RISK FACTORS AND SUBCLINICAL MANIFESTATIONS OF ATHEROSCLEROSIS IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS
Summary. Aim of the study — to assess the relationship between global and additional risk factors and subclinical manifestations of atherosclerosis in patients with SLE.Methods: all patients undergone general clinical examination, total cholesterol (TC) and triglycerides (TG) in serum were measured, determination of endothelium dependent vasodilation (EDVD), the results of tests with reactive hyperemia, the thickness of intima-media complex (IMT), risk assessment of fatal cardiovascular vascular events according SCORE scale were estimated, statistical methods were used. We examined 30 SLE patients with I and II disease activity, prolonged corticosteroids use for at least 1 year. 25 women and 5 men aged 30 to 59 years, mean duration of illness — 85.9±8.38 months were enrolled into the study. 293 persons of the rural labor force were the Control group, matched by sex and age with the main group.Results: it was found that in SLE patients among traditional risk factors for obesity (in 56.7% cases), hypertension (67%) and dyslipidemia (50% cases) are in priority. Compared with a control group SLE patients frequently had abdominal obesity (70% patients, in the control group — 64.8%, respectively), increased rates of total cholesterol and triglycerides (50% and 10% respectively in the control group — 46% and 9 %, respectively). In determining the subclinical manifestations of atherosclerosis, it was found that 33.3% cases reactive hyperemia was initiated, 53.3% of patients had increased IMT. At the same time, according to the results received cardiovascular risk in patients with SLE estimated by the traditional risk factors, averaged in 1,0±0,89%, which was considered as low risk, in the control group the rate was 2,67±0,36% respectively.Conclusions: the cardiovascular risk in patients with SLE, estimated by the classic risk factors, does not exceed population level. At the same time, these patients showed signs of subclinical atherosclerosis and a direct correlation between of cardiovascular risk level and measure of IMT, reactive hyperemia. Therefore it is possible that additional factors are responsible for the increased risk of cardiovascular events in SLE patients, which requires further investigations.
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