Atherosclerosis is accelerated in patients with long-term well-controlled systemic lupus erythematosus (SLE).
BACKGROUND
It is uncertain whether atherosclerosis is accelerated in premenopausal and postmenopausal patients with long-term well-controlled systemic lupus erythematosus (SLE).


METHODS
We measured the intima-media thickness (IMT) of the carotid arteries and the cardio-ankle vascular index (CAVI) in 39 women with SLE and in age- and sex-matched controls.


RESULTS
In the premenopausal state, carotid plaque was detected only in SLE patients (36%). In the postmenopausal state, the maximum IMT was about 2-fold greater in SLE patients than in control subjects (1.3+/-0.7 vs. 0.7+/-0.2 mm, p<0.001). CAVI was higher in both the premenopausal and postmenopausal SLE patients. The serum amyloid A protein (SAA) was higher in SLE patients in the premenopausal state (p=0.025), while remnant like particle-cholesterol (RLP-C), the homeostasis model assessment of insulin resistance (HOMA-IR), and SAA were significantly increased in postmenopausal SLE patients (p=0.001, p<0.001 and p<0.05, respectively). Multiple regression analysis revealed that the maximum IMT was associated with cumulative PSL dosage (p=0.027) and SAA (p=0.074) in the premenopausal SLE patients, and with HOMA-IR (p<0.001) in the postmenopausal SLE patients.


CONCLUSIONS
Atherosclerosis is accelerated in long-term well-controlled SLE. More attention should be given to subclinical inflammation and insulin resistance in the management of SLE patients.
Sato
Hiroe
H
Niigata University Graduate School of Medical and Dental Sciences, Division of Nephrology and Rheumatology, 1-754 Asahimachi-Dori, Chuo-Ku Niigata, Niigata 951-8510, Japan.
Miida
Takashi
T
Wada
Yoko
Y
Maruyama
Mitsuya
M
Murakami
Shuichi
S
Hasegawa
Hisashi
H
Kuroda
Takeshi
T
Narita
Ichiei
I
Nakano
Masaaki
M
Gejyo
Fumitake
F
D000328:Adult; D050197:Atherosclerosis / Q000097:blood / Q000150:complications* / Q000473:pathology*; D015415:Biomarkers; D001777:Blood Coagulation; D002340:Carotid Artery Diseases / Q000473:pathology; D002908:Chronic Disease / Q000628:therapy; D005260:Female; D006801:Humans; D007249:Inflammation / Q000473:pathology; D007333:Insulin Resistance; D008074:Lipoproteins / Q000097:blood; D008180:Lupus Erythematosus, Systemic / Q000097:blood / Q000150:complications* / Q000473:pathology / Q000628:therapy*; D008593:Menopause; D012044:Regression Analysis; D013997:Time Factors
D015415:Biomarkers; D008074:Lipoproteins