Clinical associations of the metabolic syndrome in systemic lupus erythematosus: data from an international inception cohort
Identifieur interne : 000346 ( Canada/Analysis ); précédent : 000345; suivant : 000347Clinical associations of the metabolic syndrome in systemic lupus erythematosus: data from an international inception cohort
Auteurs : Ben Parker [Royaume-Uni] ; Murray B. Urowitz [Canada] ; Dafna D. Gladman [Canada] ; Mark Lunt [Royaume-Uni] ; Sang-Cheol Bae [Corée du Sud] ; Jorge Sanchez-Guerrero [Mexique] ; Juanita Romero-Diaz [Mexique] ; Caroline Gordon [Royaume-Uni] ; Daniel J. Wallace [États-Unis] ; Ann E. Clarke [Canada] ; Sasha Bernatsky [Canada] ; Ellen M. Ginzler [États-Unis] ; David A. Isenberg [Royaume-Uni] ; Anisur Rahman [Royaume-Uni] ; Joan T. Merrill [États-Unis] ; Graciela S. Alarc N [États-Unis] ; Barri J. Fessler [États-Unis] ; Paul R. Fortin [Canada] ; John G. Hanly [Canada] ; Michelle Petri [États-Unis] ; Kristjan Steinsson [Islande] ; Mary-Anne Dooley [États-Unis] ; Susan Manzi [États-Unis] ; Munther A. Khamashta [Royaume-Uni] ; Rosalind Ramsey-Goldman [États-Unis] ; Asad A. Zoma [Royaume-Uni] ; Gunnar K. Sturfelt [Suède] ; Ola Nived [Suède] ; Cynthia Aranow [États-Unis] ; Meggan Mackay [États-Unis] ; Manuel Ramos-Casals [Espagne] ; Raymond F. Van Vollenhoven [Suède] ; Kenneth C. Kalunian [États-Unis] ; Guillermo Ruiz-Irastorza [Espagne] ; Sam Lim [États-Unis] ; Diane L. Kamen [États-Unis] ; Christine A. Peschken [Canada] ; Murat Inanc [Turquie] ; Ian N. Bruce [Royaume-Uni]Source :
- Annals of the Rheumatic Diseases [ 0003-4967 ] ; 2013-08.
English descriptors
- KwdEn :
- Active disease, American college, American heart association, Antimalarial, Antimalarial agents, Arthritis research, Atherosclerosis, Balancing disease control, Blood institute, Blood pressure, Body mass index, Cardiovascular risk, Central obesity, Centre, Cohort, Consensus statement, Coronary heart disease, Corticosteroid, Corticosteroid doses, Corticosteroid exposure, Cumulative doses, Current exposures, Dalhousie university, Damage index, Diabetes mellitus, Disease activity, Disease duration, Disease phenotype, Disease severity, Dos, Drug therapy, Early disease, Endothelial dysfunction, Enrolment, Epidemiological, Epidemiological research, Epidemiological research table, Epidemiology unit, Erythematosus, Ethnicity, Health research, Health science centre, Health sciences centre, High blood cholesterol, High prevalence, Higher doses, Hispanic, Hispanic ethnicity, Hispanic patients, Immunosuppressant, Immunosuppressive, Immunosuppressive therapies, Individual variables, Institutional research ethics boards, Insulin resistance, Internal medicine, International association, International atherosclerosis society, International diabetes federation, International diabetes federation task force, Korean adults, Korean ethnicity, Laboratory features, Longitudinal studies, Lower prevalence, Lupus, Lupus phenotype, Metabolic, Metabolic syndrome, Mets, Mets development, Mets mets, Mets phenotype, Mets prevalence, Mets status, Mets susceptibility, Minimising corticosteroid exposure, Multivariable, Multivariable model, Multivariable regression analysis, National heart, National institute, Negative association, Nova scotia, Oral corticosteroids, Other ethnicities, Personalised treatment decisions, Phenotype, Prednisolone dose, Present study, Prevalence, Prospective study, Queen elizabeth, Renal, Renal disease, Research ethics committee, Rheum, Rheumatic diseases, Rheumatology, Rheumatology research, Risk factors, Similar rates, Sledai, Slicc, Subclinical atherosclerosis, Supplementary table, Syndrome, Systemic, Systemic lupus, Systemic lupus erythematosus, Systemic lupus erythematosus disease activity index, Therapeutic exposures, Univariate analysis, University health network research institute, Waist circumference, World heart federation.
