Atherosclerosis is accelerated in patients with long-term well-controlled Systemic Lupus Erythematosus (SLE)

BackgrorundIt is uncertain whether atherosclerosis is accelerated in premenopausal and postmenopausal patients with long-term well-controlled systemic lupus erythematosus (SLE).MethodsWe measured the intima-media thickness (IMT) of the carotid arteries and the cardio-ankle vascular index (CAVI) in 39 women with SLE and in age- and sex-matched controls.ResultsIn the premenopausal state, carotid plaque was detected only in SLE patients (36%). In the postmenopausal state, the maximum IMT was about 2-fold greater in SLE patients than in control subjects (1.3 ± 0.7 vs. 0.7 ± 0.2 mm, p < 0.001). CAVI was higher in both the premenopausal and postmenopausal SLE patients. The serum amyloid A protein (SAA) was higher in SLE patients in the premenopausal state (p = 0.025), while remnant like particle-cholesterol (RLP-C), the homeostasis model assessment of insulin resistance (HOMA-IR), and SAA were significantly increased in postmenopausal SLE patients (p = 0.001, p < 0.001 and p < 0.05, respectively). Multiple regression analysis revealed that the maximum IMT was associated with cumulative PSL dosage (p = 0.027) and SAA (p = 0.074) in the premenopausal SLE patients, and with HOMA-IR (p < 0.001) in the postmenopausal SLE patients.ConclusionAtherosclerosis is accelerated in long-term well-controlled SLE. More attention should be given to subclinical inflammation and insulin resistance in the management of SLE patients.