系统性红斑狼疮患者的动脉粥样硬化和肾脏疾病：一项横断面队列研究。
Atherosclerosis and renal disease involvement in patients with systemic lupus erythematosus: a cross-sectional cohort study.
机构信息
Copenhagen Lupus and Vasculitis Clinic, Center for Rheumatology and Spine Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
Department of Vascular Surgery, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
出版信息
Rheumatology (Oxford). 2018 Nov 1;57(11):1964-1971. doi: 10.1093/rheumatology/key201.
OBJECTIVE
To investigate the association between LN, renal function and atherosclerosis measured by coronary artery calcium (CAC) and carotid plaque in a cross-sectional study of patients with SLE.
METHODS
Presence of CAC and carotid plaque was measured in 147 SLE patients with and without LN. The patients were divided into four groups according to LN and renal function [by first quartile of estimated glomerular filtration rate (eGFR): 70 ml/min/1.73 m2]. Impaired renal function was defined by an eGFR <70 ml/min/1.73 m2. We used multivariate logistic regression models to explore the association between LN, renal function, CAC and carotid plaque.
RESULTS
Of the 147 SLE patients, 74 had LN. Median age of the study cohort was 46 years, 89% were women and median eGFR was 89 ml/min/1.73 m2. CAC score >0 was present in 57 (39%) and carotid plaque in 29 (20%) of the SLE patients. The presence of CAC and/or carotid plaque was highest in SLE patients with impaired renal function. Regression analyses showed that compared with SLE patients without LN and eGFR ⩾70 ml/min/1.73 m2 (reference group), only the combination of LN and impaired renal function was associated with the presence of CAC (odds ratio: 6.82, 95% CI: 1.59, 29; P = 0.01) and carotid plaque (odds ratio: 5.60, 95% CI: 1.19, 26; P = 0.03).
CONCLUSION
Our findings indicate that LN in combination with impaired renal function defined by an eGFR <70 ml/min/1.73 m2 is strongly associated with the presence of atherosclerosis in SLE.
目的
通过冠状动脉钙（CAC）和颈动脉斑块来研究狼疮性肾炎（LN）、肾功能和动脉粥样硬化之间的关系，该研究为横断面研究。
方法
对 147 例有或无 LN 的 SLE 患者进行 CAC 和颈动脉斑块检测。根据估计肾小球滤过率（eGFR）的第一四分位数（70 ml/min/1.73 m2），将患者分为 4 组：LN 且肾功能正常、LN 且肾功能异常、无 LN 且肾功能正常、无 LN 且肾功能异常。eGFR<70 ml/min/1.73 m2 定义为肾功能异常。我们采用多变量逻辑回归模型来探讨 LN、肾功能、CAC 和颈动脉斑块之间的关系。
结果
147 例 SLE 患者中 74 例患有 LN。研究队列的中位年龄为 46 岁，89%为女性，中位 eGFR 为 89 ml/min/1.73 m2。57 例（39%）SLE 患者 CAC 评分>0，29 例（20%）SLE 患者有颈动脉斑块。肾功能异常的 SLE 患者 CAC 和/或颈动脉斑块的发生率最高。回归分析显示，与无 LN 和 eGFR ⩾70 ml/min/1.73 m2 的 SLE 患者（参考组）相比，仅 LN 合并肾功能异常与 CAC（比值比：6.82，95%CI：1.59，29；P=0.01）和颈动脉斑块（比值比：5.60，95%CI：1.19，26；P=0.03）的存在相关。
结论
我们的研究结果表明，LN 合并 eGFR<70 ml/min/1.73 m2 定义的肾功能异常与 SLE 患者动脉粥样硬化的发生密切相关。
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