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Publication Detail
Impact of early disease factors on metabolic syndrome in systemic lupus erythematosus: data from an international inception cohort.
  • Publication Type:
    Journal article
  • Publication Sub Type:
    Journal Article
  • Authors:
    Parker B, Urowitz MB, Gladman DD, Lunt M, Donn R, Bae S-C, Sanchez-Guerrero J, Romero-Diaz J, Gordon C, Wallace DJ, Clarke AE, Bernatsky S, Ginzler EM, Isenberg DA, Rahman A, Merrill JT, Alarcón GS, Fessler BJ, Fortin PR, Hanly JG, Petri M, Steinsson K, Dooley MA, Manzi S, Khamashta MA, Ramsey-Goldman R, Zoma AA, Sturfelt GK, Nived O, Aranow C, Mackay M, Ramos-Casals M, van Vollenhoven RF, Kalunian KC, Ruiz-Irastorza G, Lim SS, Kamen DL, Peschken CA, Inanc M, Bruce IN
  • Publication date:
    08/2015
  • Pagination:
    1530, 1536
  • Journal:
    Ann Rheum Dis
  • Volume:
    74
  • Issue:
    8
  • Status:
    Published
  • Country:
    England
  • PII:
    annrheumdis-2013-203933
  • Language:
    eng
  • Keywords:
    Cardiovascular Disease, Inflammation, Systemic Lupus Erythematosus, Adult, Cohort Studies, Comorbidity, Female, Humans, Logistic Models, Lupus Erythematosus, Systemic, Male, Metabolic Syndrome, Middle Aged, Phenotype, Prevalence, Young Adult
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 persistent 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.
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