Dyslipidemia in pediatric systemic lupus erythematosus: the relationship with disease activity and plasma homocysteine and cysteine concentrations.
OBJECTIVE
To evaluate the presence of dyslipidemia and plasma concentrations of homocysteine (Hcy) and cysteine (Cys) in adolescents with juvenile systemic lupus erythematosus (SLE) and relate these findings to disease activity (Systemic Lupus Erythematosus Disease Activity Index, SLEDAI) and cardiovascular risk factors.


METHODS
A cross-sectional controlled study including 26 female adolescents with SLE and 26 healthy controls was conducted. We evaluated SLEDAI, medications, anthropometric data, dietary intake, lipid profile, proteinuria, Hcy, Cys, folic acid, vitamin B12, and high-sensitivity C-reactive protein levels.


RESULTS
Dyslipidemia was observed in 46.2% of the patients and in 19.2% of the controls. The SLE group had a higher Cys concentration and a lower high-density lipoprotein cholesterol concentration compared with the controls. In the multivariate analysis only Hcy was significantly and independently associated with the presence of dyslipidemia in the juvenile SLE group; an increase of 1 μmol/l in the Hcy concentration doubled the chance of dyslipidemia (OR: 2.1; 95% CI: 1.1-4.9; p = 0.030). The Cys concentration was correlated with Hcy, total cholesterol, low-density lipoprotein cholesterol, and triglyceride concentrations.


CONCLUSIONS
We observed the presence of cardiovascular risk factors in adolescents with juvenile SLE. The early identification of biochemical alterations allows the development of intervention strategies that may lower the risk of cardiovascular disease.
Pediatric Department, Universidade Federal de São Paulo, São Paulo, Brazil.
Thaís Tobaruela
TT
Ortiz
Maria Teresa
MT
Terreri
Michelle
M
Caetano
Fabíola Suano
FS
Souza
Vânia
V
D'Almeida
Roseli Oselka Saccardo
RO
Sarni
Maria Odete Esteves
MO
Hilário
D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D000328:Adult; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology; D016022:Case-Control Studies; D002648:Child; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003430:Cross-Sectional Studies; D003545:Cysteine / Q000097:blood*; D050171:Dyslipidemias / Q000097:blood* / Q000150:complications / Q000453:epidemiology; D002149:Energy Intake; D005260:Female; D005492:Folic Acid / Q000097:blood; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000097:blood* / Q000150:complications / Q000453:epidemiology; D015999:Multivariate Analysis; D009752:Nutritional Status; D011627:Puberty / Q000502:physiology; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood; D014805:Vitamin B 12 / Q000097:blood; D055105:Waist Circumference; D055815:Young Adult
D000305:Adrenal Cortex Hormones; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D014280:Triglycerides; D006710:Homocysteine; D002097:C-Reactive Protein; D005492:Folic Acid; D003545:Cysteine; D014805:Vitamin B 12