TNF-alpha: a link between hypertriglyceridaemia and inflammation in SLE patients with cardiovascular disease.
Patients with systemic lupus erythematosus (SLE) are at high risk of cardiovascular disease (CVD). Tumour necrosis factor-alpha (TNF-alpha) has been implicated in the pathophysiological processes of both SLE and CVD. This study focuses on the role of TNF-alpha and its soluble receptors in SLE-related CVD. In summary, 26 women (52 +/- 8.2 years) with SLE and a history of CVD (SLE cases) we compared with 26 age-matched women with SLE and no clinical manifestations of CVD (SLE controls) and 26 age-matched population-based control women (population controls). Plasma concentrations of circulating TNF-alpha, TNF-alpha receptor 1 (sTNFR1) and TNF-a receptor 2 (sTNFR2) were determined by ELISA. TNF-alpha, sTNFR1 and sTNFR2 were raised in SLE cases as compared to SLE controls (P = 0.009; P = 0.001; P = 0.001, respectively), and SLE controls had higher levels than population controls (P = 0.001; P = 0.02; P = 0.001, respectively). Exclusively in the SLE case group there was a striking positive correlation between TNF-alpha and plasma triglycerides (r = 0.57, P < 0.002), VLDL triglycerides (r = 0.54, P = 0.004) and VLDL cholesterol (r = 0.58, P = 0.002). Furthermore, TNF-alpha correlated with the waist-hip ratio but not with estimated insulin resistance. TNF-alpha may thus be a major factor in SLE-related CVD acting both by contributing to hypertriglyceridaemia and by promoting atherosclerosis-related inflammation. sTNFR1 and sTNFR2 are strongly associated with CVD in SLE but their exact roles in disease development remain to be elucidated.
Svenungsson
E
E
Department of Medicine, Rheumatology Unit, Karolinska Institutet, Stockholm, Sweden. elisabet.svenungsson@medks.ki.se
Fei
G Z
GZ
Jensen-Urstad
K
K
de Faire
U
U
Hamsten
A
A
Frostegard
J
J
D001323:Autoantibodies / Q000097:blood; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000150:complications* / Q000175:diagnosis; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D015228:Hypertriglyceridemia / Q000150:complications* / Q000175:diagnosis; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000175:diagnosis; D008875:Middle Aged; D011336:Probability; D011379:Prognosis; D012016:Reference Values; D018570:Risk Assessment; D012307:Risk Factors; D012494:Sampling Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis / Q000378:metabolism*
D001323:Autoantibodies; D015415:Biomarkers; D014409:Tumor Necrosis Factor-alpha