). A total of 87.5% of the patients were female. The most frequent ultrasound findings were hepatic steatosis (in 26.8% of all patients), splenomegaly (15.2% of all patients), pancreatic lipomatosis (14.3% of all patients) and aortic sclerosis (13.9% of all patients). Based on glucocorticoid and disease-modifying antirheumatic drug use, we identified cases where immuno-modulatory medication was escalated; there was an association between therapy escalation and the findings of hepatomegaly and pleural effusion (as tested via Fisher’s exact test). In patients with several examinations during the defined time span (n = 318), we found ultrasound findings to change, especially findings of hepatomegaly, pleural effusion and splenomegaly. When justifying decisions regarding the further treatment of a patient in the discharge letter, abdominal ultrasound results were rarely discussed. Abdominal ultrasound rarely yielded disease-specific or treatment-changing results.
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Keyes E, Grinnell M, Jacoby D, Vazquez T, Diaz D, Werth VP, Williams KJ. Assessment and management of the heightened risk for atherosclerotic cardiovascular events in patients with lupus erythematosus or dermatomyositis. Int J Womens Dermatol 2021; 7:560-575. [PMID: 35024413 PMCID: PMC8721062 DOI: 10.1016/j.ijwd.2021.08.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 08/27/2021] [Accepted: 08/31/2021] [Indexed: 01/05/2023] Open
Abstract
For patients with lupus erythematosus (LE) or dermatomyositis (DM), there is an urgent need to address a heightened risk of clinical events, chiefly heart attacks and strokes, caused by atherosclerotic cardiovascular disease (ASCVD). Patients with LE or DM frequently exhibit high levels of conventional risk factors for ASCVD events, particularly dyslipoproteinemia and hypertension; an amplified burden of atherosclerotic plaques; and increased age- and sex-adjusted rates of ASCVD events compared with the general population. The rate of ASCVD events exceeds what would be expected from conventional risk factors, suggesting that disease-specific autoimmune processes exacerbate specific, known pathogenic steps in atherosclerosis. Importantly, despite their heightened risk, patients with LE or DM are often undertreated for known causative agents and exacerbators of ASCVD. Herein, we propose an approach to assess and manage the heightened risk of ASCVD events in patients with LE or DM. Our approach is modeled in large part on established approaches to patients with diabetes mellitus or stage 3 or 4 chronic kidney disease, which are well-studied conditions that also show heightened risk for ASCVD events and have been explicitly incorporated into standard clinical guidelines for ASCVD. Based on the available evidence, we conclude that patients with LE or DM require earlier and more aggressive screening and management of ASCVD. We suggest that physicians consider implementing multipliers of conventional risk calculators to trigger earlier initiation of lifestyle modifications and medical therapies in primary prevention of ASCVD events, employ vascular imaging to quantify the burden of subclinical plaques, and treat to lower lipid targets using statins and newer therapies, such as PCSK9 inhibitors, that decrease ASCVD events in nonautoimmune cohorts. More clinical vigilance is needed regarding surveillance, prevention, risk modification, and treatment of dyslipidemias, hypertension, and smoking in patients with LE or DM. All of these goals are achievable.
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Affiliation(s)
- Emily Keyes
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
- Corporal Michael J. Crescenz VAMC, Philadelphia, Pennsylvania
| | - Madison Grinnell
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
- Corporal Michael J. Crescenz VAMC, Philadelphia, Pennsylvania
| | - Douglas Jacoby
- Cardiovascular Division, Department of Medicine, University of Pennsylvania Health System, Philadelphia, Pennsylvania
| | - Thomas Vazquez
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
- Corporal Michael J. Crescenz VAMC, Philadelphia, Pennsylvania
| | - DeAnna Diaz
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
- Corporal Michael J. Crescenz VAMC, Philadelphia, Pennsylvania
| | - Victoria P. Werth
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
- Corporal Michael J. Crescenz VAMC, Philadelphia, Pennsylvania
| | - Kevin Jon Williams
- Department of Cardiovascular Sciences, Department of Medicine, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania
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Adeodato Ramos LM, Gomes KWP, de Saboia Mont'Alverne AR, Braga MV, Costa Vasconcelos AH, Rodrigues CEM. High Prevalence of Metabolic Syndrome in Patients With Psoriatic Arthritis From Northeastern Brazil: Association With Traditional Cardiovascular Risk Factors and Biologic Disease-Modifying Antirheumatic Drugs. J Clin Rheumatol 2021; 27:S186-S192. [PMID: 33298819 DOI: 10.1097/rhu.0000000000001631] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aims of this cross-sectional study were to evaluate the prevalence of MetS in PsA patients compared with sex- and age-matched healthy controls and to test possible associations with clinical and laboratory variables. METHODS The prevalence of MetS was determined for 76 PsA patients and 76 sex- and age-matched healthy controls, using the criteria of NCEP/ATPIII and Harmonizing, adjusted for South Americans. Multivariate logistic regression analysis was used to identify independent risk factors for MetS. RESULTS Metabolic syndrome was significantly more prevalent in the PsA group than in the control group (53.9% vs 18.4%, p < 0.001). Psoriatic arthritis was associated with hypertension, diabetes mellitus, increased waist circumference (WC), elevated body mass index, and raised levels of blood glucose and triglycerides. When comparing MetS and non-Mets PsA patients, MetS was not significantly associated with disease activity, skin involvement, or quality of life. In the logistic regression model, the variables independently associated with MetS were use of biologic disease-modifying antirheumatic drugs (p = 0.001), elevated arterial pressure (p = 0.006), age (p = 0.0015), WC (p = 0.004), and low HDL (p = 0.042). CONCLUSIONS In this study on PsA patients from Northeastern Brazil, MetS was highly prevalent and associated with biologic disease-modifying antirheumatic drugs use, increased WC, and low HDL.
