Traditional and specific risk factors of atherosclerosis in patients with systemic lupus erythematosus
Amosova K.M. 1, Yaremenko O.B. 2, Matiyashchuk I.G. 3, Zaharova V.I.4, Minchenko P.P. 5
Summary. Summary. Objective — to study frequency and character of traditional and potentially specific risk factors of atherosclerosis (AS) development for systemic lupus erythematosus (SLE) and their prognostic significance.
Methods. 100 patients (pts) with SLE were examined (90 women and 10 men aged from 18 to 66 years old, the disease duration — 9.93±0.88 years) with low and mild disease activity and glucocorticoid (GC) therapy lasted not less than 1 year. We evaluated demographic and clinical-laboratory signs, as well as risk factors of AS depending on a presence (66 pts)/absence (34 pts) of AS signs, and also in pts with the set diagnosis of coronary heart disease (CHD) (21 pts). The control group consisted of 32 apparently healthy volunteers.
Results. Pts with AS and CHD were considerably older (by 1.7 and 2.4 times), had longer duration of SLE (by 1.9 and 2.4 times) and longer GC therapy duration compared with pts without AS signs. Pts with AS had significantly more frequent artherial hypertension (by 6 times), diabetes mellitus (only for pts with AS), obesity (by 2.3 times), atherogenic changes of lipid profile (increased triglycerides and atherogenic index), related to nervous system damage caused by SLE (by 3.1 time) and autoimmune thyreoiditis (by 2.7 time), these pts had by 1.6 time higher index of SLICC. The similar occurrence was revealed in pts with CHD. According to the results of the binary logistic regressive analysis, independent determinants significantly affecting the risk of AS in SLE pts are the age (р<0.001), body mass index (р=0.001), increased antibodies titre to ds-DNA (р=0.023), endoteliun-dependent vasodilation index (р=0.017), and «butterfly rash» (р=0.020). Calculation formula of probability of AS development in pts with SLE is given.
Conclusion. High frequency of potentially modified risk factors and their combination is typical for SLE pts. Calculation formula of probability of AS development in pts with SLE that includes 5 determinants may be used to select the pts who are recommended to undergo full complex of anti-atherosclerotic treatment-and-prophylactic actions, as well as regular monitoring for early AS diagnosis.