TY - JOUR
T1 - Clinical associations of the metabolic syndrome in systemic lupus erythematosus
T2 - Data from an international inception cohort
AU - Parker, Ben
AU - Urowitz, Murray B.
AU - Gladman, Dafna D.
AU - Lunt, Mark
AU - Bae, Sang Cheol
AU - Sanchez-Guerrero, Jorge
AU - Romero-Diaz, Juanita
AU - Gordon, Caroline
AU - Wallace, Daniel J.
AU - Clarke, Ann E.
AU - Bernatsky, Sasha
AU - Ginzler, Ellen M.
AU - Isenberg, David A.
AU - Rahman, Anisur
AU - Merrill, Joan T.
AU - Alarcón, Graciela S.
AU - Fessler, Barri J.
AU - Fortin, Paul R.
AU - Hanly, John G.
AU - Petri, Michelle
AU - Steinsson, Kristjan
AU - Dooley, Mary Anne
AU - Manzi, Susan
AU - Khamashta, Munther A.
AU - Ramsey-Goldman, Rosalind
AU - Zoma, Asad A.
AU - Sturfelt, Gunnar K.
AU - Nived, Ola
AU - Aranow, Cynthia
AU - MacKay, Meggan
AU - Ramos-Casals, Manuel
AU - Van Vollenhoven, Raymond F.
AU - Kalunian, Kenneth C.
AU - Ruiz-Irastorza, Guillermo
AU - Lim, Sam
AU - Kamen, Diane L.
AU - Peschken, Christine A.
AU - Inanc, Murat
AU - Bruce, Ian N.
PY - 2013/8
Y1 - 2013/8
N2 - Background The metabolic syndrome (MetS) may contribute to increased cardiovascular risk in systemic lupus erythematosus (SLE). We aimed to examine the association of demographic factors, lupus phenotype and therapy exposure with the presence of MetS. Methods The Systemic Lupus International Collaborating Clinics Registry for Atherosclerosis inception cohort enrolled recently diagnosed (<15 months) SLE patients from 30 centres across 11 countries from 2000. Clinical, laboratory and therapeutic data were collected according to a standardised protocol. MetS was defined according to the 2009 consensus statement from the International Diabetes Federation. Univariate and backward stepwise multivariate logistic regression were used to assess the relationship of individual variables with MetS. Results We studied 1686 patients, of whom 1494 (86.6%) had sufficient data to determine their MetS status. The mean (SD) age at enrolment and disease duration was 35.2 years (13.4) and 24.1 weeks (18.0), respectively. MetS was present at the enrolment visit in 239 (16%). In backward stepwise multivariable regression analysis, higher daily average prednisolone dose (mg) (OR 1.02, 95% CI 1.00 to 1.03), older age (years) (OR 1.04, 95% CI 1.03 to 1.06), Korean (OR 6.33, 95% CI 3.68 to 10.86) and Hispanic (OR 6.2, 95% CI 3.78 to 10.12) ethnicity, current renal disease (OR 1.79, 95% CI 1.14 to 2.80) and immunosuppressant use (OR 1.81, 95% CI 1.18 to 2.78) were associated with MetS. Conclusions Renal lupus, higher corticosteroid doses, Korean and Hispanic ethnicity are associated with MetS in SLE patients. Balancing disease control and minimising corticosteroid exposure should therefore be at the forefront of personalised treatment decisions in SLE patients.
AB - Background The metabolic syndrome (MetS) may contribute to increased cardiovascular risk in systemic lupus erythematosus (SLE). We aimed to examine the association of demographic factors, lupus phenotype and therapy exposure with the presence of MetS. Methods The Systemic Lupus International Collaborating Clinics Registry for Atherosclerosis inception cohort enrolled recently diagnosed (<15 months) SLE patients from 30 centres across 11 countries from 2000. Clinical, laboratory and therapeutic data were collected according to a standardised protocol. MetS was defined according to the 2009 consensus statement from the International Diabetes Federation. Univariate and backward stepwise multivariate logistic regression were used to assess the relationship of individual variables with MetS. Results We studied 1686 patients, of whom 1494 (86.6%) had sufficient data to determine their MetS status. The mean (SD) age at enrolment and disease duration was 35.2 years (13.4) and 24.1 weeks (18.0), respectively. MetS was present at the enrolment visit in 239 (16%). In backward stepwise multivariable regression analysis, higher daily average prednisolone dose (mg) (OR 1.02, 95% CI 1.00 to 1.03), older age (years) (OR 1.04, 95% CI 1.03 to 1.06), Korean (OR 6.33, 95% CI 3.68 to 10.86) and Hispanic (OR 6.2, 95% CI 3.78 to 10.12) ethnicity, current renal disease (OR 1.79, 95% CI 1.14 to 2.80) and immunosuppressant use (OR 1.81, 95% CI 1.18 to 2.78) were associated with MetS. Conclusions Renal lupus, higher corticosteroid doses, Korean and Hispanic ethnicity are associated with MetS in SLE patients. Balancing disease control and minimising corticosteroid exposure should therefore be at the forefront of personalised treatment decisions in SLE patients.
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U2 - 10.1136/annrheumdis-2012-202106
DO - 10.1136/annrheumdis-2012-202106
M3 - Article
C2 - 22945501
AN - SCOPUS:84880214160
SN - 0003-4967
VL - 72
SP - 1308
EP - 1314
JO - Annals of the rheumatic diseases
JF - Annals of the rheumatic diseases
IS - 8
ER -