title: Endothelial function analysis and atherosclerotic risk factors in adolescents with systemic lupus erythematosus.
abstract: Atherosclerosis is considered an important cause of morbidity and mortality in systemic lupus erythematosus (SLE). Endothelial dysfunction represents an important factor in the onset of atherosclerosis.
  
  
  OBJECTIVE
  To assess endothelial function and the risk factors for atherosclerosis in adolescents with SLE.
  
  
  METHODS
  Thirty-five adolescents with SLE aged between 10-18 years and 27 age- and sex-matched controls.
  
  
  METHODS
  Endothelial function was assessed using a high-resolution ultrasound device (Philips ATL, HDI-3000 model) with a linear array transducer (4.0-7.0 MHz). Measures of diameter and flow were performed at rest, during reactive hyperemia and after glyceryl trinitrate. Total cholesterol and fractions, triglycerides, creatinine, fasting glucose, anticardiolipin antibodies, lupus anticoagulant and plasma homocysteine, as well as, cumulative oral corticoid dose were considered in order to establish the risk factors for atherosclerosis.
  
  
  RESULTS
  No significant difference was found between the two groups regarding endothelial function. Although dilation at 90" after cuff deflation had been smaller in patients than in controls, the difference was not statistically significant. Patients had higher levels of total cholesterol (p = 0.02), VLDL (p = 0.01), triglycerides (p = 0.01), and homocysteine (p < .001) compared with controls. Sixty eight percent of our patients showed hyperhomocysteinemia, yet, we did not find any correlation between these values and flow-mediated dilation.
  
  
  CONCLUSIONS
  According to our results, adolescents with SLE do not present alterations in endothelial function as assessed by ultrasound. However, these patients did demonstrate risk factors such as dyslipidemia and hyperhomocysteinemia for the development of atherosclerosis.
authors.affiliation: Division of Pediatric Rheumatology, Department of Pediatrics, Universidade Federal de São Paulo, Brazil.
authors.forename: Ana Karina Soares
authors.initials: AK
authors.lastname: Nascif
authors.forename: Maria Odete Esteves
authors.initials: MO
authors.lastname: Hilário
authors.forename: Maria Teresa Ramos Ascensão
authors.initials: MT
authors.lastname: Terreri
authors.forename: Sérgio Aron
authors.initials: SA
authors.lastname: Ajzen
authors.forename: Vânia
authors.initials: V
authors.lastname: D'Almeida
authors.forename: Frida Liane
authors.initials: FL
authors.lastname: Plavnik
authors.forename: Dejaldo Marcos
authors.initials: DM
authors.lastname: de Jesus Christofalo
mesh_terms: D000293:Adolescent; D050197:Atherosclerosis / Q000209:etiology*; D001786:Blood Glucose; D002648:Child; D003404:Creatinine / Q000097:blood; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D006710:Homocysteine / Q000097:blood; D006801:Humans; D008055:Lipids / Q000097:blood; D008180:Lupus Erythematosus, Systemic / Q000150:complications*; D008297:Male; D012307:Risk Factors
chemical_list: D001786:Blood Glucose; D008055:Lipids; D006710:Homocysteine; D003404:Creatinine