Background and aims To study the effect of the metabolic syndrome(MetS) on organ damage and mortality in patients with SLE.
Methods Consecutive patients who fulfilled ≥4 ACR criteria for SLE were assessed for the presence of the MetS in 2010. The MetS was defined by the updated joint consensus criteria, using the Asian criteria for central obesity. Longitudinal data on organ damage, vascular events and mortality were retrieved from our database. The association of the MetS with new organ damage and mortality was studied by logistic regression.
Results 577 SLE patients were studied (93% women; age41.2±13.4 years; SLE duration9.3±7.2 years). The mean follow-up time of the patients was 66.3±1.8 months. 85 (14.7%) patients qualified the MetS. New organ damage and vascular events developed in 128 (22%) and 23 (4.0%) patients, respectively. Thirty-nine (6.8%) patients died. Patients with MetS, compared to those without, had significantly higher SDI accrual at their last visits (0.70±1.0 vs 0.26±0.6;p<0.001). New vascular events (11% vs 2.8%; p=0.001), all-cause mortality (14% vs 5.5%; p=0.003), death due to vascular complications (7.1% vs 0.2%;p<0.001) were significantly more common in patients with MetS than those without. Logistic regression revealed that the MetS was significantly associated with new damage in the ocular, renal, cardiovascular and endocrine system, adjusted for age, sex, SLE duration and the antiphospholipid antibodies.The presence of the MetS showed a significant increase in vascular mortality after adjustment for the same covariates (OR 30.3 [3.42–268]; p=0.002).
Conclusions The MetS is significantly associated with new organ damage, vascular events and mortality in patients with SLE.
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