Impact of early disease factors on metabolic syndrome in systemic lupus erythematosus: Data from an international inception cohort

Ben Parker, Murray B. Urowitz, Dafna D. Gladman, Mark Lunt, Rachelle Donn, Sang Cheol Bae, Jorge Sanchez-Guerrero, Juanita Romero-Diaz, Caroline Gordon, Daniel J. Wallace, Ann E. Clarke, Sasha Bernatsky, Ellen M. Ginzler, David A. Isenberg, Anisur Rahman, Joan T. Merrill, Graciela S. Alarcón, Barri J. Fessler, Paul R. Fortin, John G. HanlyMichelle Petri, Kristjan Steinsson, Mary Anne Dooley, Susan Manzi, Munther A. Khamashta, Rosalind Ramsey-Goldman, Asad A. Zoma, Gunnar K. Sturfelt, Ola Nived, Cynthia Aranow, Meggan Mackay, Manuel Ramos-Casals, Ronald F. Van Vollenhoven, Kenneth C. Kalunian, Guillermo Ruiz-Irastorza, S. Sam Lim, Diane L. Kamen, Christine A. Peschken, Murat Inanc, Ian N. Bruce

Research output: Contribution to journalArticlepeer-review

Abstract

Background The metabolic syndrome (MetS) may contribute to the increased cardiovascular risk in systemic lupus erythematosus (SLE). We examined the association between MetS and disease activity, disease phenotype and corticosteroid exposure over time in patients with SLE. Methods Recently diagnosed (>15 months) patients with SLE from 30 centres across 11 countries were enrolled into the Systemic Lupus International Collaborating Clinics (SLICC) Inception Cohort from 2000 onwards. Baseline and annual assessments recorded clinical, laboratory and therapeutic data. A longitudinal analysis of factors associated with MetS in the first 2 years of follow-up was performed using random effects logistic regression. Results We studied 1150 patients with a mean (SD) age of 34.9 (13.6) years and disease duration at enrolment of 24.2 (18.0) weeks. In those with complete data, MetS prevalence was 38.2% at enrolment, 34.8% at year 1 and 35.4% at year 2. In a multivariable random effects model that included data from all visits, prior MetS status, baseline renal disease, SLICC Damage Index <1, higher disease activity, increasing age and Hispanic or Black African race/ethnicity were independently associated with MetS over the first 2 years of follow-up in the cohort. Conclusions MetS is a persi stent phenotype in a significant proportion of patients with SLE. Renal lupus, active inflammatory disease and damage are SLE-related factors that drive MetS development while antimalarial agents appear to be protective from early in the disease course.

Original languageEnglish (US)
Pages (from-to)1530-1536
Number of pages7
JournalAnnals of the rheumatic diseases
Volume74
Issue number8
DOIs
StatePublished - Aug 1 2015

ASJC Scopus subject areas

  • Immunology and Allergy
  • Rheumatology
  • Immunology
  • Biochemistry, Genetics and Molecular Biology(all)

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