Similar progression of carotid intima–media thickness in 7-year surveillance of patients with mild SLE and controls, but this progression is still promoted by dyslipidaemia, lower HDL levels, hypertension, history of lupus nephritis and a higher prednisolone usage in patients
Objective To compare progression of subclinical atherosclerosis and factors promoting it in patients with SLE and controls.Methods Consecutive patients with SLE and age-matched, sex-matched population controls from the SLEVIC cohort were assessed at inclusion and after 7 years with standardised data...
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BMJ Publishing Group
2020-10-01
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| Series: | Lupus Science and Medicine |
| Online Access: | https://lupus.bmj.com/content/7/1/e000362.full |
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| author | Thomas Gustafsson Sofia Ajeganova Linnea Lindberg Ingiäld Hafström Johan Frostegård |
| author_facet | Thomas Gustafsson Sofia Ajeganova Linnea Lindberg Ingiäld Hafström Johan Frostegård |
| author_sort | Thomas Gustafsson |
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| description | Objective To compare progression of subclinical atherosclerosis and factors promoting it in patients with SLE and controls.Methods Consecutive patients with SLE and age-matched, sex-matched population controls from the SLEVIC cohort were assessed at inclusion and after 7 years with standardised data collection and carotid ultrasound. Effect of risk factors on carotid intima–media thickness (cIMT) progression was examined with adjusted linear mixed models.Results A total of 77 patients and 74 controls, 68% and 61% of the original cohort, completed follow-up. The patients were (mean) 47 years old, 90% were women, and controls were 51 years old, 92% women. Patients had disease duration of (mean) 11 years, mild disease activity and low severity at both assessments. Baseline cIMT did not differ between the groups. An average absolute cIMT progression was 0.009 mm/year in patients and 0.011 mm/year in controls, intergroup difference p=0.9.Of factors at inclusion, dyslipidaemia, lower levels of high-density lipoprotein (HDL) and carotid plaque in patients and controls, and higher systolic blood pressure, total cholesterol:HDL and LDL:HDL ratios and triglycerides in patients were associated with cIMT progression. Of factors at follow-up, hypertension and blood lipids in patients and HDL in controls were significantly associated with cIMT progression. History of lupus nephritis and a higher average dose of prednisolone used since diagnosis were associated with cIMT progression in patients. Associations of risk factors with cIMT progression were stronger in presence of plaques.Conclusion We observed a statistically comparable progression of cIMT in patients with mild SLE and controls over 7 years, which implies that progression of subclinical atherosclerosis in some patients with SLE could follow that of the general population. Traditional cardiovascular (CV) risk factors, history of lupus nephritis and higher use of corticosteroids promote cIMT progression in SLE. Detection of carotid plaque may add to CV risk stratification. |
| format | Article |
| id | doaj-art-5e5ca5988cd04bf290309d4438189845 |
| institution | Kabale University |
| issn | 2053-8790 |
| language | English |
| publishDate | 2020-10-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | Lupus Science and Medicine |
| spelling | doaj-art-5e5ca5988cd04bf290309d44381898452024-12-16T09:40:09ZengBMJ Publishing GroupLupus Science and Medicine2053-87902020-10-017110.1136/lupus-2019-000362Similar progression of carotid intima–media thickness in 7-year surveillance of patients with mild SLE and controls, but this progression is still promoted by dyslipidaemia, lower HDL levels, hypertension, history of lupus nephritis and a higher prednisolone usage in patientsThomas Gustafsson0Sofia Ajeganova1Linnea Lindberg2Ingiäld Hafström3Johan Frostegård43Dept. Laboratory Medicine, Karolinska Institutet, Stockholm17 Department of Rheumatology, UZ Brussel, Brussel, Belgium3 Division of Clinical Physiology, Department of Laboratory Medicine and Unit of Clinical Physiology, Karolinska University Hospital, Stockholm, SwedenKarolinska Institutet, Stockholm, SwedenSection of Immunology and Chronic Disease, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, SwedenObjective