Clinical associations of the metabolic syndrome in systemic lupus erythematosus: Data from an international inception cohort

Ben Parker, Murray B. Urowitz, Dafna D. Gladman, Mark Lunt, 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. Hanly, Michelle PetriKristjan 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, Raymond F. Van Vollenhoven, Kenneth C. Kalunian, Guillermo Ruiz-Irastorza, Sam Lim, Diane L. Kamen, Christine A. Peschken, Murat Inanc, Ian N. Bruce*

*Corresponding author for this work

Research output: Contribution to journalArticle

55 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1308-1314
Number of pages7
JournalAnnals of the Rheumatic Diseases
Volume72
Issue number8
DOIs
StatePublished - Aug 2013

ASJC Scopus subject areas

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

Fingerprint Dive into the research topics of 'Clinical associations of the metabolic syndrome in systemic lupus erythematosus: Data from an international inception cohort'. Together they form a unique fingerprint.

  • Cite this

    Parker, B., Urowitz, M. B., Gladman, D. D., Lunt, M., Bae, S. C., Sanchez-Guerrero, J., Romero-Diaz, J., Gordon, C., Wallace, D. J., Clarke, A. E., Bernatsky, S., Ginzler, E. M., Isenberg, D. A., Rahman, A., Merrill, J. T., Alarcón, G. S., Fessler, B. J., Fortin, P. R., Hanly, J. G., ... Bruce, I. N. (2013). Clinical associations of the metabolic syndrome in systemic lupus erythematosus: Data from an international inception cohort. Annals of the Rheumatic Diseases, 72(8), 1308-1314. https://doi.org/10.1136/annrheumdis-2012-202106