Wang Yujiao, Guo Simin, Shi Yirui, Wei Xiaoquan, Chen Weiwei, Zhang Yaqi, Yuan Xinran, Sun Lingyun
Department of Rheumatology and Immunology, Nanjing Drum Tower Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing, China.
Department of Rheumatology and Immunology, Nanjing Drum Tower Hospital, Xuzhou Medical University, Nanjing, China.
Clin Rheumatol. 2025 May;44(5):1927-1937. doi: 10.1007/s10067-025-07413-z. Epub 2025 Mar 26.
Systemic lupus erythematosus (SLE) is associated with an elevated risk of atherosclerosis, with lupus nephritis (LN) representing a critical and potentially fatal target organ damage. This study aims to investigate the prevalence of LN in SLE patients, and its correlation with carotid atherosclerosis (CA).
A total of 151 SLE patients (age, 50.9 ± 14.6 years, 87.4% women) were included in the study. The 2024 KDIGO guideline was used to assess the LN prevalence, and carotid artery ultrasound was performed to identify plaque and intima-media thickness (IMT). The correlation between LN and CA in SLE patients was evaluated, and logistic regression analysis was conducted to identify CA risk factors.
A total of 47.0% of SLE patients exhibited LN, and the prevalence of CA was 37.7%. Patients with LN exhibited a higher carotid plaque ratio (47.9% vs 28.7%, p = 0.015) and IMT values [1.0(0.7, 1.1) mm vs. 0.8(0.7, 1.0) mm, p < 0.010] compared to those without LN. The presence of LN (p = 0.002), male sex (p = 0.039), age (p < 0.001), and serum TC (total cholesterol) (p = 0.016) were independent risk factors for SLE patients with CA. LN and related renal parameters demonstrated a strong association with CA in patients with SLE.
The prevalence of LN was significantly correlated with CA in SLE patients, indicating that early identification of LN in SLE patients has a high risk of CA, which may facilitate targeted prevention and reduce cardiovascular morbidity. Key Points • Lupus nephritis (LN) was present in 47.0% of systemic lupus erythematosus (SLE) patients, and carotid atherosclerosis (CA) was prevalent in 37.7% of the study. • Systemic lupus erythematosus (SLE) patients with lupus nephritis (LN) exhibited significantly higher carotid plaque ratios and increased intima-media thickness compared to those without LN. • The presence of lupus nephritis (LN), male sex, advanced age, and elevated total cholesterol levels was identified as independent risk factors for carotid atherosclerosis (CA) in patients with systemic lupus erythematosus (SLE).
系统性红斑狼疮（SLE）与动脉粥样硬化风险升高相关，狼疮性肾炎（LN）是一种关键且可能致命的靶器官损害。本研究旨在调查SLE患者中LN的患病率及其与颈动脉粥样硬化（CA）的相关性。
本研究共纳入151例SLE患者（年龄50.9±14.6岁，女性占87.4%）。采用2024年KDIGO指南评估LN患病率，并进行颈动脉超声检查以确定斑块和内膜中层厚度（IMT）。评估SLE患者中LN与CA的相关性，并进行逻辑回归分析以确定CA的危险因素。
共有47.0%的SLE患者患有LN，CA的患病率为37.7%。与无LN的患者相比，LN患者的颈动脉斑块比例更高（47.9%对28.7%，p = 0.015），IMT值也更高[1.0(0.7, 1.1)mm对0.8(0.7, 1.0)mm，p < 0.010]。LN的存在（p = 0.002）、男性（p = 0.039）、年龄（p < 0.001）和血清总胆固醇（TC）（p = 0.016）是SLE合并CA患者的独立危险因素。LN及相关肾脏参数在SLE患者中与CA密切相关。
SLE患者中LN的患病率与CA显著相关，表明早期识别SLE患者中的LN具有较高的CA风险，这可能有助于针对性预防并降低心血管疾病发病率。要点：• 47.0%的系统性红斑狼疮（SLE）患者存在狼疮性肾炎（LN），37.7%的研究对象存在颈动脉粥样硬化（CA）。• 与无狼疮性肾炎（LN）的系统性红斑狼疮（SLE）患者相比，患有狼疮性肾炎（LN）的患者颈动脉斑块比例显著更高，内膜中层厚度增加。• 狼疮性肾炎（LN）的存在、男性、高龄和总胆固醇水平升高被确定为系统性红斑狼疮（SLE）患者颈动脉粥样硬化（CA）的独立危险因素。
