Asymptomatic Carotid Atherosclerosis Cardiovascular Risk Factors and Common Hypertriglyceridemia Genetic Variants in Patients with Systemic Erythematosus Lupus
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population
- Demographic data: age and ethnicity;
- Cardiovascular risk factors as defined by the Spanish Society of Arteriosclerosis (SEA) [12]: smoking status, diabetes mellitus, body mass index (BMI), and family history of early cardiovascular disease. Arterial hypertension was defined as a systolic blood pressure of 140 mm Hg or more, or diastolic blood pressure of 90 mm Hg or more, or being on antihypertensive treatment. Dyslipidemia was defined as a concentration of LDL-C equal to or higher than 100 mg/dL, or as a Non-HDL-C concentration equal to or higher than 130 mg/dL or being on lipid-lowering treatment. Information on premature menopause before the age of 40 years was also collected [13];
- Drugs: antithrombotic medications, statins, immunosuppressants;
- Lifestyle: Mediterranean Diet questionnaire [14] and physical activity;
- SLE: onset and time of disease evolution, analytical immunological activity, SLE disease activity index scales (Systemic Lupus Erythematosus Disease Activity Index [SLEDAI]) [15] and Systemic Lupus International Collaborating Clinics/ACR Damage Index (SDI) [16], secondary antiphospholipid syndrome, history of immunosuppressive drugs and analytical parameters of inflammation;
- Laboratory data: serum glucose, lipid profile, liver and kidney parameters, hematology, coagulation, and immunological tests;
- Carotid US and ankle-brachial index (ABI).
2.2. Laboratory Data
2.3. Genetic Analysis of Polymorphisms Involved in Triglyceride Metabolism
2.4. Carotid Ultrasound and Ankle-Brachial Index
2.5. Statistical Analyses
3. Results
3.1. Subjects Characteristics
3.2. Comparisons between Subgroups of SLE-Patients
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Variables | Total (n = 71) | No Carotid Plaque (n = 56) | Carotid Plaque (n = 15) | p-Value |
---|---|---|---|---|
Age (years) | 52 (9.9) | 51 (10.3) | 56 (7.3) | 0.067 |
BMI (kg/m2) | 25.5 (23.0 to 29.6) | 25.4 (22.9 to 29.0) | 25.9 (23.2 to 30.7) | 0.460 |
Waist circumference (cm) | 88.4 (12.8) | 88.0 (12.2) | 90.0 (15.2) | 0.611 |
Dietary questionnaire SEA (score) | 11 (9 to 12) | 11 (9 to 12) | 11 (10 to 12) | 0.585 |
Smoking (pack/years) | 0,9 (0 to 15.7) | 3.0 (0 to 15.9) | 0 (0 to 14.5) | 0.268 |
Hypertension | 33 (46.5%) | 21 (37.5%) | 12 (80%) | 0.003 |
Diabetes mellitus | 5 (7%) | 5 (8.9%) | 0 | 0.577 |
Dyslipidemia | 38 (53.5%) | 25 (44.6%) | 13 (86.7%) | 0.004 |
CV familial history | 30 (42.3%) | 21 (37.5%) | 9 (60%) | 0.117 |
APS | 10 (14.1%) | 8 (10.7%) | 4 (26.7%) | 0.202 |
Nephritis | 34 (47.9%) | 24 (42.9%) | 10 (66.7%) | 0.101 |
SLE disease length (years) | 20.7 (8.1) | 19.8 (7.2) | 24.1 (10.1) | 0.063 |
Pathological ABI | 5 (7%) | 5 (8.9%) | 0 | 0.577 |
Corticosteroids | 63 (88.7%) | 48 (85.7%) | 15 (100%) | 0.189 |
Metrotexate | 9 (12.9%) | 4 (7.3%) | 5 (33.3%) | 0.018 |
Other immunosuppressants | 30 (42.9%) | 21 (38.2%) | 9 (60%) | 0.130 |
GFR CKD-EPI (mL/min/1.73 m2) | 90 (78 to 90) | 90 (84.5 to 90) | 89 (64 to 90) | 0.068 |
TC (mmol/L) | 4.9 (0.7) | 4.8 (0.7) | 5.2 (0.8) | 0.091 |
LDL-C (mmol/L) | 2.6 (0.6) | 2.6 (0.6) | 2.8 (0.6) | 0.431 |
HDL-C (mmol/L) | 1.7 (0.4) | 1.7 (0.5) | 1.6 (0.4) | 0.489 |
TG (mmol/L) | 1.0 (0.8 to 1.4) | 0.9 (0.7 to 1.3) | 1.5 (1.1 to 2.1) | 0.001 |
Non-HDL-C (mmol/L) | 3.2 (0.7) | 3.1 (0.7) | 3.5 (0.7) | 0.025 |
ApoB (g/L) | 0.9 (0.8 to 1.0) | 0.9 (0.8 to 1.0) | 1.0 (0.9 to 1.1) | 0.010 |
Sd-LDL (mmol/L) | 1.2 (0.3) | 1.2 (0.3) | 1.2 (0.4) | 0.572 |
Lipoprotein (a) (g/L) | 0.17 (0.07 to 0.47) | 0.17 (0.07 to 0.37) | 0.25 (0.05 to 1.30) | 0.430 |
Statins | 33 (46.5%) | 20 (35.7%) | 13 (86.7%) | <0.001 |
