【摘 要】
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Objective To study atheroslerosis in systemic lupus erythematosus in relation to traditional and non-traditional risk factors for cardiovascular disease (CVD) including atheroprotective natural antibo
【机 构】
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Department of Medicine Karolinska University Hospital Sweden
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Objective To study atheroslerosis in systemic lupus erythematosus in relation to traditional and non-traditional risk factors for cardiovascular disease (CVD) including atheroprotective natural antibodies against phosphorylcholine (anti-PC).Methods One hundred fourteen patient with SLE were compared with one hundred twenty two age-and sex matched population-based controls, all from Southern Stockholm.Common carotid intima-media thickness (IMT) and plaque occurrence (IMT >lmm) were determined by B-mode ultrasound as a surrogate measure of atherosclerosis.Plaques were graded according to echogenicity and grouped as 1-4, with 4 being highest echogenicity, and considered most vulnerable.Anti-PC was studied by ELISA.Results Hypertension, triglycerides and insulin resistance (as determined by homeostasis model assessment of insulin resistance) and C-reactive protein (CRP) were increased in SLE (p<0.01) while smoking, LDL, HDL did not differ between groups.Low levels of anti-PC IgM (below 25th percentile) was more common SLE patients than in controls (p=0.01).18.4% of SLE patients but only 1.6% of controls (p<0.01) had a history of CVD (myocardial infarction,stroke, angina, claudication or heart valve disease).IMT did not differ significantly between groups.However, plaque occurrence was increased among SLE patients (p=0.029).Age and Low density lipoprotein (LDL) and IgM anti-PC (negatively) were independently associated with plaque occurrence in SLE.Further, echogenic plaques (grade 3-4) were more prevalent in SLE as compared to controls p<0.05).Conclusion Plaque occurrence and the frequency of vulnerable plaques is increased in SLE, but not IMT in general.Anti-PC could be a novel risk marker also with a therapeutic potential in SLE.
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