title: Dyslipidemia in systemic lupus erythematosus: just another comorbidity?
abstract: OBJECTIVE
  Among traditional atherosclerotic risk factors, dyslipidemia is believed to decisively affect the long-term prognosis of lupus patients, not only with regard to cardiovascular events but also by influencing other manifestations, such as lupus nephritis. The aim of this study was to review the epidemiology, pathogenesis, evidence for its impact on atherosclerosis manifestations and management of dyslipidemia in lupus patients.
  
  
  METHODS
  English-restricted MEDLINE database search (Medical Subject Headings: lupus or systemic lupus erythematosus and dyslipidemia or hyperlipidemia).
  
  
  RESULTS
  The prevalence of dyslipidemia in systemic lupus erythematosus (SLE) ranges from 36% at diagnosis to 60% or even higher after 3 years, depending on definition. Multiple pathogenetic mechanisms are implicated, including antibodies against lipoprotein lipase and cytokines affecting the balance between pro- and anti-atherogenic lipoproteins. Dyslipidemia has a clear impact on clinical cardiovascular disease and surrogate markers for subclinical atherosclerosis. Moreover, it negatively affects end-organ damage (kidneys and brain). Treatment with statins yielded contradictory results as per minimizing cardiovascular risk.
  
  
  CONCLUSIONS
  Dyslipidemia is a significant comorbidity of lupus patients with multiple negative effects in the long term. Its treatment represents a modifiable risk factor; prompt and adequate treatment can minimize unnecessary burden in lupus patients, thus reducing hospitalizations and their overall morbidity and mortality.
authors.affiliation: Centre for Prognosis Studies in Rheumatic Diseases, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Tselios
authors.affiliation: 1st Department of Internal Medicine, 424 General Military Hospital of Thessaloniki, Thessaloniki, Greece.
authors.forename: Charalambos
authors.initials: C
authors.lastname: Koumaras
authors.affiliation: Centre for Prognosis Studies in Rheumatic Diseases, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada.
authors.forename: Dafna D
authors.initials: DD
authors.lastname: Gladman
authors.affiliation: Centre for Prognosis Studies in Rheumatic Diseases, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada. Electronic address: m.urowitz@utoronto.ca.
authors.forename: Murray B
authors.initials: MB
authors.lastname: Urowitz
mesh_terms: D015897:Comorbidity; D050171:Dyslipidemias / Q000188:drug therapy / Q000453:epidemiology*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D008180:Lupus Erythematosus, Systemic / Q000453:epidemiology*; D015995:Prevalence; D011379:Prognosis
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: Dyslipidemia; Pathogenesis; Systemic lupus erythematosus; Therapy