- Teeft :
- Active disease, American college, American heart association, Antimalarial, Antimalarial agents, Arthritis research, Atherosclerosis, Balancing disease control, Blood institute, Blood pressure, Body mass index, Cardiovascular risk, Central obesity, Centre, Cohort, Consensus statement, Coronary heart disease, Corticosteroid, Corticosteroid doses, Corticosteroid exposure, Cumulative doses, Current exposures, Dalhousie university, Damage index, Diabetes mellitus, Disease activity, Disease duration, Disease phenotype, Disease severity, Dos, Drug therapy, Early disease, Endothelial dysfunction, Enrolment, Epidemiological, Epidemiological research, Epidemiological research table, Epidemiology unit, Erythematosus, Ethnicity, Health research, Health science centre, Health sciences centre, High blood cholesterol, High prevalence, Higher doses, Hispanic, Hispanic ethnicity, Hispanic patients, Immunosuppressant, Immunosuppressive, Immunosuppressive therapies, Individual variables, Institutional research ethics boards, Insulin resistance, Internal medicine, International association, International atherosclerosis society, International diabetes federation, International diabetes federation task force, Korean adults, Korean ethnicity, Laboratory features, Longitudinal studies, Lower prevalence, Lupus, Lupus phenotype, Metabolic, Metabolic syndrome, Mets, Mets development, Mets mets, Mets phenotype, Mets prevalence, Mets status, Mets susceptibility, Minimising corticosteroid exposure, Multivariable, Multivariable model, Multivariable regression analysis, National heart, National institute, Negative association, Nova scotia, Oral corticosteroids, Other ethnicities, Personalised treatment decisions, Phenotype, Prednisolone dose, Present study, Prevalence, Prospective study, Queen elizabeth, Renal, Renal disease, Research ethics committee, Rheum, Rheumatic diseases, Rheumatology, Rheumatology research, Risk factors, Similar rates, Sledai, Slicc, Subclinical atherosclerosis, Supplementary table, Syndrome, Systemic, Systemic lupus, Systemic lupus erythematosus, Systemic lupus erythematosus disease activity index, Therapeutic exposures, Univariate analysis, University health network research institute, Waist circumference, World heart federation.
Abstract
Background The metabolic syndrome (MetS) may contribute to increased cardiovascular risk in systemic lupus erythematosus (SLE). We aimed to examine the association of demographic factors, lupus phenotype and therapy exposure with the presence of MetS. Methods The Systemic Lupus International Collaborating Clinics Registry for Atherosclerosis inception cohort enrolled recently diagnosed (<15 months) SLE patients from 30 centres across 11 countries from 2000. Clinical, laboratory and therapeutic data were collected according to a standardised protocol. MetS was defined according to the 2009 consensus statement from the International Diabetes Federation. Univariate and backward stepwise multivariate logistic regression were used to assess the relationship of individual variables with MetS. Results We studied 1686 patients, of whom 1494 (86.6%) had sufficient data to determine their MetS status. The mean (SD) age at enrolment and disease duration was 35.2 years (13.4) and 24.1 weeks (18.0), respectively. MetS was present at the enrolment visit in 239 (16%). In backward stepwise multivariable regression analysis, higher daily average prednisolone dose (mg) (OR 1.02, 95% CI 1.00 to 1.03), older age (years) (OR 1.04, 95% CI 1.03 to 1.06), Korean (OR 6.33, 95% CI 3.68 to 10.86) and Hispanic (OR 6.2, 95% CI 3.78 to 10.12) ethnicity, current renal disease (OR 1.79, 95% CI 1.14 to 2.80) and immunosuppressant use (OR 1.81, 95% CI 1.18 to 2.78) were associated with MetS. Conclusions Renal lupus, higher corticosteroid doses, Korean and Hispanic ethnicity are associated with MetS in SLE patients. Balancing disease control and minimising corticosteroid exposure should therefore be at the forefront of personalised treatment decisions in SLE patients.
Url:
DOI: 10.1136/annrheumdis-2012-202106
Affiliations:
- Canada, Corée du Sud, Espagne, Islande, Mexique, Royaume-Uni, Suède, Turquie, États-Unis
- Alabama, Angleterre, Californie, Caroline du Nord, Caroline du Sud, Catalogne, Grand Londres, Grand Manchester, Géorgie (États-Unis), Illinois, Manitoba, Maryland, Midlands de l'Ouest, Oklahoma, Ontario, Pennsylvanie, Région capitale de Séoul, Svealand, État de New York
- Barcelone, Birmingham, Londres, Manchester, Stockholm, Séoul, Toronto, Winnipeg
- University College de Londres, Université de Birmingham, Université de Manchester, Université de Toronto, Université du Manitoba
