Study of prevalence of metabolic syndrome in systemic lupus erythematosus patients in western India

Abstract

Systemic lupus erythematosus (SLE), a systemic autoimmune disease and Metabolic Syndrome (MetS), both confer a proinflammatory and pro-thrombotic state with role in coronary artery disease, hence, focussed CHD risk assessment is required in such patients. Establishing the contribution of SLE phenotype and therapeutic exposure to the development of MetS in SLE patients will yield important insights into pathophysiology of cardiovascular event and help in CHD risk stratification. Method: It is a cross-sectional observational study with 104 SLE patients in a tertiary care center. Having obtained appropriate permission and written informed consent; personal data, clinical history, general anthropometric and systemic examination are entered in the record form. Serological tests in the management of SLE and MetS are performed. Using appropriate statistical tests, association between presence of MetS and SLE and its variation with various parameters are determined. Results: Of the 104 SLE patients, 35 had MetS as per modified NCEP/ATP III criteria, higher the age more the risk. Longer disease duration and presence of lupus nephritis are significantly associated with MetS. Patients with MetS had higher disease accrual as measured by SLICC/ACR damage index. Positive anti-dsDNA and higher serum creatinine at presentation were associated with risk of MetS; whereas low C3 and high ESR were more frequent in patients without MetS. Patients with MetS had higher carotid artery intima-media thickness. Higher cumulative doses of steroids (IV pulse MPS and oral both) was associated with MetS. Conclusions: Screening for risk factors of MetS in SLE will help in identifying the risk for premature atherosclerotic cardiovascular disease for early intervention.