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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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Fatemi A, Ghanbarian A, Sayedbonakdar Z, Kazemi M, Smiley A. Metabolic syndrome in Iranian patients with systemic lupus erythematosus and its determinants. Clin Rheumatol 2018; 37:1521-1528. [PMID: 29305669 DOI: 10.1007/s10067-017-3970-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 11/27/2017] [Accepted: 12/22/2017] [Indexed: 11/28/2022]
Abstract
The aim of this study was to determine the prevalence of metabolic syndrome (MetS) in Iranian patients with systemic lupus erythematosus (SLE) and its determinants. In a cross-sectional study, 98 patients with SLE and 95 controls were enrolled. Prevalence of MetS was determined based on American Heart Association and National Heart, Lung, and Blood Institute (AHA/NHLBI) and 2009 harmonizing criteria. In addition, demographic features and lupus characteristics such as disease duration, pharmacological treatment, laboratory data, SLE disease activity index (SLEDAI), and Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage index (SDI) were recorded. The predictors of MetS were obtained by backward stepwise regression analysis. Using AHA/NHLBI, MetS was observed in 35 (35.7%) patients and 28 (29.8%) controls (P = 0.4). Using harmonizing criteria, MetS was observed in 37 (37.7%) patients and 33 (35.1%) controls (P = 0.7). There was no difference in frequency distribution of MetS components between the patients and the controls. In multivariate regression analysis, low C3, blood urea nitrogen (BUN), and body mass index were independent determinants of MetS in lupus patients. BUN, low C3, and body mass index were the major determinants of MetS in lupus patients.
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Affiliation(s)
- Alimohammad Fatemi
- Department of Rheumatology, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Azadeh Ghanbarian
- Department of Internal Medicine, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Sayedbonakdar
- Department of Rheumatology, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mehdi Kazemi
- Department of Internal Medicine, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Abbas Smiley
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University, Bloomington, IN, USA
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Margiotta DPE, Basta F, Dolcini G, Batani V, Navarini L, Afeltra A. The relation between, metabolic syndrome and quality of life in patients with Systemic Lupus Erythematosus. PLoS One 2017; 12:e0187645. [PMID: 29112985 PMCID: PMC5675433 DOI: 10.1371/journal.pone.0187645] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2017] [Accepted: 10/23/2017] [Indexed: 11/20/2022] Open
Abstract
Introduction Systemic Lupus Erythematosus (SLE) is associated to an increased prevalence of Metabolic Syndrome (MeS) and to a reduction of Quality of Life (QoL). The aim of this study is to evaluate the association between MeS and QoL in SLE. Methods SLE patients were consecutively enrolled in a cross sectional study. MeS was defined according to IFD definition. Therapy with glucocorticoids (GC) and antimalarial was analyzed as cumulative years of exposure. We used a cut off of 7.5 mg of prednisone to define high daily dose of GC. QoL was quantified using SF-36. We used BDI and HAM-H to assess symptoms of mood disorders. Fatigue was evaluated using Facit-Fatigue, physical activity using IPAQ, sleep quality using PSQI and alexithymia using TAS-20. Results We enrolled 100 SLE patients. MeS prevalence was 34%. Patients with MeS presented reduced scores in SF-36 MCS and PCS compared to patients without MeS (p 0.03 and p 0.004). BDI and HAM-H score were significantly higher in patients meeting MeS criteria compared to subjects without MeS (p 0.004, p 0.02). These results were confirmed after adjustment for confounders. Compared to patients without MeS, those with MeS presented higher age, lower education level, higher recent SELENA-SLEDAI, higher number of flares, increased SDI, longer cumulative exposure to high dose GC and shorter duration of antimalarial therapy. In the multiple logistic regression model, the variable associated to the Odds Ratio of having MeS were: the average of recent SELENA-SLEDAI (OR 1.15 p 0.04), the years of exposure to high dose of GC (OR 1.18 p 0.004), the years of exposure to antimalarials (OR 0.82 p 0.03) and the BDI score (OR 1.1 p 0.005). Conclusion A modern management of SLE should not miss to take all the possible measures to ensure an adequate QoL to SLE patients, with particular attention to those affected by MeS.
