Arthritis Research UK Epidemiology Unit, Institute of Inflammation and Repair, Manchester Academic Health Sciences Centre, The University of Manchester, Manchester, UK.
Ann Rheum Dis. 2013 Aug;72(8):1308-14. doi: 10.1136/annrheumdis-2012-202106. Epub 2012 Sep 3.
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.
The Systemic Lupus International Collaborating Clinics Registry for Atherosclerosis inception cohort enrolled recently diagnosed (<15 months) 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.
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 35.2 years (13.4) and 24.1 weeks (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.
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.
代谢综合征（MetS）可能会增加系统性红斑狼疮（SLE）患者的心血管风险。本研究旨在探讨人口统计学因素、狼疮表型和治疗暴露与 MetS 之间的关系。
系统性红斑狼疮国际合作临床研究协会动脉粥样硬化队列纳入了 2000 年以来来自 11 个国家 30 个中心的近 15 个月内确诊的 SLE 患者。根据标准化方案收集临床、实验室和治疗数据。根据 2009 年国际糖尿病联合会的共识声明定义 MetS。采用单变量和向后逐步多元逻辑回归评估个体变量与 MetS 的关系。
我们共研究了 1686 例患者，其中 1494 例（86.6%）有足够的数据来确定他们的 MetS 状态。入组时的平均（SD）年龄和疾病持续时间分别为 35.2 岁（13.4）和 24.1 周（18.0）。在入组时，239 例（16%）患者存在 MetS。在向后逐步多元回归分析中，更高的每日平均泼尼松剂量（mg）（OR 1.02，95%CI 1.00 至 1.03）、年龄较大（岁）（OR 1.04，95%CI 1.03 至 1.06）、韩国（OR 6.33，95%CI 3.68 至 10.86）和西班牙裔（OR 6.2，95%CI 3.78 至 10.12）种族、当前的肾脏疾病（OR 1.79，95%CI 1.14 至 2.80）和免疫抑制剂的使用（OR 1.81，95%CI 1.18 至 2.78）与 MetS 相关。
狼疮性肾炎、更高的皮质类固醇剂量、韩国和西班牙裔种族与 SLE 患者的 MetS 相关。因此，在 SLE 患者的个体化治疗决策中，应优先考虑平衡疾病控制和最小化皮质类固醇暴露。
