Metabolic syndrome and body composition in patients with childhood on set systemic lupus erythematosus

Author(s)

Nailú Angélica Sinicato Martin

• Document type: Master's Dissertation
• Press: Campinas, SP.
• Institution: Universidade Estadual de Campinas (UNICAMP). Faculdade de Ciências Médicas
• Defense date: 2013-05-02

Examining board members

Simone Appenzeller; Wilson Nadruz Junior; Cláudia Saad Magalhães

• Advisor: Simone Appenzeller

Abstract

Systemic lupus erythematosus (SLE) is a chronic, multisystemic, relapsing and remitting autoimmune disease. Abnormalities such as leukopenia, hemolytic anemia, presence of autoantibodies such as anti-double-stranded DNA (anti-dsDNA), anti-Smith (anti-Sm) and antinuclear antibodies (ANA) can be found. When the diagnosis was made until 16 years old the patients was called childhood-onset SLE. Because of the greatest rate of cardiac involvement of these patients is very important to evaluate the risk factors to coronary diseases development The present cross-sectional study aimed to evaluate the presence of MetS in SLE patients and to compare with controls without autoimmune disease history and to evaluate the body composition and observe its association with the activity disease, laboratory data and corticosteroid treatment and TNF-?. We selected consecutive pediatric SLE patients followed at the Pediatric Rheumatology Unit of UNICAMP between 2010/2012. Clinical, laboratory, disease activity [SLE Disease Activity Index (SLEDAI)], cumulative damage [Systemic Lupus International Collaborating Clinics / American College of Rheumatology Damage Index (SDI)] and current drug exposure were evaluated. The MetS was evaluated by IDF - International diabetes federation criteria. The measurement of cytokines was performed by ELISA (Enzyme Linked Immuno Sorbent Assay). The prevalence of MetS in approximately 20% of patients included. We observed a similar number of SLE patients <18 years with MetS compared with ? 18 years of age (p = 0.202). We found that SLE patients <18 years presented with hypertriglyceridemia and patients ? 18 years were more frequently hypercholesterolemia, high LDL-C and hypertriglyceridemia observed correlation of SLEDAI adjusted over time with the definition of the IDF in SLE patients ? 18 years (r = 0.229, p = 0.033). We also observed a higher ratio HC / WC procedures in patients with SLE compared to the control group (p <0.001). Correlation with BMI and WC (r = 0.58, p <0.001) and HC (r = 0.53, p <0.001) in patients with SLE and between BMI and weight (r = 0.86, p <0.001), height (r = 0.26, p = 0.030), WC (r = 0.59, p <0.001) and HC (r = 0.55, p <0.001) in controls. We observed a correlation between WC and BMI (r = 0.53, p <0.001) and BAI (r = 0.39, p <0.001) in patients with SLE. We observed a correlation between the BAI and BMI (r = 0.48, p <0.001). The DXA analysis showed that in patients with cSLE 36.8% by weight of the whole body matches the fat, and 42.3% is located in the trunk. In our study we observed an increase in serum levels of TNF-? in patients with cSLE, there were increased levels of TNF-? in patients with active disease, and a positive correlation between the SLEDAI score, levels of TNF-? also correlated with the percentage of fat and fat mass in the trunk region. According to our results, patients with cSLE, have a higher prevalence of MetS and a central distribution of body fat greater than control subjects. Due to the large involvement of CVD in these patients is necessary routine assessment of MetS and body composition (AU)

• FAPESP's process: 10/13637-9 - Metabolic syndrome and body composition in juvenile systemic lupus erythematosus
• Grantee: Nailú Angélica Sinicato Martin
• Support Opportunities: Scholarships in Brazil - Master