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Reis VMCP, Rocha JSB, Fonseca AA, Freitas RF, Passos BMA, Baldo MP, Freire RS, Reis GCV, Oliveira FPSLD, Magalhães TAD, Silveira MF. A Comparison of the Prevalence of Metabolic Syndrome According to Different Definitions in Climacteric Women. Metab Syndr Relat Disord 2021; 19:436-442. [PMID: 34227853 DOI: 10.1089/met.2020.0143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: The prevalence of metabolic syndrome (MS) varies according to the different definitions available for clinical practice. The study aimed to estimate and compare the prevalence of MS according to the definitions of the American Heart Association (AHA)/National Heart, Lung, and Blood Institute (NHBI), International Diabetes Federation (IDF), and Joint Interim Statement (JIS) in a sample of climacteric women in Brazil. Methods: A population-based cross-sectional study, using a probabilistic sampling by clusters, involved 874 climacteric women. Clinical and anthropometric variables were acquired while fasting, and MS was defined according to three recommendations. To define the agreement between different definitions on MS, we calculated the sensitivity and specificity for the diagnosis of MS based on AHA/NHBI and IDF in relationship to the JIS definition. Results: The prevalence of MS was 56.9% according to the AHA/NHBI definition, 61.6% by the IDF, and 64.8% by the JIS definition, without statistical significance. When prevalence of MS was stratified by climacteric stages, the ability of the different definitions identifying MS was also similar among groups. It was observed that the MS definition proposed by AHA/NHBI identified 87.4% of MS cases from the total cases diagnosed by JIS, with agreement levels by the Kappa index of 0.835. The IDF detected 95.3% of MS cases compared to the JIS definition and the agreement level was 0.934. Conclusions: The study indicates a high prevalence of MS in climacteric women regardless of the definition used (AHA/NHBI, IDF e JIS). We did not observe significant divergences between definitions.
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Affiliation(s)
| | - Josiane Santos Brant Rocha
- Department of Physical Education and Sports from the State University of Montes Claros, Montes Claros, Minas Gerais, Brazil
| | - Alenice Aliane Fonseca
- Department of Health, Society and Environment from the Federal University of the Jequitinhonha and Mucuri Valleys, Diamantina, Minas Gerais, Brazil
| | - Ronilson Ferreira Freitas
- Department of Health, Society and Environment from the Federal University of the Jequitinhonha and Mucuri Valleys, Diamantina, Minas Gerais, Brazil
| | - Betânia Maria Araújo Passos
- Department of Physical Education and Sports from the State University of Montes Claros, Montes Claros, Minas Gerais, Brazil
| | - Marcelo Perim Baldo
- Department of Pathophysiology from the State University of Montes Claros, Montes Claros, Minas Gerais, Brazil
| | - Rafael Silveira Freire
- Department of Health Sciences from the State University of Montes Claros, Montes Claros, Minas Gerais, Brazil
| | - Gabriel Chaves Veloso Reis
- Department of Mechanical Engineering from the Federal University of São João Del Rey, Minas Gerais, Brazil
| | | | | | - Marise Fagundes Silveira
- Department of Health Sciences from the State University of Montes Claros, Montes Claros, Minas Gerais, Brazil
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REIS VMCP, FREIRE RS, BRITO MFSF, PINHO LD, ROCHA JSB, SILVEIRA MF. Interrelationships between obesity, blood pressure and metabolic profile in climacteric women. REV NUTR 2021. [DOI: 10.1590/1678-9865202134e200136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
ABSTRACT Objective This study aimed to evaluate the interrelationships between obesity, blood pressure and metabolic profile in climacteric women. Methods This is a cross-sectional study with a random sample of 874 women, aged 40 to 65 years, assisted in Family Health Strategies units in Montes Claros, Minas Gerais, Brazil. A structural equation model was used to assess the interrelationships between obesity, blood pressure and metabolic profile, adjusted for age. The variables blood pressure, obesity and metabolic profile were treated as constructs, which measurement models were developed using confirmatory factor analysis. Results It was observed that age has a positive and significant effect on blood pressure (β=0.20; p<0.001) and obesity (β=0.10; p=0.004). There was a direct and positive effect of obesity on blood pressure (β=0.26; p<0.001) and on the metabolic profile (β=0.10; p=0.037), adjusted for physical activity. Conclusions The simultaneous analysis of the relationships between age, obesity, blood pressure and metabolic profile in menopausal women suggests that, ageing has an effect on the increase of obesity and blood pressure, just as obesity increases blood pressure and changes the metabolic profile.
