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

Parker, Ben; Urowitz, Murray B.; Gladman, Dafna D.; Lunt, Mark; Bae, Sang-Cheol; Sanchez-Guerrero, Jorge; Romero-Diaz, Juanita; Gordon, Caroline; Wallace, Daniel J. and Clarke, Ann E., et al. (2013) In Annals of the Rheumatic Diseases 72(8). p.1308-1314
Abstract
Background The metabolic syndrome (MetS) may contribute to increased cardiovascular risk in systemic lupus erythematosus (SLE). We aimed to examine the association of demographic factors, lupus phenotype and therapy exposure with the presence of MetS. Methods The Systemic Lupus International Collaborating Clinics Registry for Atherosclerosis inception cohort enrolled recently diagnosed (<15months) SLE patients from 30 centres across 11 countries from 2000. Clinical, laboratory and therapeutic data were collected according to a standardised protocol. MetS was defined according to the 2009 consensus statement from the International Diabetes Federation. Univariate and backward stepwise multivariate logistic regression were used to assess... (More)
Background The metabolic syndrome (MetS) may contribute to increased cardiovascular risk in systemic lupus erythematosus (SLE). We aimed to examine the association of demographic factors, lupus phenotype and therapy exposure with the presence of MetS. Methods The Systemic Lupus International Collaborating Clinics Registry for Atherosclerosis inception cohort enrolled recently diagnosed (<15months) SLE patients from 30 centres across 11 countries from 2000. Clinical, laboratory and therapeutic data were collected according to a standardised protocol. MetS was defined according to the 2009 consensus statement from the International Diabetes Federation. Univariate and backward stepwise multivariate logistic regression were used to assess the relationship of individual variables with MetS. Results We studied 1686 patients, of whom 1494 (86.6%) had sufficient data to determine their MetS status. The mean (SD) age at enrolment and disease duration was 35.2years (13.4) and 24.1weeks (18.0), respectively. MetS was present at the enrolment visit in 239 (16%). In backward stepwise multivariable regression analysis, higher daily average prednisolone dose (mg) (OR 1.02, 95% CI 1.00 to 1.03), older age (years) (OR 1.04, 95% CI 1.03 to 1.06), Korean (OR 6.33, 95% CI 3.68 to 10.86) and Hispanic (OR 6.2, 95% CI 3.78 to 10.12) ethnicity, current renal disease (OR 1.79, 95% CI 1.14 to 2.80) and immunosuppressant use (OR 1.81, 95% CI 1.18 to 2.78) were associated with MetS. Conclusions Renal lupus, higher corticosteroid doses, Korean and Hispanic ethnicity are associated with MetS in SLE patients. Balancing disease control and minimising corticosteroid exposure should therefore be at the forefront of personalised treatment decisions in SLE patients. (Less)
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published
subject
keywords
Systemic Lupus Erythematosus, Cardiovascular Disease, Inflammation, Epidemiology
in
Annals of the Rheumatic Diseases
volume
72
issue
8
pages
1308 - 1314
publisher
British Medical Association
external identifiers
  • wos:000321338400010
  • scopus:84880214160
ISSN
1468-2060
DOI
10.1136/annrheumdis-2012-202106
language
English
LU publication?
yes
id
43aad65a-d575-4e2f-8b70-4ef84403c5da (old id 3973242)
date added to LUP
2013-09-02 07:38:29
date last changed
2019-08-07 02:04:01
@article{43aad65a-d575-4e2f-8b70-4ef84403c5da,
  abstract     = {Background The metabolic syndrome (MetS) may contribute to increased cardiovascular risk in systemic lupus erythematosus (SLE). We aimed to examine the association of demographic factors, lupus phenotype and therapy exposure with the presence of MetS. Methods The Systemic Lupus International Collaborating Clinics Registry for Atherosclerosis inception cohort enrolled recently diagnosed (&lt;15months) SLE patients from 30 centres across 11 countries from 2000. Clinical, laboratory and therapeutic data were collected according to a standardised protocol. MetS was defined according to the 2009 consensus statement from the International Diabetes Federation. Univariate and backward stepwise multivariate logistic regression were used to assess the relationship of individual variables with MetS. Results We studied 1686 patients, of whom 1494 (86.6%) had sufficient data to determine their MetS status. The mean (SD) age at enrolment and disease duration was 35.2years (13.4) and 24.1weeks (18.0), respectively. MetS was present at the enrolment visit in 239 (16%). In backward stepwise multivariable regression analysis, higher daily average prednisolone dose (mg) (OR 1.02, 95% CI 1.00 to 1.03), older age (years) (OR 1.04, 95% CI 1.03 to 1.06), Korean (OR 6.33, 95% CI 3.68 to 10.86) and Hispanic (OR 6.2, 95% CI 3.78 to 10.12) ethnicity, current renal disease (OR 1.79, 95% CI 1.14 to 2.80) and immunosuppressant use (OR 1.81, 95% CI 1.18 to 2.78) were associated with MetS. Conclusions Renal lupus, higher corticosteroid doses, Korean and Hispanic ethnicity are associated with MetS in SLE patients. Balancing disease control and minimising corticosteroid exposure should therefore be at the forefront of personalised treatment decisions in SLE patients.},
  author       = {Parker, Ben and Urowitz, Murray B. and Gladman, Dafna D. and Lunt, Mark and Bae, Sang-Cheol and Sanchez-Guerrero, Jorge and Romero-Diaz, Juanita and Gordon, Caroline and Wallace, Daniel J. and Clarke, Ann E. and Bernatsky, Sasha and Ginzler, Ellen M. and Isenberg, David A. and Rahman, Anisur and Merrill, Joan T. and Alarcon, Graciela S. and Fessler, Barri J. and Fortin, Paul R. and Hanly, John G. and Petri, Michelle and Steinsson, Kristjan and Dooley, Mary-Anne and Manzi, Susan and Khamashta, Munther A. and Ramsey-Goldman, Rosalind and Zoma, Asad A. and Sturfelt, Gunnar and Nived, Ola and Aranow, Cynthia and Mackay, Meggan and Ramos-Casals, Manuel and van Vollenhoven, Raymond F. and Kalunian, Kenneth C. and Ruiz-Irastorza, Guillermo and Lim, Sam and Kamen, Diane L. and Peschken, Christine A. and Inanc, Murat and Bruce, Ian N.},
  issn         = {1468-2060},
  keyword      = {Systemic Lupus Erythematosus,Cardiovascular Disease,Inflammation,Epidemiology},
  language     = {eng},
  number       = {8},
  pages        = {1308--1314},
  publisher    = {British Medical Association},
  series       = {Annals of the Rheumatic Diseases},
  title        = {Clinical associations of the metabolic syndrome in systemic lupus erythematosus: data from an international inception cohort},
  url          = {http://dx.doi.org/10.1136/annrheumdis-2012-202106},
  volume       = {72},
  year         = {2013},
}