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Wallace</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Rheumatology, Cedars-Sinai/David Geffen School of Medicine at UCLA, Los Angeles, California</wicri:regionArea><placeName><region type="state">Californie</region></placeName></affiliation></author><author><name sortKey="Clarke, Ann E" sort="Clarke, Ann E" uniqKey="Clarke A" first="Ann E" last="Clarke">Ann E. Clarke</name><affiliation wicri:level="1"><country xml:lang="fr">Canada</country><wicri:regionArea>Divisions of Clinical Immunology/Allergy and Clinical Epidemiology, Montreal General Hospital, McGill University Health Centre, Montreal, Quebec</wicri:regionArea><wicri:noRegion>Quebec</wicri:noRegion></affiliation></author><author><name sortKey="Bernatsky, Sasha" sort="Bernatsky, Sasha" uniqKey="Bernatsky S" first="Sasha" last="Bernatsky">Sasha Bernatsky</name><affiliation wicri:level="1"><country xml:lang="fr">Canada</country><wicri:regionArea>Divisions of Clinical Immunology/Allergy and Clinical Epidemiology, Montreal General Hospital, McGill University Health Centre, Montreal, Quebec</wicri:regionArea><wicri:noRegion>Quebec</wicri:noRegion></affiliation></author><author><name sortKey="Ginzler, Ellen M" sort="Ginzler, Ellen M" uniqKey="Ginzler E" first="Ellen M" last="Ginzler">Ellen M. Ginzler</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Medicine, SUNY Downstate Medical Center, Brooklyn, New York</wicri:regionArea><placeName><region type="state">État de New York</region></placeName></affiliation></author><author><name sortKey="Isenberg, David A" sort="Isenberg, David A" uniqKey="Isenberg D" first="David A" last="Isenberg">David A. Isenberg</name><affiliation wicri:level="4"><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Centre for Rheumatology Research, University College London, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region><settlement type="city">Londres</settlement></placeName><orgName type="university">University College de Londres</orgName></affiliation></author><author><name sortKey="Rahman, Anisur" sort="Rahman, Anisur" uniqKey="Rahman A" first="Anisur" last="Rahman">Anisur Rahman</name><affiliation wicri:level="4"><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Centre for Rheumatology Research, University College London, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region><settlement type="city">Londres</settlement></placeName><orgName type="university">University College de Londres</orgName></affiliation></author><author><name sortKey="Merrill, Joan T" sort="Merrill, Joan T" uniqKey="Merrill J" first="Joan T" last="Merrill">Joan T. Merrill</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Clinical Pharmacology, Oklahoma Medical Research Foundation, Oklahoma City, Oklahoma</wicri:regionArea><placeName><region type="state">Oklahoma</region></placeName></affiliation></author><author><name sortKey="Alarc N, Graciela S" sort="Alarc N, Graciela S" uniqKey="Alarc N G" first="Graciela S" last="Alarc N">Graciela S. Alarc N</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama</wicri:regionArea><placeName><region type="state">Alabama</region></placeName></affiliation></author><author><name sortKey="Fessler, Barri J" sort="Fessler, Barri J" uniqKey="Fessler B" first="Barri J" last="Fessler">Barri J. Fessler</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama</wicri:regionArea><placeName><region type="state">Alabama</region></placeName></affiliation></author><author><name sortKey="Fortin, Paul R" sort="Fortin, Paul R" uniqKey="Fortin P" first="Paul R" last="Fortin">Paul R. Fortin</name><affiliation wicri:level="1"><country xml:lang="fr">Canada</country><wicri:regionArea>Division of Rheumatology, Centre Hospitalier Universitaire de Québec et Université Laval, Quebec City, Quebec</wicri:regionArea><wicri:noRegion>Quebec</wicri:noRegion></affiliation></author><author><name sortKey="Hanly, John G" sort="Hanly, John G" uniqKey="Hanly J" first="John G" last="Hanly">John G. Hanly</name><affiliation wicri:level="1"><country xml:lang="fr">Canada</country><wicri:regionArea>Division of Rheumatology, Department of Medicine, Queen Elizabeth II Health Sciences Centre and Dalhousie University, Halifax, Nova Scotia</wicri:regionArea><wicri:noRegion>Nova Scotia</wicri:noRegion></affiliation><affiliation wicri:level="1"><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Pathology, Queen Elizabeth II Health Sciences Centre and Dalhousie University, Halifax, Nova Scotia</wicri:regionArea><wicri:noRegion>Nova Scotia</wicri:noRegion></affiliation></author><author><name sortKey="Petri, Michelle" sort="Petri, Michelle" uniqKey="Petri M" first="Michelle" last="Petri">Michelle Petri</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Rheumatology, Johns Hopkins University, Baltimore, Maryland</wicri:regionArea><placeName><region type="state">Maryland</region></placeName></affiliation></author><author><name sortKey="Steinsson, Kristjan" sort="Steinsson, Kristjan" uniqKey="Steinsson K" first="Kristjan" last="Steinsson">Kristjan Steinsson</name><affiliation wicri:level="1"><country