Analyses On The Relative Factors Regarding Metabolic Syndrome In Systemic Lupus Erythematosus

Objective:To analyze the related factors regarding metabolic syndrome?MS?in systemic lupus erythematosus?SLE?.Methods:A total number of 1238 SLE patients in Yijishan Hospital of Wannan Medical College,Anhui province,from 2012 to 2017,were analyzed retrospectively.SLE patients with MS were grouped to group SLE-MS,the others without MS was grouped to group SLE-nMS.General characteristics,clinical signs,and laboratory parameters were then compared and related factors regarding MS in SLE.Results:The constituent ratio of metabolic syndrome was 27.14%?336/1238?.?1?Study subject demographics:There were no significant differences in gender and age(?²_gender=0.192,P=0.662,?²_age=5.391,P=0.145)between the SLE-MS group and the SLE-nMS group.More SLE patients with MS presented with more farmers??²=16.185,P=0.003?,more married people??²=11.766,P=0.003?,lower education level??²=72.793,P<0.001?than SLE patients without MS.?2?Comparison of clinical signs between SLE-MS group and SLE-nMS group:Body mass index?BMI??t=13.896,P<0.001?,SLE disease activity index?SLEDAI??Z=3.389,P=0.001?,systolic blood pressure?SBP??Z=12.888,P<0.001?and diastolic blood pressure?DBP??Z=12.438,P<0.001?in the SLE-MS group was statistically higher than that in the SLE-nMS group.The proportion of participants with lupus nephritis?LN???²=31.635,P<0.001?,arthritis??²=9.802,P=0.002?,proteinuria??²=9.802,P<0.001?,mouth ulcers??²=4.783,P=0.029?,cylindruria??²=15.063,P<0.001?and hematuria??²=10.815,P=0.001?in the SLE-MS group was statistically higher than that in the SLE-nMS group.There were no significant differences between SLE-MS and SLE-nMS in rash??²=1.966,P=0.161?,alopecia??²=3.235,P=0.072?,fever??²=1.935,P=0.164?,thrombocytopenia??²=2.835,P=0.092?,leukopenia??²=0.265,P=0.607?,headache??²=0.215,P=0.643?,epilepsy?P=0.353?,brain syndrome?P=0.264?,psychosis?P=0.396?,optic neuritis?P=0.217?,encephalitis?P=0.332?,cerebrovascular disease?P=0.271?and vasculitis?P=0.469?.?3?Comparison of laboratory parameters between SLE-MS group and SLE-nMS group:White blood cell count?WBC??Z=2.207,P=0.027?,mean red blood cell volume?MCV??Z=4.401,P<0.001?,red blood cell distribution width?RDW??Z=2.455,P=0.014?,urine microalbumin?Z=3.667,P<0.001?,urine red blood cell count?URBC??Z=3.667,P<0.001?,urinary tube type count?UTT??Z=3.559,P<0.001?,total protein?TP??Z=5.584,P<0.001?,triglyceride?TG??Z=10.677,P<0.001?,albumin?ALB??Z=4.242,P<0.001?,high density lipoprotein?HDL??Z=2.797,P=0.005?,globulin?GLB??Z=4.096,P<0.001?,low density lipoprotein?LDL??Z=2.627,P=0.009?,aspartate aminotransferase?AST??Z=2.163,P=0.031?,complement 3?C3??Z=2.000,P=0.045?,urea?UA??Z=7.833,P<0.001?,creatinine?CREA??Z=6.029,P<0.001?,immunoglobulin A?IgA??Z=2.258,P=0.024?,fasting blood glucose?GLU??t=5.857,P<0.001?,immunoglobulin G?IgG??Z=4.585,P<0.001?,total cholesterol?TC??Z=5.153,P<0.001?and 24h urine protein?UP24??Z=4.777,P<0.001?in SLE-MS group were statistically different from that in SLE-nMS group.There were no significant differences between SLE-MS and SLE-nMS in red blood cell count?RBC??Z=0.714,P=0.475?,neutrophil percentage?Z=0.175,P=0.861?,hemoglobin amount?Z=1.043,P=0.297?,hematocrit?Z=0.689,P=0.491?,platelet count?Z=0.351,P=0.726?,platelet distribution width?PDW??Z=0.469,P=0.639?,urine white blood cell count?UWBC??Z=1.423,P=0.155?,white ball ratio?WBR??Z=0.025,P=0.980?,c-reactive protein?CRP??Z=0.537,P=0.591?,alanine?Z=0.062,P=0.951?,complement4?C4??Z=0.248,P=0.804?,immunoglobulin M?IgM??Z=1.437,P=0.151?,immunoglobulin E?IgE??Z=0.733,P=0.464?,and erythrocyte sedimentation rate?ESR??Z=1.598,P=0.110?.?4?The dimensionality analysis by random forest algorithm shows that the variables ranked according to the importance importance scores are:BMI,SBP,DBP,fasting blood glucose,urine protein,arthritis,occupation,urea,triglyceride,educational level,high density lipoprotein,white blood cells,IgG,C3,low density lipoprotein,mean red blood cell volume,SLEDAI,globulin,immunoglobulin IgA,creatinine,lupus nephritis,24h urine protein,oral ulcer,alanine aminotransferase,red blood cell distribution width,albumin,total protein,proteinuria,hematuria,total cholesterol,urinary red blood cell count,urinary microalbumin,cast count,tubular urine,marital status.When the number of independent variables is 18,the error rate is the lowest.?5?Influencing factors regarding MS in SLE by binary logistic regression analysis:Data from multivariate logistic regression showed that MS in SLE was related with BMI[OR?95%CI?=1.557?1.334,1.818?],diastolic blood pressure[OR?95%CI?=1.073?1.037,1.110?],systolic blood pressure[OR?95%CI?=1.031?1.008,1.055?],fasting blood glucose[OR?95%CI?=3.813?2.537,5.730?],urea[OR?95%CI?=1.074?1.011,1.139?],triglycerides[OR?95%CI?=2.364?1.662,3.362?],high-density lipoprotein[OR?95%CI?=0.163?0.061,0.439?],and arthritis[OR?95%CI?=3.995?1.863,8.569?].Conclusion:1.A significant proportion of individuals in the SLE population have MS,effective control should be made for its risk factors.2.MS in SLE was related to farmers,married people and education level.3.For clinical signs,MS in SLE was related to BMI,SLEDAI,SBP,DBP,lupus nephritis?LN?,proteinuria,mouth ulcers,Cylindruria and hematuria.4.For physical examination and laboratory parameters,MS in SLE was related to WBC,MCV,RDW,urine microalbumin,URBC,UTT,TP,TG,ALB,HDL,GLB,LDL,AST,C3,UA,CREA,IgA,GLU,IgG,TC and UP24.5.These can provide a scientific reference for the clinical detection and prevention of MS in SLE patients.All in all,MS in SLE was closely related to BMI,blood pressure,blood sugar,blood lipids,arthritis.Targeted prevention and conclusion measures for the risk factors should be taken as early as possible.