Ezetimibe | 3 (4.2%) | 0 | 3 (20%) | 0.008 |
Homocysteine (μmol/L) | 11 (9 to 14.9) | 10.5 (8 to 14.5) | 13 (11 to 18) | 0.037 |
SLICC (score) | 0 (0 to 1) | 0 (0 to 1) | 0 (0 to 1) | 0.578 |
SLEDAI (score) | 4 (2 to 8) | 5 (2 to 8) | 4 (2 to 6) | 0.083 |
C3 complement (mg/L) | 1049 (233) | 1050 (241) | 1042 (212) | 0.904 |
C4 complement (mg/L) | 172 (84) | 175 (88) | 162 (71) | 0.601 |
Prothrombin time (ratio) | 1.0 (0.9 to 1.0) | 1.0 (0.9 to 1.0) | 1.0 (0.9 to 2.1) | 0.703 |
Fibrinogen (g/L) | 3.2 (2.7 to 3.7) | 3.2 (2.6 to 3.7) | 3.4 (2.8 to 3.8) | 0.489 |
Glucocorticoids (CPD) | No Carotid Plaque (n = 56) | Carotid Plaque (n = 15) | Total | p-Value |
---|---|---|---|---|
0 to ≥17 g | 19 (33.9%) | 4 (26.7%) | 23 (32.4%) | 0.182 |
>17 g to ≤51 g | 21 (37.5%) | 3 (20.0%) | 24 (33.8%) | |
>51 g | 16 (28.6%) | 8 (53.3%) | 24 (33.8%) |
LN | No Carotid Plaque (n = 56) | Carotid Plaque (n = 15) | Total | p-Value |
---|---|---|---|---|
No history of LN | 32 (57.1%) | 5 (33.3%) | 37 (52.1%) | 0.162 |
Class I/II | 4 (7.1%) | 3 (20.0%) | 7 (9.9%) | |
Class III-V | 20 (35.7%) | 7 (46.7%) | 27 (38.0%) |
Gene | Allelic Variant | No Carotid Plaque | Carotid Plaque | Total | p-Value |
---|---|---|---|---|---|
ZPR1 (c.*724C>G) | CC | 38 (76%) | 12 (24%) | 50 | 0.617NA |
CG | 17 (85%) | 3 (15%) | 20 | ||
GG | 1 (100%) | 0 (0%) | 1 | ||
Grouped ZPR1 (c.*724C>G) | CC or CT | 55 (78.6%) | 15 (21.4%) | 70 | >0.999 |
TT | 1 (100%) | 0 (0%) | 1 | ||
APOA5 (c.56C>G) | CC | 46 (78%) | 13 (22%) | 59 | 0.838NA |
CG | 9 (81.8%) | 2 (18.2%) | 11 | ||
GG | 1 (100%) | 0 (0%) | 1 | ||
Grouped APOA5 (c.56C>G) | CC or CT | 55 (78.6%) | 15 (21.4%) | 70 | >0.999 |
TT | 1 (100%) | 0 (0%) | 1 | ||
GCKR (c.1337C>T) | CC | 23 (85.2%) | 4 (14.8%) | 27 | 0.069NA |
CT | 27 (81.8%) | 6 (18.2%) | 33 | ||
TT | 6 (54.5%) | 5 (45.5%) | 11 | ||
Grouped GCKR (c.1337C>T) | CC or CT | 50 (83.3%) | 10 (16.7%) | 60 | 0.047 |
TT | 6 (54.5%) | 5 (45.5%) | 11 |
Variables | OR (IC 95%) | p-value |
---|---|---|
GCKR (c.1337C>T)-TT | Ref. | |
-CC | 0.026 (0.001 to 0.473) | 0.014 |
-CT | 0.119 (0.010 to 1.389) | 0.090 |
Triglycerides (mmol/L) | 12.550 (1.703 to 92.475) | 0.013 |
Hypertension | 9.691 (1.703 to 84.874) | 0.040 |
Lupus nephritis-No | Ref. | |
-class I/II | 2.979 (0.186 to 47.785) | 0.441 |
-class III-V | 2.780 (0.439 to 17.590) | 0.277 |
CPD (g) | 0.977 (0.942 to 1.013) | 0.213 |
SLE disease length (years) | 1.099 (0.974 to 1.240) | 0.124 |
SLICC (score) | 1.045 (0.613 to 1.782) | 0.871 |
Age (10 years) | 2.125 (0.878 to 5.142) | 0.094 |
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Fanlo-Maresma, M.; Candás-Estébanez, B.; Esteve-Luque, V.; Padró-Miquel, A.; Escrihuela-Vidal, F.; Carratini-Moraes, M.; Corbella, E.; Corbella, X.; Pintó, X. Asymptomatic Carotid Atherosclerosis Cardiovascular Risk Factors and Common Hypertriglyceridemia Genetic Variants in Patients with Systemic Erythematosus Lupus. J. Clin. Med. 2021, 10, 2218. https://doi.org/10.3390/jcm10102218
Fanlo-Maresma M, Candás-Estébanez B, Esteve-Luque V, Padró-Miquel A, Escrihuela-Vidal F, Carratini-Moraes M, Corbella E, Corbella X, Pintó X. Asymptomatic Carotid Atherosclerosis Cardiovascular Risk Factors and Common Hypertriglyceridemia Genetic Variants in Patients with Systemic Erythematosus Lupus. Journal of Clinical Medicine. 2021; 10(10):2218. https://doi.org/10.3390/jcm10102218
Chicago/Turabian StyleFanlo-Maresma, Marta, Beatriz Candás-Estébanez, Virginia Esteve-Luque, Ariadna Padró-Miquel, Francesc Escrihuela-Vidal, Monica Carratini-Moraes, Emili Corbella, Xavier Corbella, and Xavier Pintó. 2021. "Asymptomatic Carotid Atherosclerosis Cardiovascular Risk Factors and Common Hypertriglyceridemia Genetic Variants in Patients with Systemic Erythematosus Lupus" Journal of Clinical Medicine 10, no. 10: 2218. https://doi.org/10.3390/jcm10102218