xml:lang="fr">Islande</country><wicri:regionArea>Center for Rheumatology Research, Landspitali University Hospital, Reykjavik</wicri:regionArea><wicri:noRegion>Reykjavik</wicri:noRegion></affiliation></author><author><name sortKey="Dooley, Mary Anne" sort="Dooley, Mary Anne" uniqKey="Dooley M" first="Mary-Anne" last="Dooley">Mary-Anne Dooley</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><wicri:regionArea>University of North Carolina, Chapel Hill, North Carolina</wicri:regionArea><placeName><region type="state">Caroline du Nord</region></placeName></affiliation></author><author><name sortKey="Manzi, Susan" sort="Manzi, Susan" uniqKey="Manzi S" first="Susan" last="Manzi">Susan Manzi</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Medicine, West Penn Allegheny, Pittsburgh, Pennsylvania</wicri:regionArea><placeName><region type="state">Pennsylvanie</region></placeName></affiliation></author><author><name sortKey="Khamashta, Munther A" sort="Khamashta, Munther A" uniqKey="Khamashta M" first="Munther A" last="Khamashta">Munther A. Khamashta</name><affiliation wicri:level="3"><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Lupus Research Unit, The Rayne Institute, St Thomas’ Hospital, King's College London School of Medicine, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Ramsey Goldman, Rosalind" sort="Ramsey Goldman, Rosalind" uniqKey="Ramsey Goldman R" first="Rosalind" last="Ramsey-Goldman">Rosalind Ramsey-Goldman</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><wicri:regionArea>Northwestern University and Feinberg School of Medicine, Chicago, Illinois</wicri:regionArea><placeName><region type="state">Illinois</region></placeName></affiliation></author><author><name sortKey="Zoma, Asad A" sort="Zoma, Asad A" uniqKey="Zoma A" first="Asad A" last="Zoma">Asad A. Zoma</name><affiliation wicri:level="1"><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Lanarkshire Centre for Rheumatology, Hairmyres Hospital, East Kilbride, Scotland</wicri:regionArea><wicri:noRegion>Scotland</wicri:noRegion></affiliation></author><author><name sortKey="Sturfelt, Gunnar K" sort="Sturfelt, Gunnar K" uniqKey="Sturfelt G" first="Gunnar K" last="Sturfelt">Gunnar K. Sturfelt</name><affiliation wicri:level="1"><country xml:lang="fr">Suède</country><wicri:regionArea>Department of Rheumatology, University Hospital Lund, Lund</wicri:regionArea><wicri:noRegion>Lund</wicri:noRegion></affiliation></author><author><name sortKey="Nived, Ola" sort="Nived, Ola" uniqKey="Nived O" first="Ola" last="Nived">Ola Nived</name><affiliation wicri:level="1"><country xml:lang="fr">Suède</country><wicri:regionArea>Department of Rheumatology, University Hospital Lund, Lund</wicri:regionArea><wicri:noRegion>Lund</wicri:noRegion></affiliation></author><author><name sortKey="Aranow, Cynthia" sort="Aranow, Cynthia" uniqKey="Aranow C" first="Cynthia" last="Aranow">Cynthia Aranow</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><wicri:regionArea>Center for Autoimmune and Musculoskeletal, Feinstein Institute for Medical Research, Manhasset, New York</wicri:regionArea><placeName><region type="state">État de New York</region></placeName></affiliation></author><author><name sortKey="Mackay, Meggan" sort="Mackay, Meggan" uniqKey="Mackay M" first="Meggan" last="Mackay">Meggan Mackay</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><wicri:regionArea>Center for Autoimmune and Musculoskeletal, Feinstein Institute for Medical Research, Manhasset, New York</wicri:regionArea><placeName><region type="state">État de New York</region></placeName></affiliation></author><author><name sortKey="Ramos Casals, Manuel" sort="Ramos Casals, Manuel" uniqKey="Ramos Casals M" first="Manuel" last="Ramos-Casals">Manuel Ramos-Casals</name><affiliation wicri:level="3"><country xml:lang="fr">Espagne</country><wicri:regionArea>Josep Font Autoimmune Diseases Laboratory, IDIBAPS, Department of Autoimmune Diseases, Hospital Clínic, Barcelona</wicri:regionArea><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author><author><name sortKey="Van Vollenhoven, Raymond F" sort="Van Vollenhoven, Raymond F" uniqKey="Van Vollenhoven R" first="Raymond F" last="Van Vollenhoven">Raymond F. Van Vollenhoven</name><affiliation wicri:level="3"><country xml:lang="fr">Suède</country><wicri:regionArea>Department of Rheumatology, Karolinska Institute, Stockholm</wicri:regionArea><placeName><settlement type="city">Stockholm</settlement><region nuts="2">Svealand</region></placeName></affiliation></author><author><name sortKey="Kalunian, Kenneth C" sort="Kalunian, Kenneth C" uniqKey="Kalunian K" first="Kenneth C" last="Kalunian">Kenneth C. Kalunian</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><wicri:regionArea>UCSD School of Medicine, La Jolla, California</wicri:regionArea><placeName><region type="state">Californie</region></placeName></affiliation></author><author><name