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AB0594 The Metabolic Syndrome in Chinese Patients with Systemic Lupus Erythematosus and Its Elevated Levels of Lipoprotein-Associated Phospholipase A2
  1. M. Qiu,
  2. Z. Hu,
  3. X. Guo,
  4. J. Gu
  1. Rheumatology, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China

Abstract

Background Metabolic Syndrome (MS) may contribute to increased cardiovascular risk in the population. Lipoprotein-associated phospholipase A2 (Lp-PLA2) is involved in the modification of lipids within atheromatous plaques. The increased prevalence of MS in SLE patients has been reported. However, few studies report the prevalence of MS in patients with SLE in southern China, and no study reveals its association with Lp-PLA2.

Objectives To investigate the prevalence and clinical features of MS in patients with SLE in southern China, and to evaluate its association with Lp-PLA2.

Methods 415 inpatients with SLE diagnosed in our Rheumatology Department from 2012 to 2014 were retrospectively investigated for their incidence of MS, compared with 830 age- and gender-matched general individuals. MS was defined according to the 2009 consensus statement of the International Diabetes Foundation.Data of medical records review, physical examination and laboratory tests were collected. Furthermore, SLE patients were classified according to the prevalence of MS. Plasma Lp-PLA2 level, SLE disease activity index (SLEDAI) and lupus characteristics were compared between SLE group with MS and SLE group without MS.

Results There were 140 patients with SLE presented MS. The prevalence of MS in the cohort was 33.73% (140/415), significantly higher than that of the matched controls (14.22%, 118/830, P<0.05), the same both in males (30.51% vs 20.0%) and females (34.27% vs 13.27%) (P<0.05). However, no significant difference was found regarding the incidence of MS between male and female groups with SLE (30.51% vs 34.27%, P>0.05). The MS component with the highest prevalence in the SLE population was low HDL-Cholesterol (<50mg/dL) with a prevalence of 58.60%. And the ratios of patients with higher TG, higher LDL-C and impaired fasting glucose in SLE group were 33.12%, 31.74% and 19.11% respectively. The incidence of MS in the age group (44 years old) with SLE was significantly higher than that of the age-matched controls (28.45% vs 10.37%, P<0.05), but we found no significant difference in the age ranges of both 45–64 years and 65 years (P>0.05). The plasma Lp-PLA2 level of SLE group with MS was significantly higher than that of SLE group without MS (497.40 vs 324.65, ng/ml, P<0.05), while neither SLEDAI nor renal involvement showed significant difference between these two SLE groups (P>0.05).

Conclusions Patients with SLE have a higher prevalence of metabolic syndrome, compared with the general population in southern China, characterized prominently by dyslipidemia. The Lp-PLA2 signatures may contribute to the increased cardiovascular risk in the SLE patients with MS. SLE patients should begin to pay attention to the occurrence of MS before 45 years old.

References

  1. Sabio JM, Zamora-Pasadas M, Jimenez-Jaimez J, et al. Metabolic syndrome in patients with systemic lupus erythematosus from Southern Spain. Lupus 2008;17:849–59.

  2. Serruys PW, García-García HM, Buszman P, et al. Effects of the direct lipoprotein associated phospholipase A (2) inhibitor darapladib on human coronary atherosclerotic plaque [J]. Circulation, 2008,118 (11): 1172-1182.

  3. Colley KJ,Wolfert RL,Cobble ME.Lipoprotein associated phospholipase A (2):role in atherosclerosis and utility as a biomarker for cardiovascular risk [J]. EPMA J,2011,2(1):27-38.

Disclosure of Interest None declared

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