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Affiliation(s)
| | - Fabio Basta
- Unit of Allergology, Clinical Immunology and Rheumatology, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Giulio Dolcini
- Unit of Allergology, Clinical Immunology and Rheumatology, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Veronica Batani
- Unit of Allergology, Clinical Immunology and Rheumatology, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Luca Navarini
- Unit of Allergology, Clinical Immunology and Rheumatology, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Antonella Afeltra
- Unit of Allergology, Clinical Immunology and Rheumatology, Università Campus Bio-Medico di Roma, Rome, Italy
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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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de Lima-Júnior JC, Lemos TM, Azevedo GD, Vilar MJ. Revisiting an unsolved problem – impact of SLICC criteria on the risk of metabolic syndrome. Lupus 2016; 25:1505-1506. [DOI: 10.1177/0961203316644332] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- J C de Lima-Júnior
- Department of Internal Medicine, University of Campinas, Campinas, Brazil
| | - T M Lemos
- Department of Clinical Biochemistry, Federal University of Rio Grande do Norte, Natal, Brazil
| | - G D Azevedo
- Department of Morphology, Federal University of Rio Grande do Norte, Natal, Brazil
| | - M J Vilar
- Department of Clinical Medicine, Federal University of Rio Grande do Norte, Natal, Brazil
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Hatef-Fard MR, Khodabandeh M, Sahebari M, Ghayour-Mobarhan M, Rezaieyazdi Z. Metabolic syndrome in lupus patients in northeast of Iran, and their lifestyle habits. CASPIAN JOURNAL OF INTERNAL MEDICINE 2016; 7:195-200. [PMID: 27757205 PMCID: PMC5062178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
BACKGROUND Systemic lupus erythematous is an autoimmune disease associated with atherosclerotic manifestations or metabolic disturbance due to inflammation. The aim of this study was to determine frequency of metabolic syndrome (MetS) in SLE compared to healthy controls. METHODS In this cross-sectional study, 150 SLE patients and 220 healthy volunteers were enrolled. MetS was diagnosed according to ATPIII criteria. Patients and controls were compared according to prevalence of MetS. In addition, SLE patients with and without MetS were compared according to laboratory parameters. Each patient also fulfilled a checklist about routine daily activities and diet program. Data were analyzed by SPSS-11 software. RESULTS MetS was significantly lower in SLE than healthy controls (18% vs 29.1%, P=0.015). Disease manifestations, major organ involvement, serum values of complements and anti-DNA antibody and pharmacological therapy did not correlate with MetS occurrence in patients. The mean TG, FBS, systolic and diastolic BP were statistically higher in lupus patients compared to healthy volunteers in contrast to waist circumference. HDL-cholesterol serum values did not show any significant difference between two groups. CONCLUSION It seems that despite higher values of blood pressure, serum lipids and glucose in lupus patients, the cumulative metabolic components were in a manner to make MetS more prevalent in healthy volunteers. As far as life habits are concerned, lupus patients in general did not exercise enough and did not go on a healthy diet despite of glucocorticoid therapy and hypertension.
