الفهرس 
METABOLIC SYNDROME
DyslipidemiasOnly 14 pages are availabe for public view
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Abstract
The metabolic syndrome is an independent risk factor for ischemic heart disease. Patients with systemic lupus erythematosus (SLE) have accelerated atherosclerosis but the cause was not clear; however, there are few controlled studies of the metabolic syndrome in patients with SLE.
Aim of the present study was to study the prevalence of the metabolic syndrome in patients with SLE and compare with the control, and to evaluate its association with disease charateristics and the cardiovascular risk factors.
Seventy patients with SLE who satisfied the American College of Rheumatology (ACR) criteria, aged ≥16 years and had disease duration ≥ 1 year and 30 controls normal volunteer age and sex matched were studied. The patients were recruited from the out patient clinic of rheumatology and internal medicine department Ain Shams University Hospitals. The patients were classified according to presence & absence of metabolic syndrome by using WHO definition criteria, NCEP definition criteria & by using both definition criteria.
The prevalence of the metabolic syndrome was compared in patients and controls using the National Cholesterol Education Program Adult Treatment Panel III (NCEP) and the World Health Organization (WHO) definitions, and associations with cardiovascular risk factors as smoking, family history of coronary heart disease, drug history, lupus characteristics were examined and assessment of disease activity and damage by using Systemic Lupus Activity Measure (SLAM) score and Systemic Lupus International Collaborating Clinics Damage Index (SLICC/ACR),CBC, ESR, quantitative c-reactive protein, lipid profile (TG, cholesterol, LDL & HDL), liver & kidney function, urine analysis, albumin - creatinine ratio, carotid duplex, ECHO & renal biopsy (patients with albumin –creatinine ratio> 0.5) was done.
In our study, the metabolic syndrome was present in 51.4% of patients and in 16.7% of controls using the WHO definition that requires direct determination of insulin resistance, and in 38.6% of patients with SLE and in 10% of controls using the NCEP definition, and in 34.3% of patients and in 6.6% of controls fulfilling metabolic syndrome criteria by both definitions.
In our study we found that central obesity, dyslipidemia & hypertension were independent risk factors for the occurrence of metabolic syndrome in SLE patients. We also found that higher measurements of waist, BMI, systolic & diastolic blood pressure present in SLE patients than controls as well as in SLE patients with metabolic syndrome than those without metabolic syndrome.
There was no difference between SLE patients with or without metabolic syndrome as regard disease duration, treatment duration & different types of drugs used.
In this study, we found higher level of FBS, insulin, insulin resistance, dyslipidemia, kidney function tests & ESR in SLE patients more than controls. There were also, higher levels of dyslipidemia, kidney function tests, ESR & albumin/creatinine ratio in urine in SLE patients with metabolic syndrome more than those without metabolic syndrome.
In our study, SLE patients with metabolic syndrome had more aggressive nephritis and higher Systemic Lupus Activity Measure (SLAM) score and Systemic Lupus International Collaborating Clinics Damage Index (SLICC) score. And there was positive correlation between insulin resistance and FBS & classes of lupus nephritis.