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12
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Jin LR, Tao MJ, Zhou J, Xu L, Li Q, Li Z, Peng H, Yuan H. Metabolic syndrome in systemic lupus erythematosus was closely related to body mass index, blood pressure, blood sugar, blood lipids, and arthritis. Pak J Med Sci 2020; 36:1220-1227. [PMID: 32968384 PMCID: PMC7501005 DOI: 10.12669/pjms.36.6.2093] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Background and Objective: Prevention and control of metabolic syndrome is the key to improving the development of systemic lupus erythematosus. The aim of this study was to analyze the relevant factors regarding metabolic syndrome (MS) in systemic lupus erythematosus (SLE). Methods: A total number of 1238 SLE patients in Yijishan Hospital of Wannan Medical College, Anhui province, from February 2012 to July 2017, were analyzed retrospectively. SLE patients with MS were grouped to group SLE-MS, the others without MS was grouped to group SLE-nMS. The two groups were compared with respect to general characteristics, clinical signs, and laboratory parameters. Random forest approach and multivariate logistic regression were conducted to analyze the related factors regarding MS in SLE. Results: The constituent ratio of metabolic syndrome was 27.14% (336/1238). More SLE patients with MS presented with more farmers, more married people, lower education level, and more lupus nephritis, proteinuria, oral ulcers, tubular urine, hematuria than SLE patients without MS (P<0.05). Moreover, eighteen important variables, whose average importance scores were highest and whose error rates were lowest, were selected by random forest method. Data from multivariate logistic regression showed that MS in SLE was related with BMI, diastolic blood pressure, systolic blood pressure, fasting blood glucose, arthritis, urea, triglycerides, high-density lipoprotein, and white blood cells. Conclusion: MS in SLE was closely related to BMI, blood pressure, blood sugar, blood lipids, arthritis, white blood cells, and urea. Targeted prevention and conclusion measures for the risk factors should be taken as early as possible.
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Affiliation(s)
- Lai-Run Jin
- Lai-Run Jin, Office of Educational Administration, The First Affiliated Hospital of Wannan Medical College (Yijishan Hospital of Wannan Medical College), Wuhu 241001, China
| | - Meng-Jun Tao
- Meng-Jun Tao, School of Public Health, Wannan Medical College, Wuhu 241001, China
| | - Jun Zhou
- Jun Zhou, School of Public Health, Wannan Medical College, Wuhu 241001, China
| | - Liang Xu
- Liang Xu, Department of Rheumatology, The First Affiliated Hospital of Wannan Medical College (Yijishan Hospital of Wannan Medical College), Wuhu 241001, China
| | - Qiang Li
- Qiang Li, Department of Medical Record, The First Affiliated Hospital of Wannan Medical College (Yijishan Hospital of Wannan Medical College), Wuhu 241001, China
| | - Zhi Li
- Zhi Li, Department of Rheumatology, The First Affiliated Hospital of Wannan Medical College (Yijishan Hospital of Wannan Medical College), Wuhu 241001, China
| | - Hui Peng
- Hui Peng, Administration Office of Hospital Admission and Discharge, The First Affiliated Hospital of Wannan Medical College (Yijishan Hospital of Wannan Medical College), Wuhu 241001, China
| | - Hui Yuan
- Hui Yuan, School of Public Health, Wannan Medical College, Wuhu 241001, China
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Masson W, Rossi E, Mora-Crespo LM, Cornejo-Peña G, Pessio C, Gago M, Alvarado RN, Scolnik M. Cardiovascular risk stratification and appropriate use of statins in patients with systemic lupus erythematosus according to different strategies. Clin Rheumatol 2019; 39:455-462. [PMID: 31802350 DOI: 10.1007/s10067-019-04856-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 11/07/2019] [Accepted: 11/12/2019] [Indexed: 12/18/2022]
Abstract
INTRODUCTION/OBJECTIVES Cardiovascular risk management of patients with systemic lupus erythematosus (SLE) is medically relevant. The objectives were to estimate the cardiovascular risk by different strategies in patients with SLE, analyzing which proportion of patients would be candidates to receive statin therapy, and identify how many patients with statin indication received such drugs. METHOD A cross-sectional study was performed from a secondary database. Following the recommendations of National Institute for Health and Care Excellence (NICE) guidelines and the Argentine Consensus, the QRISK-3 and the adjusted Framingham (multiplying factor × 2) scores were calculated in primary prevention subjects. The indications for statin therapy according to these recommendations were analyzed. RESULTS In total, 110 patients were included. Regarding patients without previous cardiovascular history, the