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Affiliation(s)
- Mohammad Reza Hatef-Fard
- Rheumatic Diseases Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mina Khodabandeh
- School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maryam Sahebari
- Rheumatic Diseases Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.,Correspondence: Maryam Sahebari, Rheumatic Diseases Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. E-mail: , Tel: 0098 5138012753, Fax: 0098 5138012753
| | - Majid Ghayour-Mobarhan
- Biochemistry and Nutrition Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Zahra Rezaieyazdi
- Rheumatic Diseases Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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Medeiros MMDC, Xavier de Oliveira ÍM, Ribeiro ÁTM. Prevalence of metabolic syndrome in a cohort of systemic lupus erythematosus patients from Northeastern Brazil: association with disease activity, nephritis, smoking, and age. Rheumatol Int 2015; 36:117-24. [PMID: 26149124 DOI: 10.1007/s00296-015-3316-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Accepted: 06/26/2015] [Indexed: 01/21/2023]
Abstract
Systemic lupus erythematosus (SLE), an autoimmune inflammatory disease, is associated with an increased prevalence of accelerated atherosclerosis and cardiovascular events. Metabolic syndrome (MetS) is a set of cardiovascular risk factors in SLE patients, which may lead to a proinflammatory condition and increased morbidity and mortality. The objective of this study was to evaluate the prevalence of MetS in a cohort of SLE patients versus healthy controls, and to analyze the association of clinical and demographic factors. SLE patients (n = 146) treated at a Northeast Brazilian university hospital were evaluated with regard to demographic, clinical, laboratory, and anthropometric parameters and compared to controls (n = 101). MetS was diagnosed according to the definition of 2005 NCEP/ATP III. The average age of SLE patients was 41.7 ± 12.5 years, and 91.8 % were female. MetS was significantly more prevalent in SLE patients (45.2 %) than in controls (32.7 %; p = 0.04). The MetS components such as hypertension, diabetes, and hypertriglyceridemia were significantly more prevalent in SLE. In the univariate analysis, MetS in SLE patients was associated with age, disease duration, Systemic Lupus International Collaborating Clinics/American College of Rheumatology damage index, smoking, menopause, nephritis, cyclophosphamide use, prednisone dose, and chloroquine use, which appeared to have a protective effect. In the logistic regression analysis, age, disease activity, nephritis, and smoking were statistically significant. The prevalence of MetS observed in our cohort of SLE patients from Northeastern Brazil is higher than controls. MetS components should be routinely investigated to minimize the occurrence of MetS and associated cardiovascular morbidity and mortality.
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Affiliation(s)
- Marta Maria das Chagas Medeiros
- Department of Clinical Medicine, Federal University of Ceara, Fortaleza, Ceará, Brazil. .,, Av. Litoranea 2040- Casa K2-1, Bairro Precabura, Eusébio, Ceará, CEP: 61760-000, Brazil.
| | - Ídila Mont'Alverne Xavier de Oliveira
- Hospital Universitario Walter Cantidio, Federal University of Ceará, Fortaleza, Ceará, Brazil. .,, Av. Imperador 1772/504, Centro, Fortaleza, Ceará, CEP: 60015-051, Brazil.
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da Silva TF, Levy-Neto M, Bonfá E, Pereira RMR. High prevalence of metabolic syndrome in Takayasu arteritis: increased cardiovascular risk and lower adiponectin serum levels. J Rheumatol 2013; 40:1897-904. [PMID: 24037555 DOI: 10.3899/jrheum.130162] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE The prevalence of metabolic syndrome (MetS) tends to be high among rheumatic patients, and cardiovascular disease is the leading cause of death in these conditions. We aimed to determine the prevalence of MetS in patients with Takayasu arteritis (TA) and its association with risk factors and adipokine and cytokine levels. METHODS A cross-sectional study was conducted in 45 consecutive women with TA and 47 healthy controls matched by age and body mass index. RESULTS The prevalence of MetS (International Diabetes Federation/American Heart Association criteria) was higher in TA compared to controls (33.34 vs 8.51%, p = 0.003). Patients with TA had a higher frequency of hypertension (p < 0.001) and dyslipidemia (p = 0.001) and higher levels of insulin (p = 0.021), homeostasis model assessment index (p = 0.024), apolipoprotein E (p = 0.029), resistin (p = 0.018), and C-reactive protein (CRP, p < 0.001) compared to healthy subjects, with similar levels of adiponectin and plasminogen activator inhibitor-1 (PAI-1; p > 0.05). Further analysis of patients with TA with and without MetS revealed a higher frequency of overweight/obesity (66.66 vs 26.66%, p = 0.022), higher Framingham score ≥ 1 (p = 0.032), and lower adiponectin levels (20.37 ± 21.16 vs 38.64 ± 22.62 μg/ml, p = 0.022) in the patients with MetS. No differences were found regarding disease duration, activity, glucocorticoid use, resistin, and PAI-1 levels in the 2 groups of patients with TA (p > 0.05). Patients with and without MetS showed no differences in cytokine levels [interleukin 12 (IL-12, IL-1a, IL-6) and tumor necrosis factor-α]. IL-6 had a positive Pearson correlation with CRP only in TA patients with MetS (r = 0.57; p = 0.050). CONCLUSION A high prevalence of MetS was observed in patients with TA and this comorbidity seems to identify a subgroup of overweight/obese patients with high cardiovascular risk without a significant association with disease status. Further longitudinal studies are necessary to observe the effects of controlling this modifiable risk factor in the quality of life and survival of patients with TA.
