title: Hypertension is associated with serologically active disease in patients with systemic lupus erythematosus: role of increased Th1/Th2 ratio and oxidative stress.
abstract: OBJECTIVE
  To determine whether disease activity verified by laboratorial parameters is associated with a higher frequency of hypertension in patients with systemic lupus erythematosus (SLE) without renal impairment and to investigate factors that could influence this hypertension.
  
  
  METHODS
  This study included 102 controls, 70 patients with inactive SLE, and 53 patients with active SLE without renal impairment. We evaluated T helper type 1 (Th1)/Th2 lineage cytokines, nitric oxide (NO), insulin resistance (IR), and oxidative stress.
  
  
  RESULTS
  Patients with active SLE had a higher probability of developing hypertension compared to controls [odds ratio (OR) 3.833, 95% confidence interval (CI) 1.806-8.137, p < 0.0003] and patients with inactive SLE (OR 2.215, 95% CI 1.032-4.752, p = 0.0394). Active SLE patients had a higher interleukin (IL)-12/IL-4 ratio (p < 0.05) than both controls and inactive SLE patients. Protein oxidation was significantly higher in patients with active SLE than in the control group and in patients with inactive SLE (p < 0.01 and p < 0.05, respectively). Multivariate analysis revealed an association between the presence of hypertension and he levels of glucose (p = 0.0276), insulin (p = 0.0498), hydroperoxides (p = 0.0221), IFN-γ (p = 0.0494), IL-17 (p = 0.0272), IL-12/IL-10 (p = 0.0373), IFN-γ/IL-10 (p = 0.0142), IFN-γ/IL-4 (p = 0.0320), and adiponectin (p = 0.0433).
  
  
  CONCLUSIONS
  Patients with active SLE without renal impairment had an increased frequency of high blood pressure (43.4%) compared with patients with inactive SLE (25.7%) and controls (16.7%). Hypertension was associated with serologically active disease and was influenced by an increased Th1/Th2 ratio and oxidative stress.
authors.affiliation: Department of Clinical Analysis, University of North Paraná (UNOPAR) , Londrina, Paraná , Brazil.
authors.forename: M A B
authors.initials: MA
authors.lastname: Lozovoy
authors.forename: A N C
authors.initials: AN
authors.lastname: Simão
authors.forename: H K
authors.initials: HK
authors.lastname: Morimoto
authors.forename: T M V
authors.initials: TM
authors.lastname: Iryioda
authors.forename: C
authors.initials: C
authors.lastname: Panis
authors.forename: E M V
authors.initials: EM
authors.lastname: Reiche
authors.forename: S D
authors.initials: SD
authors.lastname: Borelli
authors.forename: S R
authors.initials: SR
authors.lastname: Oliveira
authors.forename: R
authors.initials: R
authors.lastname: Cecchini
authors.forename: I
authors.initials: I
authors.lastname: Dichi
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D016207:Cytokines / Q000097:blood; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000276:immunology / Q000378:metabolism; D007328:Insulin / Q000097:blood; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000276:immunology / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress / Q000502:physiology*; D018417:Th1 Cells / Q000276:immunology / Q000378:metabolism*; D018418:Th2 Cells / Q000276:immunology / Q000378:metabolism*
chemical_list: D001786:Blood Glucose; D016207:Cytokines; D007328:Insulin