median adjusted Framingham score was 12.8% (4.1-21.9), and 45.2%, 22.6%, and 32.2% of them were classified at low, moderate, or high risk. The median QRISK-3 score was 6.0% (2.1-14.1) and 42.1% of subjects were classified "at risk". Only 60% of subjects in secondary prevention received statins, although no patient received the recommended doses. Analyzing patients in primary prevention who did not receive statins (87%), 43.4% and 45.2% of the patients were eligible for statin therapy according to NICE guidelines and Argentine Consensus, respectively. CONCLUSIONS Our findings showed that a large proportion of patients with SLE have a considerable cardiovascular risk and many of them would be eligible for statin therapy. However, the statin use observed was low.Key Points• A large proportion of patients with lupus have a considerable cardiovascular risk, explained in part by dyslipidemia.• Many patients with SLE would be eligible for statin therapy according to risk stratification based on conventional risk factors.• The use of statins in this population is inadequate.
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Affiliation(s)
- Walter Masson
- Hospital Italiano de Buenos Aires, Tte. Gral. Juan Domingo Perón 4190, C1199ABB, Ciudad Autónoma de Buenos Aires, Argentina.
| | - Emiliano Rossi
- Hospital Italiano de Buenos Aires, Tte. Gral. Juan Domingo Perón 4190, C1199ABB, Ciudad Autónoma de Buenos Aires, Argentina
| | - Lorena M Mora-Crespo
- Hospital Italiano de Buenos Aires, Tte. Gral. Juan Domingo Perón 4190, C1199ABB, Ciudad Autónoma de Buenos Aires, Argentina
| | - Guillermo Cornejo-Peña
- Hospital Italiano de Buenos Aires, Tte. Gral. Juan Domingo Perón 4190, C1199ABB, Ciudad Autónoma de Buenos Aires, Argentina
| | - Carla Pessio
- Hospital Italiano de Buenos Aires, Tte. Gral. Juan Domingo Perón 4190, C1199ABB, Ciudad Autónoma de Buenos Aires, Argentina
| | - Mariela Gago
- Hospital Italiano de Buenos Aires, Tte. Gral. Juan Domingo Perón 4190, C1199ABB, Ciudad Autónoma de Buenos Aires, Argentina
| | - Rodolfo N Alvarado
- Hospital Italiano de Buenos Aires, Tte. Gral. Juan Domingo Perón 4190, C1199ABB, Ciudad Autónoma de Buenos Aires, Argentina
| | - Marina Scolnik
- Hospital Italiano de Buenos Aires, Tte. Gral. Juan Domingo Perón 4190, C1199ABB, Ciudad Autónoma de Buenos Aires, Argentina
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Díaz-Coronado JC, Rojas-Villarraga A, Hernandez-Parra D, Betancur-Vásquez L, Lacouture-Fierro J, Gonzalez-Hurtado D, González-Arango J, Uribe-Arango L, Gaviria-Aguilar MC, Pineda-Tamayo RA. Clinical and sociodemographic factors associated with lupus nephritis in Colombian patients: A cross-sectional study. ACTA ACUST UNITED AC 2019; 17:351-356. [PMID: 31784395 DOI: 10.1016/j.reuma.2019.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2019] [Revised: 09/12/2019] [Accepted: 09/17/2019] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Over the past decades, incidence of SLE (Systemic Lupus Erythematosus) has increased due to early case detection and improved survival of patients. SLE presents at an earlier age and has a more severe presentation in African-American, Native American, Asian, and Hispanic populations. Worldwide, lupus nephritis (LN) is observed in 29-60% of SLE patients, it has a negative impact in renal survival and patient mortality. Several cohorts have established potential risk factors associated with lupus nephritis, such as male sex, serological markers, and some extra-renal manifestations. OBJECTIVES To describe sociodemographic, clinical, immunological, and environmental risk factors in Colombian SLE patients and to compare the population with and without nephritis, in order to establish risk factors and possible associations. MATERIALS AND METHODS A total of 1175 SLE patients participated in this study. During medical care, an interview and structured survey was conducted and later registered in a database. Sociodemographic, clinical, immunological, and environmental exposure variables were analyzed. Bivariate and multivariate analyses were performed using presence of LN as an outcome. RESULTS Prevalence of LN was 38.7%. Variables significantly associated with LN included being male (OR 1.98), a duration of SLE>10 years (OR 1.48), positive anti-DNA (OR 1.34), positive anti-Sm (OR 1.45), and smoking (OR 1.66). Being non-smoker was a protective factor (OR 0.52). CONCLUSION This study describes potential factors associated with lupus nephritis in a Latin American population. Smoking status could be a target for intervention as it is a modifiable risk factor. The association between being male and LN is observed in Latin-American populations such as presented here. Further research in other large-scale population studies and more efforts are needed to gain better insights to explicate these relationships.
