title: Impact of Disease Duration on Vascular Surrogates of Early Atherosclerosis in Childhood-Onset Systemic Lupus Erythematosus.
abstract: OBJECTIVE
  To determine whether longer disease duration negatively impacts carotid intima-media thickness (CIMT), flow-mediated dilation (FMD), and pulse wave velocity (PWV) in a cohort of patients with childhood-onset systemic lupus erythematosus (SLE), and to compare CIMT, FMD, and PWV in patients with childhood-onset SLE with those in healthy children and explore determinants of vascular test results in childhood-onset SLE.
  
  
  METHODS
  Cross-sectional analysis was performed in a prospective longitudinal cohort of patients with childhood-onset SLE at the latest followup visit. Clinical and laboratory data were collected for patients with childhood-onset SLE. CIMT, FMD, and PWV were measured using standardized protocols in patients with childhood-onset SLE and healthy children. Correlations between disease duration and results of the 3 vascular tests were performed. Vascular data in patients with childhood-onset SLE were compared with those in healthy children. Multivariable linear regression was used to identify determinants of CIMT, FMD, and PWV in childhood-onset SLE.
  
  
  RESULTS
  Patients with childhood-onset SLE (n = 149) and healthy controls (n = 178) were enrolled. The median age of the patients was 17.2 years (interquartile range [IQR] 15.7-17.9 years), and their median disease duration was 3.2 years (IQR 1.8-4.9 years). The median age of the healthy children was 14.7 years (IQR 13.1-15.9 years). Longer disease duration correlated with worse FMD (r = -0.2, P = 0.031) in patients with childhood-onset SLE. Patients with childhood-onset SLE had smaller (better) CIMT, higher (better) FMD, and similar PWV compared with healthy controls. Linear regression analysis explained <24% of the variation in vascular test results in patients with childhood-onset SLE, suggesting that other variables should be explored as important determinants of CIMT, FMD, and PWV.
  
  
  CONCLUSIONS
  In this cohort of 149 patients with childhood-onset SLE, patients did not have worse CIMT, FMD, or PWV than did healthy controls. Longer disease duration was associated with worse FMD, suggesting progressive endothelial dysfunction over time.
authors.affiliation: Centre Hospitalier Universitaire St. Justine, University of Montreal, Montreal, Quebec, Canada), Timothy J. Bradley, MBChB, FRACP, Cameron Slorach, RDCS, Lawrence W. K. Ng, BSc, Deborah M. Levy, MD, MS, FRCPC: The Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: Julie
authors.initials: J
authors.lastname: Barsalou
authors.affiliation: Centre Hospitalier Universitaire St. Justine, University of Montreal, Montreal, Quebec, Canada), Timothy J. Bradley, MBChB, FRACP, Cameron Slorach, RDCS, Lawrence W. K. Ng, BSc, Deborah M. Levy, MD, MS, FRCPC: The Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Bradley
authors.affiliation: University of Toronto, Toronto, Ontario, Canada.
authors.forename: Pascal N
authors.initials: PN
authors.lastname: Tyrrell
authors.affiliation: Centre Hospitalier Universitaire St. Justine, University of Montreal, Montreal, Quebec, Canada), Timothy J. Bradley, MBChB, FRACP, Cameron Slorach, RDCS, Lawrence W. K. Ng, BSc, Deborah M. Levy, MD, MS, FRCPC: The Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: Cameron
authors.initials: C
authors.lastname: Slorach
authors.affiliation: Centre Hospitalier Universitaire St. Justine, University of Montreal, Montreal, Quebec, Canada), Timothy J. Bradley, MBChB, FRACP, Cameron Slorach, RDCS, Lawrence W. K. Ng, BSc, Deborah M. Levy, MD, MS, FRCPC: The Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: Lawrence W K
authors.initials: LW
authors.lastname: Ng
authors.affiliation: Centre Hospitalier Universitaire St. Justine, University of Montreal, Montreal, Quebec, Canada), Timothy J. Bradley, MBChB, FRACP, Cameron Slorach, RDCS, Lawrence W. K. Ng, BSc, Deborah M. Levy, MD, MS, FRCPC: The Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: Deborah M
authors.initials: DM
authors.lastname: Levy
authors.affiliation: The Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada.
authors.forename: Earl D
authors.initials: ED
authors.lastname: Silverman
mesh_terms: D000293:Adolescent; D017668:Age of Onset; D050197:Atherosclerosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology*; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology*; D059168:Carotid Intima-Media Thickness; D016022:Case-Control Studies; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology*; D008297:Male; D011446:Prospective Studies; D063177:Pulse Wave Analysis; D013997:Time Factors; D014664:Vasodilation / Q000502:physiology*