To compare progression of subclinical atherosclerosis and factors promoting it in patients with SLE and controls.Methods Consecutive patients with SLE and age-matched, sex-matched population controls from the SLEVIC cohort were assessed at inclusion and after 7 years with standardised data collection and carotid ultrasound. Effect of risk factors on carotid intima–media thickness (cIMT) progression was examined with adjusted linear mixed models.Results A total of 77 patients and 74 controls, 68% and 61% of the original cohort, completed follow-up. The patients were (mean) 47 years old, 90% were women, and controls were 51 years old, 92% women. Patients had disease duration of (mean) 11 years, mild disease activity and low severity at both assessments. Baseline cIMT did not differ between the groups. An average absolute cIMT progression was 0.009 mm/year in patients and 0.011 mm/year in controls, intergroup difference p=0.9.Of factors at inclusion, dyslipidaemia, lower levels of high-density lipoprotein (HDL) and carotid plaque in patients and controls, and higher systolic blood pressure, total cholesterol:HDL and LDL:HDL ratios and triglycerides in patients were associated with cIMT progression. Of factors at follow-up, hypertension and blood lipids in patients and HDL in controls were significantly associated with cIMT progression. History of lupus nephritis and a higher average dose of prednisolone used since diagnosis were associated with cIMT progression in patients. Associations of risk factors with cIMT progression were stronger in presence of plaques.Conclusion We observed a statistically comparable progression of cIMT in patients with mild SLE and controls over 7 years, which implies that progression of subclinical atherosclerosis in some patients with SLE could follow that of the general population. Traditional cardiovascular (CV) risk factors, history of lupus nephritis and higher use of corticosteroids promote cIMT progression in SLE. Detection of carotid plaque may add to CV risk stratification.https://lupus.bmj.com/content/7/1/e000362.full |
| spellingShingle | Thomas Gustafsson Sofia Ajeganova Linnea Lindberg Ingiäld Hafström Johan Frostegård Similar progression of carotid intima–media thickness in 7-year surveillance of patients with mild SLE and controls, but this progression is still promoted by dyslipidaemia, lower HDL levels, hypertension, history of lupus nephritis and a higher prednisolone usage in patients Lupus Science and Medicine |
| title | Similar progression of carotid intima–media thickness in 7-year surveillance of patients with mild SLE and controls, but this progression is still promoted by dyslipidaemia, lower HDL levels, hypertension, history of lupus nephritis and a higher prednisolone usage in patients |
| title_full | Similar progression of carotid intima–media thickness in 7-year surveillance of patients with mild SLE and controls, but this progression is still promoted by dyslipidaemia, lower HDL levels, hypertension, history of lupus nephritis and a higher prednisolone usage in patients |
| title_fullStr | Similar progression of carotid intima–media thickness in 7-year surveillance of patients with mild SLE and controls, but this progression is still promoted by dyslipidaemia, lower HDL levels, hypertension, history of lupus nephritis and a higher prednisolone usage in patients |
| title_full_unstemmed | Similar progression of carotid intima–media thickness in 7-year surveillance of patients with mild SLE and controls, but this progression is still promoted by dyslipidaemia, lower HDL levels, hypertension, history of lupus nephritis and a higher prednisolone usage in patients |
| title_short | Similar progression of carotid intima–media thickness in 7-year surveillance of patients with mild SLE and controls, but this progression is still promoted by dyslipidaemia, lower HDL levels, hypertension, history of lupus nephritis and a higher prednisolone usage in patients |
| title_sort | similar progression of carotid intima media thickness in 7 year surveillance of patients with mild sle and controls but this progression is still promoted by dyslipidaemia lower hdl levels hypertension history of lupus nephritis and a higher prednisolone usage in patients |
| url | https://lupus.bmj.com/content/7/1/e000362.full |
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