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Impact of early disease factors on metabolic syndrome in systemic lupus erythematosus: data from an international inception cohort.

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Authors
Parker, Ben
Urowitz, Murray B
Gladman, Dafna D
Lunt, Mark
Donn, Rachelle
Bae, Sang-Cheol
Sanchez-Guerrero, Jorge
Romero-Diaz, Juanita
Gordon, Caroline
Wallace, Daniel J
Clarke, Ann E
Bernatsky, Sasha
Ginzler, Ellen M
Isenberg, David A
Rahman, Anisur
Merrill, Joan T
Alarcón, Graciela S
Fessler, Barri J
Fortin, Paul R
Hanly, John G
Petri, Michelle
Steinsson, Kristjan
Dooley, Mary Anne
Manzi, Susan
Khamashta, Munther A
Ramsey-Goldman, Rosalind
Zoma, Asad A
Sturfelt, Gunnar K
Nived, Ola
Aranow, Cynthia
Mackay, Meggan
Ramos-Casals, Manuel
van Vollenhoven, Ronald F
Kalunian, Kenneth C
Ruiz-Irastorza, Guillermo
Lim, S Sam
Kamen, Diane L
Peschken, Christine A
Inanc, Murat
Bruce, Ian N
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Issue Date
2015-08

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Citation
Ann. Rheum. Dis. 2015, 74 (8):1530-6
Abstract
The metabolic syndrome (MetS) may contribute to the increased cardiovascular risk in systemic lupus erythematosus (SLE). We examined the association between MetS and disease activity, disease phenotype and corticosteroid exposure over time in patients with SLE.
Recently diagnosed (<15 months) patients with SLE from 30 centres across 11 countries were enrolled into the Systemic Lupus International Collaborating Clinics (SLICC) Inception Cohort from 2000 onwards. Baseline and annual assessments recorded clinical, laboratory and therapeutic data. A longitudinal analysis of factors associated with MetS in the first 2 years of follow-up was performed using random effects logistic regression.
We studied 1150 patients with a mean (SD) age of 34.9 (13.6) years and disease duration at enrolment of 24.2 (18.0) weeks. In those with complete data, MetS prevalence was 38.2% at enrolment, 34.8% at year 1 and 35.4% at year 2. In a multivariable random effects model that included data from all visits, prior MetS status, baseline renal disease, SLICC Damage Index >1, higher disease activity, increasing age and Hispanic or Black African race/ethnicity were independently associated with MetS over the first 2 years of follow-up in the cohort.
MetS is a persistent phenotype in a significant proportion of patients with SLE. Renal lupus, active inflammatory disease and damage are SLE-related factors that drive MetS development while antimalarial agents appear to be protective from early in the disease course.
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To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked Files. This article is open access.
Additional Links
http://dx.doi.org/ 10.1136/annrheumdis-2013-203933
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4515988/
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Archived with thanks to Annals of the rheumatic diseases
ae974a485f413a2113503eed53cd6c53
10.1136/annrheumdis-2013-203933
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