Lipid metabolism and disease activity in juvenile Systemic Lupus Erythematosus

Abstract

Objective: To assess the relationship between lipid profile and disease activity in juvenile Systemic Lupus Erythematosus (jSLE) patients. Methods: Retrospective study of jSLE patients (2012 to 2019 EULAR/ACR classification criteria for Systemic Lupus Erythematosus (SLE)). Juvenile-onset was defined as age at diagnosis 18 years. Demographic and clinical characteristics were collected: age of the patient at diagnosis and at the time of the last hospital visit and sex; laboratorial study with Sedimentation Rate, C-Reactive Protein, Albumin, Creatinine, Complement (C3 and C4), antibodies related to LES and lipid profile; urinalyses; clinical manifestations and patient's medication. To evaluate the activity of jSLE, the Systemic Lupus Erythematosus Disease Activity Index-2K (SLEDAI-2K) was used. The statistical analysis was performed using the software SPSS 22.0. Spearman's rank non-parametric test, Pearson's parametric test, T-test and Mann-Whitney test were used. P value < 0.05 was considered significant for all the statistical tests. Results: 35 patients were included (91.4% female). The current median age and the average age at diagnosis of the patients were 22 (16-35) and 15.8 (2.4) years, respectively. Total cholesterol was negatively correlated with serum albumin (p= 0.043, rho=-0.378) and positively with SLEDAI (p=0.032; rho= 0.392), proteinuria (p=0.009; rho= 0.469) and leukocyturia (p=0.031; rho= 0.394). A positive correlation was found between LDL cholesterol and proteinuria (p=0.043; rho= 0.385). Triglycerides were positively correlated with C-Reactive Protein (p=0.001; rho= 0.575) and prednisolone daily dose (p=0.035; rho= 0.394). HDL cholesterol correlated positively with proteinuria (p=0.026, rho= 0.407) and serum creatinine (p= 0.045, rho= 0.369). Mean LDL cholesterol was higher in anti-Sm positive patients (p=0.022). No differences were found regarding anti-phospholipids antibodies. Conclusion: In our LESj patients group an increased expression of total cholesterol, LDL cholesterol, HDL cholesterol and triglycerides is associated with disease activity. High doses of corticotherapy is also associated with worse lipid profile.