代谢综合征与狼疮性肾炎活动度之间的关联。
Association between metabolic syndrome and lupus nephritis activity.
作者信息
Rabrenović Violeta, Petrović Milica, Rabrenović Milorad, Rančić Nemanja
机构信息
Military Medical Academy, Clinic of Nephrology, Belgrade.
Military Medical Academy, Center for Hyperbaric Medicine, Belgrade.
出版信息
J Med Biochem. 2024 Jun 15;43(4):565-573. doi: 10.5937/jomb0-45732.
BACKGROUND
Metabolic syndrome (MetS) in patients with systemic lupus erythematosus (SLE) represents an additional burden and a poor prognostic factor for the onset or worsening of atherosclerosis and cardiovascular complications. In many patients with lupus nephritis (LN), MetS is often already manifested initially. Our work aimed to determine the frequency and characteristics of MetS in patients with LN, as well as the relationship components of MetS and characteristics of disease activity.
METHODS
The clinical study included 67 patients with LN, 54 (80.59%) female and 13 (19.41%) male, with an average age of 42.86±14.46 years. Patients were divided into two groups: with MetS (35.82%) and without MetS (64.18%), active LN had (34 or 50.74%), and LN in remission (33 or 49.25%). We monitored clinical and biochemical parameters of interest.
RESULTS
Comparing patients with LN collectively, as well as those with MetS and without MetS, we observed that patients with MetS were older (p=0.001), BMI (p<0.001), and systolic arterial pressure was higher (p=0.002), and smokers were more common in this group (p<0.001). In the analysis, increased triglycerides (p<0.001) and creatinine (p=0.027), and decreased albumin (p=0.050) and GFR (p=0.020) were observed in the group with MetS. MetS was present in 44.11% of patients with active LN and in 27.7% with LN in remission. The most common MetS parameter was arterial hypertension (76.6%), which correlated with GFR and creatinine; hypertriglyceridemia (47.8%), which is correlated with anti-ds-DNA Ab, erythrocyturia, proteinuria, and SLEDAI/r index; decreased HDL cholesterol (28.4%) which significantly correlated with albumin, C3 and anti-ds-DNA Ab.
CONCLUSIONS
In our patients with LN, MetS was associated with older age, impaired kidney function, and smoking. The most common parameter of MetS was arterial hypertension and dyslipidemia, which were significantly correlated with disease activity parameters, indicating an increased risk of cardiovascular complications in this group of patients.
背景
系统性红斑狼疮（SLE）患者的代谢综合征（MetS）是动脉粥样硬化和心血管并发症发生或恶化的额外负担及不良预后因素。在许多狼疮性肾炎（LN）患者中，MetS往往在疾病初期就已出现。我们的研究旨在确定LN患者中MetS的发生率和特征，以及MetS各组成成分与疾病活动特征之间的关系。
方法
临床研究纳入67例LN患者，其中女性54例（80.59%），男性13例（19.41%），平均年龄42.86±14.46岁。患者分为两组：患有MetS组（35.82%）和未患MetS组（64.18%），活动期LN患者34例（50.74%），缓解期LN患者33例（49.25%）。我们监测了相关的临床和生化参数。
结果
总体比较LN患者，以及患有和未患MetS的患者，我们观察到患有MetS的患者年龄更大（p=0.001），体重指数更高（p<0.001），收缩压更高（p=0.002），且该组吸烟者更常见（p<0.001）。分析发现，患有MetS的组中甘油三酯升高（p<0.001）、肌酐升高（p=0.027），白蛋白降低（p=0.050）和肾小球滤过率降低（p=0.020）。活动期LN患者中44.11%存在MetS，缓解期LN患者中27.7%存在MetS。最常见的MetS参数是动脉高血压（76.6%），其与肾小球滤过率和肌酐相关；高甘油三酯血症（47.8%），其与抗双链DNA抗体、红细胞尿、蛋白尿及SLEDAI/r指数相关；高密度脂蛋白胆固醇降低（28.4%），其与白蛋白、C3及抗双链DNA抗体显著相关。
结论
在我们的LN患者中，MetS与年龄较大、肾功能受损及吸烟有关。MetS最常见的参数是动脉高血压和血脂异常，它们与疾病活动参数显著相关，表明该组患者心血管并发症风险增加。
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