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巴西东北部系统性红斑狼疮患者队列中代谢综合征的患病率:与疾病活动、肾炎、吸烟和年龄的关联

Prevalence of metabolic syndrome in a cohort of systemic lupus erythematosus patients from Northeastern Brazil: association with disease activity, nephritis, smoking, and age.

作者信息

Medeiros Marta Maria das Chagas, Xavier de Oliveira Ídila Mont'Alverne, Ribeiro Ádilla Thaysa Mendes

机构信息

Department of Clinical Medicine, Federal University of Ceara, Fortaleza, Ceará, Brazil.

, Av. Litoranea 2040- Casa K2-1, Bairro Precabura, Eusébio, Ceará, CEP: 61760-000, Brazil.

出版信息

Rheumatol Int. 2016 Jan;36(1):117-24. doi: 10.1007/s00296-015-3316-z. Epub 2015 Jul 7.

DOI:10.1007/s00296-015-3316-z
PMID:26149124
Abstract

Systemic lupus erythematosus (SLE), an autoimmune inflammatory disease, is associated with an increased prevalence of accelerated atherosclerosis and cardiovascular events. Metabolic syndrome (MetS) is a set of cardiovascular risk factors in SLE patients, which may lead to a proinflammatory condition and increased morbidity and mortality. The objective of this study was to evaluate the prevalence of MetS in a cohort of SLE patients versus healthy controls, and to analyze the association of clinical and demographic factors. SLE patients (n = 146) treated at a Northeast Brazilian university hospital were evaluated with regard to demographic, clinical, laboratory, and anthropometric parameters and compared to controls (n = 101). MetS was diagnosed according to the definition of 2005 NCEP/ATP III. The average age of SLE patients was 41.7 ± 12.5 years, and 91.8 % were female. MetS was significantly more prevalent in SLE patients (45.2 %) than in controls (32.7 %; p = 0.04). The MetS components such as hypertension, diabetes, and hypertriglyceridemia were significantly more prevalent in SLE. In the univariate analysis, MetS in SLE patients was associated with age, disease duration, Systemic Lupus International Collaborating Clinics/American College of Rheumatology damage index, smoking, menopause, nephritis, cyclophosphamide use, prednisone dose, and chloroquine use, which appeared to have a protective effect. In the logistic regression analysis, age, disease activity, nephritis, and smoking were statistically significant. The prevalence of MetS observed in our cohort of SLE patients from Northeastern Brazil is higher than controls. MetS components should be routinely investigated to minimize the occurrence of MetS and associated cardiovascular morbidity and mortality.

摘要

系统性红斑狼疮(SLE)是一种自身免疫性炎症性疾病,与加速动脉粥样硬化和心血管事件的患病率增加有关。代谢综合征(MetS)是SLE患者中的一组心血管危险因素,可能导致促炎状态以及发病率和死亡率增加。本研究的目的是评估一组SLE患者与健康对照者中MetS的患病率,并分析临床和人口统计学因素之间的关联。对巴西东北部一家大学医院治疗的146例SLE患者进行了人口统计学、临床、实验室和人体测量学参数评估,并与101例对照者进行比较。根据2005年美国国家胆固醇教育计划成人治疗组第三次报告(NCEP/ATP III)的定义诊断MetS。SLE患者的平均年龄为41.7±12.5岁,91.8%为女性。MetS在SLE患者中的患病率(45.2%)显著高于对照组(32.7%;p=0.04)。SLE患者中高血压、糖尿病和高甘油三酯血症等MetS组分的患病率显著更高。在单因素分析中,SLE患者的MetS与年龄、病程、系统性红斑狼疮国际协作临床/美国风湿病学会损伤指数、吸烟、绝经、肾炎、环磷酰胺使用、泼尼松剂量和氯喹使用有关,氯喹使用似乎具有保护作用。在逻辑回归分析中,年龄、疾病活动度、肾炎和吸烟具有统计学意义。在我们来自巴西东北部的SLE患者队列中观察到的MetS患病率高于对照组。应常规调查MetS组分,以尽量减少MetS的发生以及相关的心血管发病率和死亡率。

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