title: Atherosclerosis in Asian Indians with systemic lupus erythematosus.
abstract: OBJECTIVE
  Atherosclerosis has emerged as an important late complication of systemic lupus erythematosus (SLE). Asian Indians, as an ethnic group, are known to be metabolically predisposed to development of early atherosclerosis. No data on this aspect of SLE are available from Asia. This study was undertaken to find the frequency of atherosclerosis in Indian lupus patients and the factors affecting such an occurrence.
  
  
  METHODS
  Carotid artery intimo-medial thickness (IMT) and plaque were used as markers of atherosclerosis. High-resolution B-mode ultrasonography was used to compare carotid IMT and plaque in 50 patients with SLE and 50 age- and sex-matched healthy controls.
  
  
  RESULTS
  Patients with lupus (age 31.6+/-10.05, median 30.5 years; disease duration 52.3+/-36.7, median 46 months) exhibited a significantly greater IMT than controls (0.417+/-0.07 vs. 0.362+/-00.07 mm; p = 0.003). Carotid plaques were seen in seven (14%) cases. None of the control population had plaques (p = 0.006). On bivariate analysis, the IMT was significantly affected by age, systolic blood pressure (SBP), disease duration and menopausal status. On multivariate analysis, the only factor significantly affecting IMT was SBP. The Systemic Lupus International Collaborating Clinics/American College of Rheumatology (SLICC/ACR) score was the sole factor found to significantly affect the occurrence of plaque.
  
  
  CONCLUSIONS
  Asian Indian lupus patients in our study, despite being relatively young and with shorter disease duration, exhibited premature atherosclerosis in the form of significantly thicker intimo-media and plaque. The factors found to affect accelerated atherosclerosis in our cohort were age, SBP, disease duration, postmenopausal status and the SLICC/ACR score.
authors.affiliation: Department of Medicine, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: S P
authors.initials: SP
authors.lastname: Bhatt
authors.forename: R
authors.initials: R
authors.lastname: Handa
authors.forename: G S
authors.initials: GS
authors.lastname: Gulati
authors.forename: S
authors.initials: S
authors.lastname: Sharma
authors.forename: R M
authors.initials: RM
authors.lastname: Pandey
authors.forename: P
authors.initials: P
authors.lastname: Aggarwal
authors.forename: L
authors.initials: L
authors.lastname: Ramakrishnan
authors.forename: S
authors.initials: S
authors.lastname: Shankar
mesh_terms: D000293:Adolescent; D000328:Adult; D044466:Asian People; D050197:Atherosclerosis / Q000150:complications / Q000000981:diagnostic imaging / Q000208:ethnology*; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000208:ethnology; D008297:Male; D008875:Middle Aged; D018608:Ultrasonography, Doppler