Rodríguez-Carrio J, Martínez-Zapico A, Cabezas-Rodríguez I, Benavente L, Pérez-Álvarez Á I, López P, Cannata-Andía J B, Naves-Díaz M, Suárez A
Area of Immunology, Department of Functional Biology, Faculty of Medicine, University of Oviedo, Oviedo, Spain; Bone and Mineral Research Unit, Instituto Reina Sofía de Investigación Nefrológica, REDinREN del ISCIII, Hospital Universitario Central de Asturias, Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain.
Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; Department of Internal Medicine, Hospital Universitario Central de Asturias, Oviedo, Spain.
Nutr Metab Cardiovasc Dis. 2019 Feb;29(2):135-143. doi: 10.1016/j.numecd.2018.09.007. Epub 2018 Oct 15.
Since accelerated atherosclerosis has been reported in systemic lupus erythematosus (SLE), predictive biomarkers of cardiovascular disease (CVD) are needed. Among non-traditional risk factors, bone mineral density (BMD) has been related to CVD. However, its role in SLE remains controversial. This study aims to analyze the associations of subclinical atherosclerosis with traditional and non-traditional CV risk factors.
In a cross-sectional study, atherosclerosis burden was compared between 112 female SLE patients and 31 controls. Plaque number and carotid intima-media wall thickness (cIMT) were assessed by ultrasonography. In a retrospective study, BMD determinations obtained 5-years before the ultrasonography assessment were analyzed in a subgroup of 62 patients. Plaque frequency was increased in SLE, even in patients without CV events or carotid wall thickening. cIMT was increased in patients with CVD, positively correlated with body mass index (BMI). Interestingly, a paradoxical effect of BMI on carotid parameters was observed. Whereas underweight patients (BMI < 20) showed increased prevalence of carotid plaques with low cIMT, those with BMI > 30 showed higher cIMT and plaque burden. Overweight patients (25 < BMI<30) exhibited both elevated cIMT and plaque number. BMI was an independent predictor of BMD. In our retrospective study, patients with either clinical or subclinical CVD exhibited lower BMD levels than their CV-free counterparts. A low lumbar spine BMD independently predicted CVD development after adjusting for confounders.
SLE was associated with a higher subclinical atherosclerosis burden, a bimodal effect being observed for BMI. Decreased BMD can be a CV risk biomarker in SLE.
由于系统性红斑狼疮（SLE）患者已被报道存在动脉粥样硬化加速的情况，因此需要心血管疾病（CVD）的预测生物标志物。在非传统风险因素中，骨密度（BMD）与CVD有关。然而，其在SLE中的作用仍存在争议。本研究旨在分析亚临床动脉粥样硬化与传统和非传统心血管风险因素之间的关联。
在一项横断面研究中，比较了112例女性SLE患者和31例对照者的动脉粥样硬化负担。通过超声评估斑块数量和颈动脉内膜中层厚度（cIMT）。在一项回顾性研究中，对62例患者亚组在超声评估前5年获得的骨密度测定结果进行了分析。SLE患者的斑块发生率增加，即使是没有心血管事件或颈动脉壁增厚的患者。CVD患者的cIMT增加，与体重指数（BMI）呈正相关。有趣的是，观察到BMI对颈动脉参数有矛盾的影响。体重过轻的患者（BMI < 20）显示颈动脉斑块发生率增加且cIMT较低，而BMI > 30的患者显示cIMT和斑块负担较高。超重患者（25 < BMI < 30）的cIMT和斑块数量均升高。BMI是骨密度的独立预测因子。在我们的回顾性研究中，有临床或亚临床CVD的患者的骨密度水平低于无心血管疾病的患者。调整混杂因素后，低腰椎骨密度可独立预测CVD的发生。
SLE与较高的亚临床动脉粥样硬化负担相关，BMI呈现双峰效应。骨密度降低可能是SLE中的一种心血管风险生物标志物。