sortKey="Ruiz Irastorza, Guillermo" sort="Ruiz Irastorza, Guillermo" uniqKey="Ruiz Irastorza G" first="Guillermo" last="Ruiz-Irastorza">Guillermo Ruiz-Irastorza</name><affiliation wicri:level="1"><country xml:lang="fr">Espagne</country><wicri:regionArea>Autoimmune Disease Unit, Department of Internal Medicine, Hospital Universitario Cruces, University of the Basque Country, Barakaldo</wicri:regionArea><wicri:noRegion>Barakaldo</wicri:noRegion></affiliation></author><author><name sortKey="Lim, Sam" sort="Lim, Sam" uniqKey="Lim S" first="Sam" last="Lim">Sam Lim</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><wicri:regionArea>School of Medicine, Emory University, Atlanta, Georgia</wicri:regionArea><placeName><region type="state">Géorgie (États-Unis)</region></placeName></affiliation></author><author><name sortKey="Kamen, Diane L" sort="Kamen, Diane L" uniqKey="Kamen D" first="Diane L" last="Kamen">Diane L. Kamen</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><wicri:regionArea>Medical University of South Carolina, Charleston, South Carolina</wicri:regionArea><placeName><region type="state">Caroline du Sud</region></placeName></affiliation></author><author><name sortKey="Peschken, Christine A" sort="Peschken, Christine A" uniqKey="Peschken C" first="Christine A" last="Peschken">Christine A. Peschken</name><affiliation wicri:level="4"><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba</wicri:regionArea><orgName type="university">Université du Manitoba</orgName><placeName><settlement type="city">Winnipeg</settlement><region type="state">Manitoba</region></placeName></affiliation></author><author><name sortKey="Inanc, Murat" sort="Inanc, Murat" uniqKey="Inanc M" first="Murat" last="Inanc">Murat Inanc</name><affiliation wicri:level="1"><country xml:lang="fr">Turquie</country><wicri:regionArea>Division of Rheumatology, Department of Internal Medicine, Istanbul University, Istanbul</wicri:regionArea><wicri:noRegion>Istanbul</wicri:noRegion></affiliation></author><author><name sortKey="Bruce, Ian N" sort="Bruce, Ian N" uniqKey="Bruce I" first="Ian N" last="Bruce">Ian N. Bruce</name><affiliation wicri:level="4"><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Arthritis Research UK Epidemiology Unit, Institute of Inflammation and Repair, Manchester Academic Health Sciences Centre, The University of Manchester, Manchester</wicri:regionArea><placeName><settlement type="city">Manchester</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Manchester</region><settlement type="city">Manchester</settlement></placeName><orgName type="university">Université de Manchester</orgName></affiliation><affiliation wicri:level="3"><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester</wicri:regionArea><placeName><settlement type="city">Manchester</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Manchester</region></placeName></affiliation></author></analytic><monogr></monogr><series><title level="j">Annals of the Rheumatic Diseases</title><title level="j" type="abbrev">Ann Rheum Dis</title><idno type="ISSN">0003-4967</idno><idno type="eISSN">1468-2060</idno><imprint><publisher>BMJ Publishing Group Ltd and European League Against Rheumatism</publisher><date type="published" when="2013-08">2013-08</date><biblScope unit="volume">72</biblScope><biblScope unit="issue">8</biblScope><biblScope unit="page" from="1308">1308</biblScope></imprint><idno type="ISSN">0003-4967</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0003-4967</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Active disease</term><term>American college</term><term>American heart association</term><term>Antimalarial</term><term>Antimalarial agents</term><term>Arthritis research</term><term>Atherosclerosis</term><term>Balancing disease control</term><term>Blood institute</term><term>Blood pressure</term><term>Body mass index</term><term>Cardiovascular risk</term><term>Central obesity</term><term>Centre</term><term>Cohort</term><term>Consensus statement</term><term>Coronary heart disease</term><term>Corticosteroid</term><term>Corticosteroid doses</term><term>Corticosteroid exposure</term><term>Cumulative doses</term><term>Current exposures</term><term>Dalhousie university</term><term>Damage index</term><term>Diabetes mellitus</term><term>Disease activity</term><term>Disease duration</term><term>Disease phenotype</term><term>Disease severity</term><term>Dos</term><term>Drug therapy</term><term>Early disease</term><term>Endothelial dysfunction</term><term>Enrolment</term><term>Epidemiological</term><term>Epidemiological research</term><term>Epidemiological research table</term><term>Epidemiology unit</term><term>Erythematosus</term><term>Ethnicity</term><term>Health research</term><term>Health science centre</term><term>Health sciences centre</term><term>High blood cholesterol</term><term>High prevalence</term><term>Higher