Excess atherosclerosis in systemic lupus erythematosus,-A matter of renal involvement: Case control study of 281 SLE patients and 281 individually matched population controls
Excess atherosclerosis in systemic lupus erythematosus,-A matter of renal involvement: Case control study of 281 SLE patients and 281 individually matched population controls
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DOI：
10.1371/journal.pone.0174572
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发表时间：
2017-04-17
期刊：
影响因子：
3.7
通讯作者：
Svenungsson, Elisabet
中科院分区：
文献类型：
--
作者：
Gustafsson, Johanna T.;Lindberg, Marie Herlitz;Svenungsson, Elisabet
背景系统性红斑狼疮（SLE）是一种异质性疾病，主要影响年轻女性（90%）。系统性红斑狼疮与一般人群的预期寿命相比较短。据报道，标准化死亡率 (SMR) 为 2.4，与糖尿病相当。在现代社会，心血管疾病（CVD）是过早死亡的主要原因。通常认为加速动脉粥样硬化是 SLE 相关 CVD 的根本原因。然而，先前的研究对于动脉粥样硬化在系统性红斑狼疮中是否比对照组更常见存在分歧。考虑到这一点并根据自己的临床经验，我们假设加速动脉粥样硬化不是 SLE 的一般特征，而是在 SLE 亚组中普遍存在。方法对 281 名 SLE 患者和 281 名年龄和性别匹配的人群对照进行临床调查。收集空腹血样和危险因素数据。所有参与者均接受颈动脉 B 型超声检查。记录颈动脉斑块的发生和平均内膜中层厚度（mIMT）。先前描述的两个 SLE 亚组具有高 CVD 风险； 1) 肾炎患者和 2) 抗磷脂抗体 (aPL) 患者，以及据报道 CVD 风险相对较低的一个亚组；干燥综合征抗原 A/B (SSA/SSB) 抗体阳性的患者与各自的匹配对照进行了单独分析。结果中位年龄为 49 (IQR 36-59) 岁，93% 为女性。明显的CVD；缺血性心、脑和周围血管疾病在患者中普遍存在（12% vs. 1%，p
BackgroundSystemic lupus erythematosus (SLE), is a heterogeneous disease which predominantly affects young females (90%). SLE is associated with a shorter life expectancy than in the general population. Standardized mortality ratios (SMR) of 2.4 have been reported, which is comparable to diabetes. In modern societies cardiovascular disease (CVD) is the major cause of premature mortality. Accelerated atherosclerosis is generally assumed to be the underlying cause for SLE related CVD. However, previous studies diverge regarding whether atherosclerosis is more common in SLE than in controls. With this in mind and based on own clinical experience we hypothesized that accelerated atherosclerosis is not a general feature of SLE, but prevails in SLE subgroups.Methods281 SLE patients and 281 individually age and sex matched population controls, were investigated clinically. Fasting blood samples and risk factor data were collected. All participants were subject to B-mode ultrasonography of the carotid arteries. Carotid plaque occurrence and mean intima media thickness (mIMT) were recorded. Two SLE subgroups previously described to be at high CVD risk; 1) patients with nephritis and 2) patients with anti-phospholipid antibodies (aPL), and one subgroup reported to be at comparatively lower CVD risk; patients positive for Sjogrens syndrome antigens A/B (SSA/SSB) antibodies were analyzed separately in comparison with their respective matched controls.ResultsMedian age was 49 (IQR 36-59) years, 93% were females. Manifest CVD; ischemic heart, cerebro-and peripheral vascular disease, prevailed in patients (12% vs. 1%, p