Low physical activity is associated with proinflammatory high-density lipoprotein and increased subclinical atherosclerosis in women with systemic lupus erythematosus.
OBJECTIVE
To investigate the association between physical activity, functional activity of high-density lipoprotein (HDL), and subclinical cardiovascular disease in patients with systemic lupus erythematosus (SLE).


METHODS
A total of 242 SLE patients (all women) participated in this cross-sectional study from February 2004 to February 2008. Carotid plaque and intima-media thickness (IMT), antioxidant function of HDL, and traditional cardiac risk factors were measured. Physical activity was assessed from self-reports by calculating the metabolic equivalents (METS) per week and by the physical function domain of the Medical Outcomes Study Short Form 36 (SF-36). Data were analyzed using bivariate and multivariate regression analyses.


RESULTS
Number of METS per week spent performing strenuous exercise was negatively correlated with IMT (r = -0.4, P = 0.002) and number of plaques (r = -0.30, P = 0.0001). Physical function as assessed by the SF-36 was also negatively correlated with IMT (r = -0.14, P = 0.03) and number of plaques (r = -0.14, P = 0.04). In multivariate analyses, number of strenuous exercise METS was significantly associated with IMT (t = -2.2, P = 0.028) and number of plaques (t = -2.5, P = 0.014) when controlling for markers of SLE disease activity and damage, but not after controlling for traditional cardiac risk factors. Low physical activity, defined as <225 total METS per week, was associated with the presence of proinflammatory HDL (P = 0.03).


CONCLUSIONS
Low physical activity is associated with increased subclinical atherosclerosis and proinflammatory HDL in patients with SLE. Increased strenuous exercise may reduce the risk of atherosclerosis in SLE.
Volkmann
Elizabeth R
ER
David Geffen School of Medicine, University of California, Los Angeles, CA 90095-1670, USA. evolkmann@mednet.ucla.edu
Grossman
Jennifer M
JM
Sahakian
Lori J
LJ
Skaggs
Brian J
BJ
FitzGerald
John
J
Ragavendra
Nagesh
N
Charles-Schoeman
Christina
C
Chen
Weiling
W
Gorn
Alan
A
Karpouzas
George
G
Weisman
Michael
M
Wallace
Daniel J
DJ
Hahn
Bevra H
BH
McMahon
Maureen
M
D000328:Adult; D050197:Atherosclerosis / Q000150:complications*; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D016893:Carotid Stenosis / Q000150:complications; D005260:Female; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood*; D008077:Lipoproteins, LDL / Q000097:blood*; D008180:Lupus Erythematosus, Systemic / Q000097:blood / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008875:Middle Aged; D009043:Motor Activity; D017539:Tunica Intima / Q000000981:diagnostic imaging; D017540:Tunica Media / Q000000981:diagnostic imaging; D014463:Ultrasonography
D018836:Inflammation Mediators; D008077:Lipoproteins, LDL