doses</term><term>Hispanic</term><term>Hispanic ethnicity</term><term>Hispanic patients</term><term>Immunosuppressant</term><term>Immunosuppressive</term><term>Immunosuppressive therapies</term><term>Individual variables</term><term>Institutional research ethics boards</term><term>Insulin resistance</term><term>Internal medicine</term><term>International association</term><term>International atherosclerosis society</term><term>International diabetes federation</term><term>International diabetes federation task force</term><term>Korean adults</term><term>Korean ethnicity</term><term>Laboratory features</term><term>Longitudinal studies</term><term>Lower prevalence</term><term>Lupus</term><term>Lupus phenotype</term><term>Metabolic</term><term>Metabolic syndrome</term><term>Mets</term><term>Mets development</term><term>Mets mets</term><term>Mets phenotype</term><term>Mets prevalence</term><term>Mets status</term><term>Mets susceptibility</term><term>Minimising corticosteroid exposure</term><term>Multivariable</term><term>Multivariable model</term><term>Multivariable regression analysis</term><term>National heart</term><term>National institute</term><term>Negative association</term><term>Nova scotia</term><term>Oral corticosteroids</term><term>Other ethnicities</term><term>Personalised treatment decisions</term><term>Phenotype</term><term>Prednisolone dose</term><term>Present study</term><term>Prevalence</term><term>Prospective study</term><term>Queen elizabeth</term><term>Renal</term><term>Renal disease</term><term>Research ethics committee</term><term>Rheum</term><term>Rheumatic diseases</term><term>Rheumatology</term><term>Rheumatology research</term><term>Risk factors</term><term>Similar rates</term><term>Sledai</term><term>Slicc</term><term>Subclinical atherosclerosis</term><term>Supplementary table</term><term>Syndrome</term><term>Systemic</term><term>Systemic lupus</term><term>Systemic lupus erythematosus</term><term>Systemic lupus erythematosus disease activity index</term><term>Therapeutic exposures</term><term>Univariate analysis</term><term>University health network research institute</term><term>Waist circumference</term><term>World heart federation</term></keywords><keywords scheme="Teeft" xml:lang="en"><term>Active disease</term><term>American college</term><term>American heart association</term><term>Antimalarial</term><term>Antimalarial agents</term><term>Arthritis research</term><term>Atherosclerosis</term><term>Balancing disease control</term><term>Blood institute</term><term>Blood pressure</term><term>Body mass index</term><term>Cardiovascular risk</term><term>Central obesity</term><term>Centre</term><term>Cohort</term><term>Consensus statement</term><term>Coronary heart disease</term><term>Corticosteroid</term><term>Corticosteroid doses</term><term>Corticosteroid exposure</term><term>Cumulative doses</term><term>Current exposures</term><term>Dalhousie university</term><term>Damage index</term><term>Diabetes mellitus</term><term>Disease activity</term><term>Disease duration</term><term>Disease phenotype</term><term>Disease severity</term><term>Dos</term><term>Drug therapy</term><term>Early disease</term><term>Endothelial dysfunction</term><term>Enrolment</term><term>Epidemiological</term><term>Epidemiological research</term><term>Epidemiological research table</term><term>Epidemiology unit</term><term>Erythematosus</term><term>Ethnicity</term><term>Health research</term><term>Health science centre</term><term>Health sciences centre</term><term>High blood cholesterol</term><term>High prevalence</term><term>Higher doses</term><term>Hispanic</term><term>Hispanic ethnicity</term><term>Hispanic patients</term><term>Immunosuppressant</term><term>Immunosuppressive</term><term>Immunosuppressive therapies</term><term>Individual variables</term><term>Institutional research ethics boards</term><term>Insulin resistance</term><term>Internal medicine</term><term>International association</term><term>International atherosclerosis society</term><term>International diabetes federation</term><term>International diabetes federation task force</term><term>Korean adults</term><term>Korean ethnicity</term><term>Laboratory features</term><term>Longitudinal studies</term><term>Lower prevalence</term><term>Lupus</term><term>Lupus phenotype</term><term>Metabolic</term><term>Metabolic syndrome</term><term>Mets</term><term>Mets development</term><term>Mets mets</term><term>Mets phenotype</term><term>Mets prevalence</term><term>Mets status</term><term>Mets susceptibility</term><term>Minimising corticosteroid exposure</term><term>Multivariable</term><term>Multivariable model</term><term>Multivariable regression analysis</term><term>National heart</term><term>National institute</term><term>Negative association</term><term>Nova scotia</term><term>Oral corticosteroids</term><term>Other ethnicities</term><term>Personalised treatment