Rheumatology Department, RinggoldID:280155Hospital Nacional Guillermo Almenara Irigoyen, Lima, Perú.
187071Universidad Científica del Sur, Lima, Perú.
Lupus. 2022 Jan;31(1):105-109. doi: 10.1177/09612033211061481. Epub 2022 Jan 6.
This study aims to determine whether the MetS predicts damage accrual in SLE patients.
This longitudinal study was conducted in a cohort of consecutive SLE patients seen since 2012 at one single Peruvian institution. Patients had a baseline visit and then follow-up visits every 6 months. Patients with ≥ 2 visits were included. Evaluations included interview, medical records review, physical examination, and laboratory tests. Damage accrual was ascertained with the SLICC/ACR damage index (SDI) and disease activity with the SLEDAI-2K. Univariable and multivariable Cox-regression survival models were carried out to determine the risk of developing new damage. The multivariable model was adjusted for age at diagnosis; disease duration; socioeconomic status; SLEDAI; baseline SDI; the Charlson Comorbidity Index; daily dose; and time of exposure of prednisone (PDN), antimalarials, and immunosuppressive drugs.
Two hundred and forty-nine patients were evaluated; 232 of them were women (93.2%). Their mean (SD) age at diagnosis was 35.8 (13.1) years; nearly all patients were Mestizo. Disease duration was 7.4 (6.6) years. The SLEDAI-2K was 5.2 (4.3) and the SDI, 0.9 (1.3). One hundred and eight patients (43.4%) had MetS at baseline. During follow-up, 116 (46.6%) patients accrued at least one new point in the SDI damage index. In multivariable analyses, the presence of MetS was a predictor of the development of new damage (HR: 1.54 (1.05-2.26); < 0.029).
The presence of MetS predicts the development of new damage in SLE patients, despite other well-known risk factors for such occurrence.
本研究旨在确定代谢综合征（MetS）是否可预测系统性红斑狼疮（SLE）患者的器官损害累积。
这是一项在秘鲁某单一机构自 2012 年开始连续入组 SLE 患者的纵向研究。患者在基线时有一次就诊，随后每 6 个月随访一次。有≥2 次就诊的患者被纳入。评估包括访谈、病历回顾、体格检查和实验室检查。采用 SLICC/ACR 损害指数（SDI）确定器官损害累积，采用 SLEDAI-2K 确定疾病活动度。采用单变量和多变量 Cox 回归生存模型确定发生新损害的风险。多变量模型调整了诊断时的年龄、疾病持续时间、社会经济状况、SLEDAI、基线 SDI、Charlson 合并症指数、每日剂量以及泼尼松（PDN）、抗疟药和免疫抑制剂的暴露时间。
共评估了 249 例患者，其中 232 例（93.2%）为女性。她们诊断时的平均（SD）年龄为 35.8（13.1）岁；几乎所有患者均为梅斯蒂索人。疾病持续时间为 7.4（6.6）年。SLEDAI-2K 为 5.2（4.3），SDI 为 0.9（1.3）。108 例（43.4%）患者基线时存在 MetS。随访期间，116 例（46.6%）患者的 SDI 损害指数至少增加了 1 分。多变量分析显示，MetS 的存在是发生新损害的预测因素（HR：1.54（1.05-2.26）； < 0.029）。
尽管存在其他已知的发生这种情况的危险因素，但 MetS 的存在可预测 SLE 患者发生新的器官损害。
