Background Patients affected by Systemic Lupus Erythematosus (SLE) show an increase in cardiovascular mortality and morbidity. The accelerated atherosclerosis observed in patients with SLE cannot be entirely explained by the traditional cardiovascular risk factors. Patients with SLE show increased subclinical atherosclerosis determined by an increased carotid arterial thickness, endothelial dysfunction and central arterial stiffness. Analysis of lipoproteins by magnetic nuclear resonance (MNR) provide information of those lipoproteins associated with sublcinial atherosclerosis in SLE.
Objectives To investigate the metabolic and immunological factors associated with the presence of central arterial stiffness determined by the Augmentation Index (AIx) as well as the detailed analysis of the lipid profile performed by magnetic nuclear resonance (MNR)
Methods Descriptive cross-sectional study of 69 women with SLE compared with a control group of 34 age matched healthy women. On the same day of the study, blood extraction, physical examination and augmentation index (AIx) obtained by Peripheral Arterial Tonometry were performed. The carotid intima-media thickness (IMTc) was also performed on the same day of the study to correlate the arterial stiffness with another subclinical atherosclerosis marker. Analysis of lipoprotein populations by NMR (Liposcale,Biosfer Teslab) were performed.
Results Patients with SLE showed significant increased arterial stiffness respect the control group (20.30 (21.54)% vs 10.84 (11.51)%, P=0.0021)The values of AIx were well correlated with Framingham risk score (r=0.486, P <0.001) as well as the IMTc (r=0.456, P<0.001). The classic cardiovascular risk factors associated with the AIx were the SBP levels (r=0.456, P<0.001) and age (r=0.456, P <0.001). Patients under antimalarial drugs showed significant decreased AIx (11.74 (11.28) vs 24.97 (20.63); P=0.024. Immunological variables associated with AIx were levels of C4 (r=0.259; P=0.046) and the IgM-β2-glycoprotein levels (r=0.284, P=0.284).As for the lipoprotein populations, AI values correlated with ApoB plasma levels, remnant particles, the number of large, medium and small VLDL particles, the number of small LDL particles and the number of small-dense HDL particles. In the multivariate analysis we found that age (β=0.377 (0.117–0.636), P=0.005) IgM-B2-GLP levels (β=0.303 (0.026–0.580),P=0.033) and the small-dense HDL particles (β=1,463 (0.605–2.322), P=0.001).
Conclusions SLE patients show increased central arterial stiffness respect healthy population. Patients treated with antamalarial drugs show lower arterial stifness. In multivariate analyses variables that predicted levels of AIx were age, levels of IgM-β2-glycoprotein and the number of small-dense HDL particles.
Disclosure of Interest None declared