Metabolic Syndrome In Chinese Patients With Systemic Lupus Erythematosus

Background and objectiveSystemic lupus erythematosus (SLE) is a chronic systemic autoimmune inflammatory disease, with its hallmark of diversity of clinical presentation and the presence of diverse autoantibodies, especially antinuclear antibody. Deaths after 5 years of diagnosis are often the results of cardiovascular disease (CVD). The incidence of both atherosclerosis and CVD is higher in lupus patients compared with controls, often at a younger age, associated with inflammation, completment activation, renal disease and thrombosis. Researches from abroad showed higher incidence of metabolic syndrome (MeS) in lupus patients than in controlled group, and associations between MeS and CVD. But there is lack of relevant research about Chinese lupus patients, so our objective was to determine the prevalence of MeS in Chinese lupus patients, to analyse the factors associated to it, and to compare the results with a controlled group without inflammatory disorders.MethodsThis was a cross-sectional study involving 116 patients who fulfilled revised 1997 American College of Rheumatology criteria for SLE, without pregnancy, infection, or major organ failure. A control group matched for age, sex, without a previous history of inflammatory disorder was recruited from Medical Examination Department of The First Affliated Hospital of Zhengzhou University. MeS was defined according to the IDF/NHBIL/AHA/WHF/IAS/IASO Joint Scientific Statement definition of Chinese people. The incidence of MeS was compared in patients and controls, and the relationship between MeS and SLEDAI, lupus characteristics, cumulative dosage of prednisone, current dosage of prednisone and hydroxychloroquine use were assessed.Results(1) The incidence of MeS was higher in SLE patients than in controls(34.20% vs 14.80%, P<0.05). More patients presented with higher blood pressure, higher triglyceride and lower high density lipoprotein than controls(50.70% vs 34.80%, 27.80% vs 16.50%,46.60% vs 20.00%, P<0.05). (2) Lupus patients with MeS presented with higher waist circumference, body mass index, systolic blood pressure, diastolic blood pressure and lower high density lipoprotein than SLE without MeS(P <0.05). No significant difference was found regarding duration of disease, renal involvement, ESR, CRP, hsCRP, SLEDAI, cumulative dosage of prednisone and current dosage of prednisone between SLE patients with and without MeS. More SLE patients without MeS take hydroxychloroquine than patients with MeS (45.80% vs 16.00%, P< 0.05).Conclusions1. There was a high frequency of MeS in SLE patients.2. There was no association between the occurance of MeS and renal involvement, duration of disease, ESR, CRP, hsCRP, SLEDAI, cumulative dosage or current dosage of glucocorticoid in SLE.3. Hydroxychloroquine use may be protective against MeS in SLE.