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Affiliation(s)
- Juan C Díaz-Coronado
- Grupo de Información Clínica, Artmedica IPS, Medellín, Colombia; Departamento de Medicina Interna, Universidad CES, Medellín, Colombia
| | - Adriana Rojas-Villarraga
- Grupo de Información Clínica, Artmedica IPS, Medellín, Colombia; Fundación Universitaria de Ciencias de la Salud -FUCS, Bogotá, Colombia
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Falasinnu T, O'Shaughnessy MM, Troxell ML, Charu V, Weisman MH, Simard JF. A review of non-immune mediated kidney disease in systemic lupus erythematosus: A hypothetical model of putative risk factors. Semin Arthritis Rheum 2019; 50:463-472. [PMID: 31866044 DOI: 10.1016/j.semarthrit.2019.10.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 10/08/2019] [Accepted: 10/30/2019] [Indexed: 12/13/2022]
Abstract
About half of patients with systemic lupus erythematosus (SLE) are diagnosed with lupus nephritis (LN). Patients with SLE are also at increased risk for diabetes, hypertension and obesity, which together account for >70% of end-stage renal disease in the general population. The frequencies of non-LN related causes of kidney disease, and their contribution to kidney disease development and progression among patients with SLE have been inadequately studied. We hypothesize that a substantial, and increasing proportion of kidney pathology in patients with SLE might not directly relate to LN but instead might be explained by non-immune mediated factors such as diabetes, hypertension, and obesity. The goal of the manuscript is to draw attention to hypertension, diabetes and obesity as potential alternative causes of kidney damage in patients with SLE. Further, we suggest that misclassification of kidney disease etiology in patients with SLE might have important ramifications for clinical trial recruitment, epidemiologic investigation, and clinical care. Future studies aiming to elucidate and distinguish discrete causes of kidney disease - both clinically and histologically - among patients with SLE are desperately needed as improved understanding of disease mechanisms is paramount to advancing therapeutic discovery. Collaboration among rheumatologists, pathologists, nephrologists, and endocrinologists, and the availability of dedicated research funding, will be critical to the success of such efforts.
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Affiliation(s)
- Titilola Falasinnu
- Department of Health Research and Policy, Stanford University School of Medicine, 150 Governor's Lane Stanford, Palo Alto, CA 94305, United States
| | | | - Megan L Troxell
- Department of Pathology, Stanford University Medical Center, Palo Alto, CA. United States
| | - Vivek Charu
- Department of Pathology, Stanford University Medical Center, Palo Alto, CA. United States
| | - Michael H Weisman
- Division of Rheumatology, Cedars-Sinai Medical Center, David Geffen School of Medicine, UCLA, United States
| | - Julia F Simard
- Department of Health Research and Policy, Stanford University School of Medicine, 150 Governor's Lane Stanford, Palo Alto, CA 94305, United States; Division of Immunology and Rheumatology, Stanford University, Palo Alto, CA, United States.