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Affiliation(s)
- Thiago Ferreira da Silva
- From the Rheumatology Division, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
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RIZK A, GHEITA TA, NASSEF S, ABDALLAH A. The impact of obesity in systemic lupus erythematosus on disease parameters, quality of life, functional capacity and the risk of atherosclerosis. Int J Rheum Dis 2011; 15:261-7. [DOI: 10.1111/j.1756-185x.2011.01698.x] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Bellomio V, Spindler A, Lucero E, Berman A, Sueldo R, Berman H, Santana M, Molina MJ, Góngora V, Cassano G, Paira S, Saurit V, Retamozo S, Retamozo G, Alvarellos A, Caerio F, Alba P, Gotero M, Velozo EJ, Ceballos F, Soriano E, Catoggio L, García MA, Eimon A, Agüero S. Metabolic syndrome in Argentinean patients with systemic lupus erythematosus. Lupus 2010; 18:1019-25. [PMID: 19762406 DOI: 10.1177/0961203309105876] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
The objective was to determine the prevalence of the metabolic syndrome (MS) in patients with systemic lupus erythematosus (SLE) in Argentina, to assess the factors associated to it, and to compare the results with a control group with non-inflammatory disorders. The study included 147 patients with SLE and 119 controls. MS was defined according to criteria by the American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI) Scientific Statement. Demographic characteristics, Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) and Systemic Lupus International Collaborating Clinics/ACR Damage Index (SDI) were assessed as well as administration, maximum dose and cumulative dose of prednisone and hydroxychloroquine (HCQ). MS prevalence was 28.6% (CI 95%: 21.4-36.6) in patients with SLE and 16% in controls (P = 0.0019). Patients with SLE presented higher arterial hypertension frequency compared with controls (43 vs 25%, P = 0.007). When comparing lupus patients with MS (n = 41) and without MS (n = 106), no significant differences were observed regarding duration of the disease, SLEDAI or cumulative prednisone dose. Cumulative damage was associated independently with MS (OR 1.98; P = 0.021), whereas HCQ use was found to be protective (OR 0.13; P = 0.015). Patients with lupus presented higher MS prevalence than controls with non-inflammatory disorders, and occurrence of arterial hypertension was also higher. MS was associated with cumulative damage; the use of HCQ showed to be protective against presence of MS.
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Affiliation(s)
- V Bellomio
- Servicio de Reumatología, Hospital Angel Padilla, Universidad Nacional de Tucumán, Tucumán, Argentina
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Pereira RMR, de Carvalho JF, Bonfá E. Metabolic syndrome in rheumatological diseases. Autoimmun Rev 2009; 8:415-9. [DOI: 10.1016/j.autrev.2009.01.001] [Citation(s) in RCA: 79] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2009] [Accepted: 01/07/2009] [Indexed: 11/27/2022]
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