decisions</term><term>Phenotype</term><term>Prednisolone dose</term><term>Present study</term><term>Prevalence</term><term>Prospective study</term><term>Queen elizabeth</term><term>Renal</term><term>Renal disease</term><term>Research ethics committee</term><term>Rheum</term><term>Rheumatic diseases</term><term>Rheumatology</term><term>Rheumatology research</term><term>Risk factors</term><term>Similar rates</term><term>Sledai</term><term>Slicc</term><term>Subclinical atherosclerosis</term><term>Supplementary table</term><term>Syndrome</term><term>Systemic</term><term>Systemic lupus</term><term>Systemic lupus erythematosus</term><term>Systemic lupus erythematosus disease activity index</term><term>Therapeutic exposures</term><term>Univariate analysis</term><term>University health network research institute</term><term>Waist circumference</term><term>World heart federation</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract">Background The metabolic syndrome (MetS) may contribute to increased cardiovascular risk in systemic lupus erythematosus (SLE). We aimed to examine the association of demographic factors, lupus phenotype and therapy exposure with the presence of MetS. Methods The Systemic Lupus International Collaborating Clinics Registry for Atherosclerosis inception cohort enrolled recently diagnosed (<15 months) SLE patients from 30 centres across 11 countries from 2000. Clinical, laboratory and therapeutic data were collected according to a standardised protocol. MetS was defined according to the 2009 consensus statement from the International Diabetes Federation. Univariate and backward stepwise multivariate logistic regression were used to assess the relationship of individual variables with MetS. Results We studied 1686 patients, of whom 1494 (86.6%) had sufficient data to determine their MetS status. The mean (SD) age at enrolment and disease duration was 35.2 years (13.4) and 24.1 weeks (18.0), respectively. MetS was present at the enrolment visit in 239 (16%). In backward stepwise multivariable regression analysis, higher daily average prednisolone dose (mg) (OR 1.02, 95% CI 1.00 to 1.03), older age (years) (OR 1.04, 95% CI 1.03 to 1.06), Korean (OR 6.33, 95% CI 3.68 to 10.86) and Hispanic (OR 6.2, 95% CI 3.78 to 10.12) ethnicity, current renal disease (OR 1.79, 95% CI 1.14 to 2.80) and immunosuppressant use (OR 1.81, 95% CI 1.18 to 2.78) were associated with MetS. Conclusions Renal lupus, higher corticosteroid doses, Korean and Hispanic ethnicity are associated with MetS in SLE patients. Balancing disease control and minimising corticosteroid exposure should therefore be at the forefront of personalised treatment decisions in SLE patients.</div></front></TEI><affiliations><list><country><li>Canada</li><li>Corée du Sud</li><li>Espagne</li><li>Islande</li><li>Mexique</li><li>Royaume-Uni</li><li>Suède</li><li>Turquie</li><li>États-Unis</li></country><region><li>Alabama</li><li>Angleterre</li><li>Californie</li><li>Caroline du Nord</li><li>Caroline du Sud</li><li>Catalogne</li><li>Grand Londres</li><li>Grand Manchester</li><li>Géorgie (États-Unis)</li><li>Illinois</li><li>Manitoba</li><li>Maryland</li><li>Midlands de l'Ouest</li><li>Oklahoma</li><li>Ontario</li><li>Pennsylvanie</li><li>Région capitale de Séoul</li><li>Svealand</li><li>État de New York</li></region><settlement><li>Barcelone</li><li>Birmingham</li><li>Londres</li><li>Manchester</li><li>Stockholm</li><li>Séoul</li><li>Toronto</li><li>Winnipeg</li></settlement><orgName><li>University College de Londres</li><li>Université de Birmingham</li><li>Université de Manchester</li><li>Université de Toronto</li><li>Université du Manitoba</li></orgName></list><tree><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Parker, Ben" sort="Parker, Ben" uniqKey="Parker B" first="Ben" last="Parker">Ben Parker</name></region><name sortKey="Bruce, Ian N" sort="Bruce, Ian N" uniqKey="Bruce I" first="Ian N" last="Bruce">Ian N. Bruce</name><name sortKey="Bruce, Ian N" sort="Bruce, Ian N" uniqKey="Bruce I" first="Ian N" last="Bruce">Ian N. Bruce</name><name sortKey="Gordon, Caroline" sort="Gordon, Caroline" uniqKey="Gordon C" first="Caroline" last="Gordon">Caroline Gordon</name><name sortKey="Isenberg, David A" sort="Isenberg, David A" uniqKey="Isenberg D" first="David A" last="Isenberg">David A. Isenberg</name><name sortKey="Khamashta, Munther A" sort="Khamashta, Munther A" uniqKey="Khamashta M" first="Munther A" last="Khamashta">Munther A. Khamashta</name><name sortKey="Lunt, Mark" sort="Lunt, Mark" uniqKey="Lunt M" first="Mark" last="Lunt">Mark Lunt</name><name sortKey="Lunt, Mark" sort="Lunt, Mark" uniqKey="Lunt M" first="Mark" last="Lunt">Mark Lunt</name><name sortKey="Rahman, Anisur" sort="Rahman, Anisur" uniqKey="Rahman A" first="Anisur" last="Rahman">Anisur Rahman</name><name sortKey="Zoma, Asad A" sort="Zoma, Asad A" uniqKey="Zoma A" first="Asad