title: Subclinical atherosclerosis in systemic lupus erythematosus patients and its relationship to disease activity and damage indices.
abstract: OBJECTIVE
  To detect the incidence of premature atherosclerosis in systemic lupus erythematosus (SLE) patients and to study its association with disease activity and damage indices.
  
  
  METHODS
  This study involved 50 adult female SLE patients with mean age 26.24 ± 8.63 years and mean disease duration 3.44 ± 4.01 years. The control group comprised 25 healthy adult females. All patients were subjected to a detailed clinical examination and laboratory investigations, and full case history was recorded. Assessment of disease activity was performed according to the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) and disease damage was assessed using the Systemic Lupus International Collaborating Clinics (SLICC) score. B mode ultrasound was used to measure the intima-media wall thickness (IMT) and detect the presence of carotid plaques.
  
  
  RESULTS
  In 15 patients (30 %), positive ultrasonographic findings represented by a significant increase in IMT (> 0.9 mm) could be shown; plaques were found in 3 of these patients (6 %). A significant difference was found between SLE patients and controls in terms of IMT (P < 0.0001). On subgrouping the SLE patients according to their IMT, there was a significant difference between those with thickened and normal IMT in terms of SLEDAI (P < 0.0001) and SLICC (p = 0.035) scores.
  
  
  CONCLUSIONS
  Subclinical atherosclerosis is frequent in SLE patients. Increased disease activity and damage are associated with the occurrence of premature atherosclerosis.
authors.affiliation: Rheumatology and Rehabilitation Department, Faculty of Medicine, Cairo University, Egypt-Cairo-Nasr city- emtedad ramsis street-4 elgabal elakhdar building, Cairo , Egypt.
authors.forename: S
authors.initials: S
authors.lastname: Fadda
authors.forename: H
authors.initials: H
authors.lastname: Nassar
authors.forename: S M
authors.initials: SM
authors.lastname: Gamal
authors.forename: H
authors.initials: H
authors.lastname: Al-azizi
mesh_terms: D000328:Adult; D058070:Asymptomatic Diseases; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging* / Q000209:etiology*; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000175:diagnosis*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D014463:Ultrasonography
references.citation: Ann Rheum Dis. 2013 Nov;72(11):1764-70
references.pmid: 23852762
references.citation: ISRN Pediatr. 2013 Sep 19;2013:765253
references.pmid: 24171119
references.citation: Curr Opin Rheumatol. 2003 Sep;15(5):519-27
references.pmid: 12960475
references.citation: N Engl J Med. 2003 Dec 18;349(25):2399-406
references.pmid: 14681505
references.citation: Rheumatology (Oxford). 2007 Jun;46(6):983-8
references.pmid: 17384179
references.citation: Rom J Morphol Embryol. 2012;53(1):29-34
references.pmid: 22395496
references.citation: Arthritis Rheum. 1992 Jun;35(6):630-40
references.pmid: 1599520
references.citation: J Clin Rheumatol. 2009 Apr;15(3):111-6
references.pmid: 19300290
references.citation: Arthritis Rheum. 1999 Jan;42(1):51-60
references.pmid: 9920014
references.citation: Arthritis Care Res (Hoboken). 2014 Aug;66(8):1177-85
references.pmid: 24376005
references.citation: Arthritis Rheum. 1997 Sep;40(9):1725
references.pmid: 9324032
references.citation: PLoS One. 2014 Apr 10;9(4):e94511
references.pmid: 24722263
references.citation: Arthritis Res Ther. 2011 Feb 28;13(1):203
references.pmid: 21371346
references.citation: Expert Rev Clin Immunol. 2011 Mar;7(2):227-41
references.pmid: 21426260
references.citation: Rheumatology (Oxford). 2014 Apr;53(4):704-13
references.pmid: 24357811
references.citation: Arthritis Rheum. 2002 Jun;46(6):1489-97
references.pmid: 12115178
references.citation: Lupus. 2013 Oct;22(12):1232-42
references.pmid: 24097995
references.citation: Nihon Rinsho Meneki Gakkai Kaishi. 2012;35(6):470-80
references.pmid: 23291482
references.citation: J Rheumatol. 2010 Feb;37(2):322-9
references.pmid: 19955047
references.citation: Rheumatology (Oxford). 2012 Jan;51(1):110-9
references.pmid: 22039268
references.citation: Ann Rheum Dis. 2011 May;70(5):760-5
references.pmid: 21177297
references.citation: Mod Rheumatol. 2014 Jan;24(1):86-92
references.pmid: 24261763
references.citation: Ann Rheum Dis. 2003 Nov;62(11):1066-70
references.pmid: 14583569
references.citation: Arthritis Rheum. 1996 Mar;39(3):363-9
references.pmid: 8607884
references.citation: Lupus. 2000;9(3):166-9
references.pmid: 10805482
references.citation: Nutr Metab Cardiovasc Dis. 2014 Jul;24(7):751-9
references.pmid: 24787906
references.citation: Arthritis Rheum. 2008 Mar;58(3):835-42
references.pmid: 18311797
references.citation: Scand J Rheumatol. 2011;40(4):279-82
references.pmid: 21469940
references.citation: Int J Rheum Dis. 2012 Jun;15(3):261-7
references.pmid: 22212605
references.citation: Ann Rheum Dis. 2003 Nov;62(11):1071-7
references.pmid: 14583570