Background Against a background of urbanisation and widespread poverty, the prevalence of the metabolic syndrome (MetS) is increasing in South Africa, and atherosclerotic cardiovascular diseases are emerging as a major cause of mortality. Patients with systemic lupus erythematosus (SLE) are at increased risk of the MetS and its complications, but there are no published studies of the prevalence or associations of the MetS amongst sub-Saharan Africans with SLE.
Objectives To investigate the prevalence and associations of the MetS amongst recent-onset SLE patients.
Methods A cross-sectional study of baseline features of an inception cohort of recent onset (<5 years' disease duration) SLE patients. All patients met the SLICC SLE classification criteria and were attending the rheumatology clinic in a state-sector tertiary academic hospital. The MetS was defined by Joint Interim Statement criteria1.
Results Of 90 patients, the mean (SD) age was 36.7 (12.2) yrs, disease duration was 24.7 (22.9) months, 81 (87.8%) were female, and of these 67 (82.7%) were premenopausal. In terms of ethnicity, 70.0% were of mixed ethnic ancestry and 25.6% were Black Africans. Patients were of poor socio-economic status: 31.1% were unemployed, with a mean (SD) schooling of 10.2 (2.6) yrs. The mean (SD) SLEDAI score was 5.9 (3.4), and 94.4% were ANA positive, and 15 (16.7%) had lupus nephritis. The majority of patients were prescribed chloroquine (97.8%) and low dose corticosteroids (67.1%). The mean (SD) BMI was 26.2 (6.8) kg/m2, and 53.3% were smokers. The overall prevalence of MetS in this cohort was 33.3%, and increased waist circumference and reduced HDL- C were the most frequently observed features (Table). There was a trend toward more females having MetS (OR 0.2 (95%CI 0.02–1.4, p=0.09), but there was no association between the MetS and age, menopausal status, disease duration, ethnic group nor with SLEDAI score, presence of dsDNA, hypocomplementaemia, or with organ involvement including nephritis. Surprisingly, neither the use of corticosteroid or their dose was associated with MetS.
Conclusions South Africans with recently diagnosed SLE are at particularly high risk of atherosclerotic cardiovascular disease due to the high prevalence of the MetS and cigarette smoking. This calls for aggressive primary prevention strategies.
Alberti KG et al. Circulation 2009
Disclosure of Interest None declared
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.