Nephrotic-range proteinuria, the major risk factor for early atherosclerosis in juvenile-onset systemic lupus erythematosus

Francesco Falaschi, Angelo Ravelli, Alessandra Martignoni, Daniela Migliavacca, Marta Sartori, Angela Pistorio, Guido Perani, Alberto Martini

Research output: Contribution to journalArticle

Abstract

Objective. To determine the presence of early carotid atherosclerosis and associated risk factors in patients with juvenile-onset systemic lupus erythematosus (SLE). Methods. The carotid intima-media wall thickness (IMT) was measured by B-mode ultrasound in patients with SLE onset before the age of 16 years and in sex- and age-matched healthy control subjects. Risk factors for atherosclerosis were determined at the time of the ultrasound scan and included traditional cardiovascular and SLE-related risk factors. Results. Twenty-six patients with juvenile-onset SLE and 26 healthy controls were studied. The mean (± SD) IMT of the SLE patients was signifcantly higher than that of the control group (0.57 ± 0.05 mm and 0.54 ± 0.03 mm, respectively; P = 0.006). The results of IMT measurement were not correlated with the patients' age, disease duration, SLE Disease Activity Index (SLEDAI) score, Systemic Lupus International Collaborating Clinics/American College of Rheumatology (SLICC/ACR) Damage Index (DI) score, laboratory indicators of lupus activity, or cumulative prednisone dose. Patients with nephrotic-range (NR) proteinuria ≥3.5 gm/24 hours; n = 6) had a significantly higher IMT than did those without (n = 20) (P = 0.02). Patients with NR proteinuria also had significantly higher SLEDAI scores, SLICC/ACR DI scores, and systolic and diastolic blood pressures, and significantly higher levels of total cholesterol, low-density lipoprotein cholesterol, apolipoprotein B, and fibrinogen. No difference in any of the above variables, including the IMT, was observed when SLE patients without NR proteinuria were compared with healthy controls. Conclusion. These patients with juvenile-onset SLE had ultrasonographic evidence of premature atherosclerosis. The risk of early atherosclerosis may be higher in patients with NR proteinuria.

Original languageEnglish
Pages (from-to)1405-1409
Number of pages5
JournalArthritis and Rheumatism
Volume43
Issue number6
DOIs
Publication statusPublished - Jun 2000

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ASJC Scopus subject areas

  • Immunology
  • Rheumatology

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