Inflammatory mechanisms affecting the lipid profile in patients with systemic lupus erythematosus.
OBJECTIVE
Increased low density lipoprotein (LDL) cholesterol and triglycerides, and decreased high density lipoprotein (HDL) cholesterol concentrations are associated with adverse cardiovascular risk in the general population. Patients with systemic lupus erythematosus (SLE) have an altered lipid profile characterized by increased triglycerides and decreased HDL cholesterol concentrations. We examined the relationships between lipid concentrations, cytokines, and inflammatory markers in patients with SLE.


METHODS
Fasting lipid concentrations, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) were measured in 110 patients with SLE. Disease activity was quantified by the SLE Disease Activity Index (SLEDAI), and disease damage by the Systemic Lupus International Collaborating Clinics (SLICC) score. Concentrations of circulating tumor necrosis factor-alpha (TNF-alpha), interleukin 6 (IL-6), and insulin were measured and insulin sensitivity calculated.


RESULTS
Lower concentrations of HDL cholesterol were independently associated with higher ESR (p < 0.001), IL-6 (p = 0.02), SLEDAI (p = 0.04), and TNF-alpha (p = 0.04) after adjustment for age, sex, race, body mass index, insulin sensitivity, and current use of corticosteroids or hydroxychloroquine. Triglyceride concentrations were associated with higher CRP concentrations (p = 0.02) and SLICC score (p = 0.04).


CONCLUSIONS
Deleterious changes in lipid profile are independently associated with higher concentrations of markers and mediators of inflammation and disease activity and damage in patients with SLE.
Departments of Medicine, Molecular Physiology and Biophysics, Biostatistics, Pathology, and Pharmacology, Vanderbilt University, Nashville, Tennessee, USA. c.chung@vanderbilt.edu
Cecilia P
CP
Chung
Annette
A
Oeser
Joseph
J
Solus
Ingrid
I
Avalos
Tebeb
T
Gebretsadik
Ayumi
A
Shintani
Macrae F
MF
Linton
Sergio
S
Fazio
C Michael
CM
Stein
D000328:Adult; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000032:analysis / Q000276:immunology; D008076:Cholesterol, HDL / Q000097:blood* / Q000276:immunology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood; D008180:Lupus Erythematosus, Systemic / Q000097:blood* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D014280:Triglycerides / Q000097:blood* / Q000276:immunology
D008076:Cholesterol, HDL; D014280:Triglycerides; D002097:C-Reactive Protein