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Munguia-Realpozo P, Mendoza-Pinto C, Sierra Benito C, Escarcega RO, Garcia-Carrasco M, Mendez Martinez S, Etchegaray Morales I, Galvez Romero JL, Ruiz-Arguelles A, Cervera R. Systemic lupus erythematosus and hypertension. Autoimmun Rev 2019; 18:102371. [DOI: 10.1016/j.autrev.2019.102371] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 04/02/2019] [Indexed: 01/01/2023]
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Abstract
Introduction: The metabolic syndrome (MetS) is now recognized as a chronic proinflammatory and prothrombotic state that aggravates insulin resistance, oxidative injury, and cardiovascular risk. MetS is more prevalent in patients with systemic lupus erythematosus (SLE), a prototype of systemic autoimmune disease associated with premature atherosclerosis that cannot be accounted by traditional vascular risk factors alone. Dysregulation of the cytokines and adipokines is a common feature in both SLE and MetS, suggesting a complex relationship among autoimmunity, obesity, inflammation, and atherosclerosis. Areas covered: This review summarizes the prevalence of MetS and its effect on cardiovascular outcome and organ damage in patients with SLE. The pathophysiology of MetS and its relevance to SLE is also briefly discussed. Expert opinion: Imbalance of adipokine production in MetS contributes to inflammation and atherosclerosis. MetS predisposes SLE patients to new cardiovascular events and vascular mortality, as well as the development of chronic kidney disease and diabetes mellitus. However, conflicting results have been reported in the literature regarding the levels of the proinflammatory leptin and anti-inflammatory adiponectin, and their relationship with disease activity in SLE patients. While lifestyle modifications and targeting dyslipidemia, hypertension and diabetes mellitus is essential, there is little information on the efficacy and safety of metformin and hydroxychloroquine in alleviating insulin resistance in SLE or MetS. Further research on adipokines in SLE and the role of anti-obesity medications and probiotics in MetS is necessary.
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Affiliation(s)
- Chi Chiu Mok
- a Department of Medicine , Tuen Mun Hospital , Hong Kong , SAR China
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18
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19
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Mobini M, Niksolat F, Mohammadpour RA, Dashti Dargahloo S, Marzban D. Metabolic syndrome in patients with systemic lupus erythematosus: Association with disease activity, disease damage and age. Int J Rheum Dis 2018; 21:1023-1030. [DOI: 10.1111/1756-185x.13276] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Maryam Mobini
- Department of Internal Medicine; Diabetes Research Center; Mazandaran University of Medical Sciences; Sari Iran
| | - Fatemeh Niksolat
- Department of Internal Medicine; Orthopedic Research Center; Mazandaran University of Medical Sciences; Sari Iran
| | - Reza Ali Mohammadpour
- Department of Biostatistics; Diabetes Research Center; Mazandaran University of Medical Sciences; Sari Iran
| | | | - Dorsa Marzban
- Faculty of Medicine; Mazandaran University of Medical Sciences; Sari Iran
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20
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Hallajzadeh J, Khoramdad M, Izadi N, Karamzad N, Almasi-Hashiani A, Ayubi E, Qorbani M, Pakzad R, Sullman MJM, Safiri S. The association between metabolic syndrome and its components with systemic lupus erythematosus: a comprehensive systematic review and meta-analysis of observational studies. Lupus 2018; 27:899-912. [PMID: 29301471 DOI: 10.1177/0961203317751047] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Based upon inflammatory-related factors in chronic systemic lupus erythematosus (SLE), as well as the long-term prescription of corticosteroids, metabolic syndrome (MetS) prevalence is expected to be higher in SLE patients than among those without SLE. The aim of this study was to systematically analyze: (1) the worldwide prevalence of MetS in patients with SLE using different criteria, (2) the risk of MetS in patients with SLE compared with those without SLE, and (3) the risk of MetS component in patients with SLE compared with healthy controls. METHODS We searched international databases, such as: Web of Science, Medline, PubMed, Scopus, Embase, CABI, CINAHL, DOAJ and Google Scholar. The articles which reported the prevalence of MetS in SLE patients, between 2006 and 2017, were included in the study if they had a: clear study design, study time and location, sound sampling approach and appropriate statistical analyses. Studies without sufficient data to determine the prevalence of MetS were excluded. Also, studies in patients suffering from other clinical diseases were not included. RESULTS The meta-analyses of the prevalence (40 studies (n = 6085)) and risk (20 studies (n = 2348)) of MetS in SLE patients were conducted separately. The pooled prevalence of MetS among SLE patients was found to be 26% (95% confidence interval (CI): 22-30%), but varied from 18% (95% CI: 11-25%) to 34% (95% CI: 25-42%), depending upon the diagnostic criteria used. The overall pooled odds ratio (OR) of MetS in SLE patients, compared with healthy controls, was (OR = 2.50; 95% CI: 1.86-3.35), but this ranged from (OR = 1.23; 95% CI: 0.61-2.49) to (OR = 10.71; 95% CI: 1.33-86.48), depending upon the criteria used. Also, the risk of high fasting blood sugar (FBS; OR = 1.59; 95% CI: 1.05-2.40), low high-density lipoprotein cholesterol (HDL-C; OR = 1.43; 95% CI: 1.02-2.01), high blood pressure (BP; OR = 2.76; 95% CI: 2.19-3.47), high triglycerides (TG; OR = 2.85; 95% CI: 2.05-3.95) and high waist circumference (WC; OR = 1.37; 95% CI: 0.97-1.94) were all found to be higher in SLE patients compared with healthy controls. CONCLUSIONS The risk of MetS was significantly higher in SLE patients, compared with healthy controls, even after adjusting for publication bias. Among MetS components, high TG and high BP were most strongly associated with SLE. Considering that high TG and high BP are preventable, there is an international need to implement effective interventions to reduce MetS components in SLE patients in order to prevent serious outcomes such as cardiovascular diseases and mortality.
