Background Cardiovascular disease (CVD) is a major cause of death in systemic lupus erythematosus (SLE) patients. Obesity is an additional risk factor for cardiovascular disease that appears to be more prevalent in SLE population

Objectives We aimed to determine whether overweight (defined as a BMI>25) contributed to subclinical atherosclerosis in SLE patients at low risk for CVD according to traditional factors.

Methods Internal carotid wall thickness (ICWT) and carotid plaques were prospectively assessed, as a measure of subclinical atherosclerosis, in 49 SLE patients asymptomatic for CVD and 49 controls matched on Framingham score. Factors associated to ICWT were identified in SLE patients and in controls and multiple linear regression (multivariate analysis) was performed.

Results SLE patients and controls displayed a low 10-year risk for CVD according to Framingham score (mean 1.9±3.5 in SLE vs 1.8±3.2% in controls, p=0.37). ICWT (1.3±0.6 vs 1±0.3mm, p=0.0007) and number of patients with carotid plaques (18.4% vs 2.0%, p=0.015) were however higher in SLE patients as compared to controls. In multivariable analysis, SLE was an independent the risk for a carotid plaque (OR [95%CI]: 3.53 [1.36 - 9.14]; p=0.009 as compared to controls). Older age, higher body mass index (BMI) and higher Framingham score were associated with atherosclerosis in SLE patients in univariate analysis. In multivariate analysis, only the association with overweight (i.e. BMI>25kg/m²) remained significant (OR [95%CI]: 4.13 [1.02 - 16.75]; p=0.047).

Conclusions Overweight is an independent contributor to atherosclerosis in systemic lupus erythematosus. Identifying SLE patients at a higher risk for CVD is mandatory. Body weight control should be a specific target in clinical practice in order to prevent the occurrence of atherosclerosis and its deleterious consequences in patients with SLE.

Disclosure of Interest None declared