Sinicato Nailú Angélica, Postal Mariana, de Oliveira Peliçari Karina, Rittner Leticia, Marini Roberto, Appenzeller Simone
Department of Pediatrics and PostgraduateProgram of Child and Adolescent Health, Faculty of Medical Science, State University of Campinas, Campinas, Brazil.
Rheumatology Unit, Department of Medicine, Faculty of Medical Science, State University of Campinas, Cidade Universitária, Campinas, SP, Brazil.
Clin Rheumatol. 2017 Jul;36(7):1527-1535. doi: 10.1007/s10067-017-3602-0. Epub 2017 Apr 19.
To estimate the prevalence and features of metabolic syndrome (MetS) in childhood-onset systemic lupus erythematosus (cSLE), we performed a cross-sectional study of 76 consecutive cSLE patients and 54 healthy controls, age and sex matched. All individuals were assessed for anthropometric and MetS features according to World Health Organization (WHO), NCEP Adult Treatment Panel III (NCEP-ATP III), and International Diabetes Federation (IDF) criteria. The cSLE patients were further assessed for clinical and laboratory manifestations, disease activity (Systemic Lupus Erythematosus Disease Activity Index), cumulative damage (Systemic Lupus International Collaborating Clinics (SLICC)), and current and cumulative drug exposures. Sixty-nine (90.8%) patients were female with mean age of 16.8 years [standard deviation (SD) ±4.0 years]. Mean disease duration was 4.8 years (SD ± 4.1). Based on the WHO MetS criteria, MetS was observed in two (2.6%) cSLE patients. We observed high prevalence of the MetS in cSLE patients according to NCEP-ATP III MetS criteria (18.4%) (p = 0.002) and according to IDF MetS criteria (17.1%) (p = 0.003). We did not observe MetS in the control group. No difference in cSLE patients <18 and ≥18 years was observed. We observed an association between the presence of MetS and SLICC scores in cSLE <18 years and cumulative corticosteroid dose adjusted by weight in cSLE ≥18 years. This study showed that MetS is frequently observed in cSLE using NCEP-ATP III MetS criteria and IDF MetS criteria. The identification of MetS is important to indicate cardiovascular morbidity and mortality in cSLE.
为评估儿童期起病的系统性红斑狼疮（cSLE）患者代谢综合征（MetS）的患病率及特征，我们对76例连续的cSLE患者和54例年龄及性别匹配的健康对照进行了一项横断面研究。根据世界卫生组织（WHO）、美国国家胆固醇教育计划成人治疗专家组第三次报告（NCEP-ATP III）以及国际糖尿病联盟（IDF）的标准，对所有个体进行人体测量学和MetS特征评估。对cSLE患者进一步评估其临床和实验室表现、疾病活动度（系统性红斑狼疮疾病活动指数）、累积损伤（系统性红斑狼疮国际协作临床诊所（SLICC））以及当前和累积药物暴露情况。69例（90.8%）患者为女性，平均年龄16.8岁[标准差（SD）±4.0岁]。平均病程为4.8年（SD±4.1）。根据WHO的MetS标准，在2例（2.6%）cSLE患者中观察到MetS。根据NCEP-ATP III的MetS标准，我们观察到cSLE患者中MetS的患病率较高（18.4%）（p = 0.002），根据IDF的MetS标准患病率为17.1%（p = 0.003）。在对照组中未观察到MetS。未观察到年龄＜18岁和≥18岁的cSLE患者之间存在差异。我们观察到年龄＜18岁的cSLE患者中MetS的存在与SLICC评分之间以及年龄≥18岁的cSLE患者中按体重调整的累积皮质类固醇剂量之间存在关联。本研究表明，使用NCEP-ATP III的MetS标准和IDF的MetS标准，在cSLE患者中经常观察到MetS。识别MetS对于提示cSLE患者的心血管发病率和死亡率很重要。