A" last="Zoma">Asad A. Zoma</name></country><country name="Canada"><region name="Ontario"><name sortKey="Urowitz, Murray B" sort="Urowitz, Murray B" uniqKey="Urowitz M" first="Murray B" last="Urowitz">Murray B. Urowitz</name></region><name sortKey="Bernatsky, Sasha" sort="Bernatsky, Sasha" uniqKey="Bernatsky S" first="Sasha" last="Bernatsky">Sasha Bernatsky</name><name sortKey="Clarke, Ann E" sort="Clarke, Ann E" uniqKey="Clarke A" first="Ann E" last="Clarke">Ann E. Clarke</name><name sortKey="Fortin, Paul R" sort="Fortin, Paul R" uniqKey="Fortin P" first="Paul R" last="Fortin">Paul R. Fortin</name><name sortKey="Gladman, Dafna D" sort="Gladman, Dafna D" uniqKey="Gladman D" first="Dafna D" last="Gladman">Dafna D. Gladman</name><name sortKey="Hanly, John G" sort="Hanly, John G" uniqKey="Hanly J" first="John G" last="Hanly">John G. Hanly</name><name sortKey="Hanly, John G" sort="Hanly, John G" uniqKey="Hanly J" first="John G" last="Hanly">John G. Hanly</name><name sortKey="Peschken, Christine A" sort="Peschken, Christine A" uniqKey="Peschken C" first="Christine A" last="Peschken">Christine A. Peschken</name></country><country name="Corée du Sud"><region name="Région capitale de Séoul"><name sortKey="Bae, Sang Cheol" sort="Bae, Sang Cheol" uniqKey="Bae S" first="Sang-Cheol" last="Bae">Sang-Cheol Bae</name></region></country><country name="Mexique"><noRegion><name sortKey="Sanchez Guerrero, Jorge" sort="Sanchez Guerrero, Jorge" uniqKey="Sanchez Guerrero J" first="Jorge" last="Sanchez-Guerrero">Jorge Sanchez-Guerrero</name></noRegion><name sortKey="Romero Diaz, Juanita" sort="Romero Diaz, Juanita" uniqKey="Romero Diaz J" first="Juanita" last="Romero-Diaz">Juanita Romero-Diaz</name></country><country name="États-Unis"><region name="Californie"><name sortKey="Wallace, Daniel J" sort="Wallace, Daniel J" uniqKey="Wallace D" first="Daniel J" last="Wallace">Daniel J. Wallace</name></region><name sortKey="Alarc N, Graciela S" sort="Alarc N, Graciela S" uniqKey="Alarc N G" first="Graciela S" last="Alarc N">Graciela S. Alarc N</name><name sortKey="Aranow, Cynthia" sort="Aranow, Cynthia" uniqKey="Aranow C" first="Cynthia" last="Aranow">Cynthia Aranow</name><name sortKey="Dooley, Mary Anne" sort="Dooley, Mary Anne" uniqKey="Dooley M" first="Mary-Anne" last="Dooley">Mary-Anne Dooley</name><name sortKey="Fessler, Barri J" sort="Fessler, Barri J" uniqKey="Fessler B" first="Barri J" last="Fessler">Barri J. Fessler</name><name sortKey="Ginzler, Ellen M" sort="Ginzler, Ellen M" uniqKey="Ginzler E" first="Ellen M" last="Ginzler">Ellen M. Ginzler</name><name sortKey="Kalunian, Kenneth C" sort="Kalunian, Kenneth C" uniqKey="Kalunian K" first="Kenneth C" last="Kalunian">Kenneth C. Kalunian</name><name sortKey="Kamen, Diane L" sort="Kamen, Diane L" uniqKey="Kamen D" first="Diane L" last="Kamen">Diane L. Kamen</name><name sortKey="Lim, Sam" sort="Lim, Sam" uniqKey="Lim S" first="Sam" last="Lim">Sam Lim</name><name sortKey="Mackay, Meggan" sort="Mackay, Meggan" uniqKey="Mackay M" first="Meggan" last="Mackay">Meggan Mackay</name><name sortKey="Manzi, Susan" sort="Manzi, Susan" uniqKey="Manzi S" first="Susan" last="Manzi">Susan Manzi</name><name sortKey="Merrill, Joan T" sort="Merrill, Joan T" uniqKey="Merrill J" first="Joan T" last="Merrill">Joan T. Merrill</name><name sortKey="Petri, Michelle" sort="Petri, Michelle" uniqKey="Petri M" first="Michelle" last="Petri">Michelle Petri</name><name sortKey="Ramsey Goldman, Rosalind" sort="Ramsey Goldman, Rosalind" uniqKey="Ramsey Goldman R" first="Rosalind" last="Ramsey-Goldman">Rosalind Ramsey-Goldman</name></country><country name="Islande"><noRegion><name sortKey="Steinsson, Kristjan" sort="Steinsson, Kristjan" uniqKey="Steinsson K" first="Kristjan" last="Steinsson">Kristjan Steinsson</name></noRegion></country><country name="Suède"><noRegion><name sortKey="Sturfelt, Gunnar K" sort="Sturfelt, Gunnar K" uniqKey="Sturfelt G" first="Gunnar K" last="Sturfelt">Gunnar K. Sturfelt</name></noRegion><name sortKey="Nived, Ola" sort="Nived, Ola" uniqKey="Nived O" first="Ola" last="Nived">Ola Nived</name><name sortKey="Van Vollenhoven, Raymond F" sort="Van Vollenhoven, Raymond F" uniqKey="Van Vollenhoven R" first="Raymond F" last="Van Vollenhoven">Raymond F. Van Vollenhoven</name></country><country name="Espagne"><region name="Catalogne"><name sortKey="Ramos Casals, Manuel" sort="Ramos Casals, Manuel" uniqKey="Ramos Casals M" first="Manuel" last="Ramos-Casals">Manuel Ramos-Casals</name></region><name sortKey="Ruiz Irastorza, Guillermo" sort="Ruiz Irastorza, Guillermo" uniqKey="Ruiz Irastorza G" first="Guillermo" last="Ruiz-Irastorza">Guillermo Ruiz-Irastorza</name></country><country name="Turquie"><noRegion><name sortKey="Inanc, Murat" sort="Inanc, Murat" uniqKey="Inanc M" first="Murat" last="Inanc">Murat Inanc</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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