| Objectives:To investigate the characteristics of blood glucose and lipid and uric acid and analyze the high risk factors in systemic lupus erythematosus (SLE) complicated with atherosclerosis (AS).Methods:A total of112consecutive SLE patients, gender-matched100consecutive AS patients and100consecutive SLE patients complicating with AS were recruited in the Second Hospital of Shanxi Medical University between September2012and September2013. Another109consecutive healthy people served as controls (Con). The basic characteristics of the subjects in each group and the serum levels of glucose (GLU), triglyceride (TG), cholesterol (CHO), high density lipoproteinm (HDL), low density lipoprotein (LDL), apolipoprotein A (ApoA), apolipoprotein B (ApoB), apolipoprotein E (ApoE), lipoprotein a (LPa) and uric acid (UA) were compared. All variables significant on univariate analysis were entered into a multiple logistic regression model to ascertain the high risk factors on the complication of AS in SLE patients. The predictive value of these factors were evaluated by the receiver operating characteristic (ROC) curve.Results:1The basic characteristics of the subjects: The age in SLE group was significantly younger than SLE+AS group (P<0.01), which was younger than AS group (P<0.01). Patients in AS group had a significant higher blood pressure compared with other groups (P<0.05or P<0.01). SLE+AS patients suffered more serious hypertension than SLE patients (P<0.05).2The comparision of blood glucose and lipid in the subjects:The serum level of GLU was significantly lower in SLE+AS group compared with AS group (P <0.05). There was no statistical difference of TG in each group (P>0.05). The serum level of CHO was significantly higher in SLE+AS group compared with SLE group (P<0.01). The level of HDL was significantly lower in SLE, AS and SLE+AS group compared with Con group (P<0.01). The serum level of LDL was significantly higher in AS and SLE+AS group compared with SLE group (P<0.01and P<0.05).3The comparision of apolipoprotein, LPa and U A in the subjects: The serum level of ApoA was significantly lower in SLE and AS group compared with Con group (P<0.01), and significantly higher in SLE+AS group compared with SLE and AS group (P<0.01and P<0.05). The serum level of ApoB was significantly higher in AS and SLE+AS group compared with Con and SLE group (P<0.01), respectively. There was no statistical difference of ApoE in each group (P>0.05). The serum level of LPa was significantly higher in AS and SLE+AS group compared with SLE group (P<0.05). The serum level of UA was significantly higher in AS and SLE+AS group compared with Con and SLE group (P<0.05and P<0.01), respectively.4Linear correlation analysis:The serum level of CHO was positively correlated with ApoA, ApoB, LPa, HDL and LDL (P0.001, r=0.328,0.874,0.318,0.413and0.889, respectively), and also positively correlated with UA (r=0.118, P=0.015). The serum level of HDL was positively correlated with ApoA, ApoB, LDL and CHO (P <0.001, r=0.558,0.162,0.328, and0.413, respectively). The serum level of LDL was positively correlated with ApoA, ApoB, LPa, CHO and HDL (P<0.001, r=0.299,0.861,0.349,0.889and0.328, respectively).5Multiple logistic regression analysis:The result of multiple logistic regression analysis showed that age, CHO and UA were independent risk factors to predict complication of AS in SLE patients.6Evaluation of the predictive value by ROC cerve:Age≥35.5years had a best predictive value for complication of AS in SLE patients, the sensitivity and specificity was76.0%and65.8%, respectively. CHO concentration≥5.07mmol/L had a best predictive value for complication of AS in SLE patients, the sensitivity and specificity was88.0%and55.0%, respectively. UA concentration≥382μmol/L had a best predictive value for complication of AS in SLE patients, the sensitivity and specificity was61.0%and81.8%, respectively.Conclusions:1SLE patients have a tendency that development of AS in an earlier age. Patients with SLE, AS or SLE+AS have specific metabolic characteristics of blood glucose and lipid. SLE patients complicated with AS have significantly different levels of age, blood pressure, CHO, LDL, ApoA, ApoB, LPa and UA. Pearson correlation analysis demonstrates a relationship between blood lipid, apolipoprotein, LPa and UA. These indicators may play a critical role in the development of AS in SLE patients. 2Multiple logistic regression analysis indicates that age, CHO and UA are the independently predictive factors for complication of AS in SLE patients. ROC curve shows that Age≥35.5years, CHO concentration≥5.07mmol/L or UA concentration≥382μmol/L has a best predictive value for complication of AS in SLE patients. |
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