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Affiliation(s)
- J Hallajzadeh
- Managerial Epidemiology Research Center, Department of Public Health, School of Nursing and Midwifery, 440826 Maragheh University of Medical Sciences , Maragheh, Iran
| | - M Khoramdad
- Department of Epidemiology and Biostatistics, Faculty of Health, 48464 Kermanshah University of Medical Sciences , Kermanshah, Iran
| | - N Izadi
- Department of Epidemiology, School of Public Health, 48486 Shahid Beheshti University of Medical Sciences , Tehran, Iran
| | - N Karamzad
- Nutrition Research Center, Department of Biochemistry and Diet Therapy, School of Nutrition and Food Sciences, 48432 Tabriz University of Medical Sciences , Tabriz, Iran
| | - A Almasi-Hashiani
- Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, 48499 Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - E Ayubi
- Department of Community Medicine, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
| | - M Qorbani
- Non-Communicable Diseases Research Center, 391934 Alborz University of Medical Sciences , Karaj, Iran
| | - R Pakzad
- Department of Epidemiology, Faculty of Health, 48443 Ilam University of Medical Sciences , Ilam, Iran
| | - M J M Sullman
- Department of Psychology, Middle East Technical University, Northern Cyprus Campus, Güzelyurt/Morphou, Northern Cyprus
| | - S Safiri
- Managerial Epidemiology Research Center, Department of Public Health, School of Nursing and Midwifery, 440826 Maragheh University of Medical Sciences , Maragheh, Iran.,Department of Epidemiology and Biostatistics, School of Public Health, 48439 Tehran University of Medical Sciences , Tehran, Iran
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Sun C, Qin W, Zhang YH, Wu Y, Li Q, Liu M, He CD. Prevalence and risk of metabolic syndrome in patients with systemic lupus erythematosus: A meta-analysis. Int J Rheum Dis 2017; 20:917-928. [PMID: 28851080 DOI: 10.1111/1756-185x.13153] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Chong Sun
- Department of Dermatology; First Hospital of China Medical University; Shenyang China
| | - Wen Qin
- Department of Obstetrics and Gynecology; Shan Dong University Hospital; Jinan China
| | - Yu-Hui Zhang
- Department of Dermatology; First Hospital of China Medical University; Shenyang China
| | - Yan Wu
- Department of Dermatology; First Hospital of China Medical University; Shenyang China
| | - Qian Li
- Department of Dermatology; First Hospital of China Medical University; Shenyang China
| | - Mei Liu
- Department of Dermatology; First Hospital of China Medical University; Shenyang China
| | - Chun-Di He
- Department of Dermatology; First Hospital of China Medical University; Shenyang China
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Effects of risk factors for and components of metabolic syndrome on the quality of life of patients with systemic lupus erythematosus: a structural equation modeling approach. Qual Life Res 2017; 27:105-113. [DOI: 10.1007/s11136-017-1689-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/19/2017] [Indexed: 01/09/2023]
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Liu S, Gong Y, Ren H, Zhang W, Chen X, Zhou T, Li X, Chen N. The prevalence, subtypes and associated factors of hyperuricemia in lupus nephritis patients at chronic kidney disease stages 1-3. Oncotarget 2017; 8:57099-57108. [PMID: 28915657 PMCID: PMC5593628 DOI: 10.18632/oncotarget.19051] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 06/20/2017] [Indexed: 11/25/2022] Open
Abstract
There is a high prevalence of hyperuricemia (HUA) in the chronic kidney disease (CKD) population. However, there's a dearth of research on HUA's prevalence, subtypes, early detection, and treatment strategies of HUA in lupus nephritis (LN) patients. The aim of this study is to address these knowledge gaps. LN patients presenting to the Department of Nephrology at Shanghai Rui Jin Hospital from January 2011 to January 2016 were recruited. The effective sample size was derived using the power analysis. The demographic, clinical and laboratory characteristics of the LN patients with HUA were compared with those of patients without HUA. Two statistical models for analyzing HUA were built and compared using the receiver operating characteristic (ROC) curve analysis. The total prevalence of HUA in the cohort was 40.11%. The subtypes of HUA included urate underexcretion-type, overproduction-type and combined-type, which proportion being 67.7%, 9.7% and 22.6% respectively. The CKD stage was closely associated with the prevalence of HUA in patients with LN. The other significant associated factors were hypertension, triglycerides, serum creatinine, serum albumin, hemoglobin, parathyroid hormone, phosphorus, calcium, etc. The statistical algorithm successfully identified LN patients at risk of HUA. In conclusion, there was a high prevalence of HUA in LN patients at CKD stages 1-3, and renal underexcretion hyperuricemia was the most prevalent subtype. The occurrence of HUA in LN may be related to renal insufficiency, metabolic disorder and lupus itself. Early care coordination programs can employ risk models to improve HUA prevention and target interventions in LN patients.
