Endothelial function analysis and atherosclerotic risk factors in adolescents with systemic lupus erythematosus.
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.
Nascif
Ana Karina Soares
AK
Division of Pediatric Rheumatology, Department of Pediatrics, Universidade Federal de São Paulo, Brazil.
Hilário
Maria Odete Esteves
MO
Terreri
Maria Teresa Ramos Ascensão
MT
Ajzen
Sérgio Aron
SA
D'Almeida
Vânia
V
Plavnik
Frida Liane
FL
de Jesus Christofalo
Dejaldo Marcos
DM
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
D001786:Blood Glucose; D008055:Lipids; D006710:Homocysteine; D003404:Creatinine