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Affiliation(s)
- Simeng Liu
- Department of Nephrology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | | | - Hong Ren
- Department of Nephrology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wen Zhang
- Department of Nephrology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaonong Chen
- Department of Nephrology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Tong Zhou
- Department of Nephrology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiao Li
- Department of Nephrology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Nan Chen
- Department of Nephrology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Sinicato NA, Postal M, de Oliveira Peliçari K, Rittner L, Marini R, Appenzeller S. Prevalence and features of metabolic syndrome in childhood-onset systemic lupus erythematosus. Clin Rheumatol 2017; 36:1527-1535. [DOI: 10.1007/s10067-017-3602-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2016] [Revised: 03/06/2017] [Accepted: 03/12/2017] [Indexed: 10/19/2022]
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Abstract
: Since the introduction of HMG-CoA reductase inhibitors, also known as statins, as an adjunct to diet in the treatment of hyperlipidemia and the greater emphasis placed on reducing low-density lipoprotein (LDL) cholesterol levels in the prevention of atherosclerosis and cardiovascular disease (CVD), there has been less focus on the value of lowering serum triglyceride levels. Many patients are aware of their "good" and "bad" cholesterol levels, but they may not be aware of their triglyceride level or of the association between high triglycerides and the development of CVD. In recent years, however, in light of the increasing incidences of obesity, insulin resistance, and type 2 diabetes, lowering triglyceride levels has gained renewed interest. In addition to the focus on lowering LDL cholesterol levels in CVD prevention, clinicians need to be aware of the role of triglycerides-their contribution to CVD, and the causes and treatment of hypertriglyceridemia.
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High Prevalence of Metabolic Syndrome in Patients with Discoid Lupus Erythematosus: A Cross-Sectional, Case-Control Study. J Immunol Res 2017; 2017:3972706. [PMID: 28127570 PMCID: PMC5239982 DOI: 10.1155/2017/3972706] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Accepted: 12/07/2016] [Indexed: 02/06/2023] Open
Abstract
Although it is known that systemic form of lupus erythematosus (LE) and metabolic syndrome (MetS) are frequently observed together, there are no published reports on MetS in patients with skin-restricted LE. We aimed to compare the frequencies of MetS and its components in discoid LE (DLE) with the non-DLE control group. Additionally, we intended to determine the differences of sociodemographic and clinical data of the DLE patients with MetS compared to the patients without MetS. This was a cross-sectional, case-control study, including 60 patients with DLE and 82 age- and gender-matched control subjects. In DLE group, the presence of MetS was observed as more frequent (48.3% versus 24.4%, p = 0.003), and hypertriglyceridemia (43.3% versus 22.0%, p = 0.006) and reduced HDL-cholesterol (61.7% versus 23.2%, p < 0.001) among the MetS components were found significantly higher when compared to the control group. DLE patients with MetS were at older age (50.45 ± 11.49 versus 43.06 ± 12.09, p = 0.02), and hypertension, hyperlipidemia/dyslipidemia, and cardiovascular disease histories were observed at a higher ratio when compared to the patients without MetS. Between the DLE patients with and without MetS, no significant difference was observed in terms of clinical characteristics of DLE. Moreover, further large case-control studies with follow-up periods would be required to clearly assess the impact of MetS on the clinical outcomes of DLE.
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