Featured New InvestigatorsDifferences in subclinical cardiovascular disease between African American and Caucasian women with systemic lupus erythematosus
Section snippets
Study population
A total of 309 SLE women, all of whom met at least 4 classification criteria for SLE, aged 18 years or older, and without a history of clinical CVD events (which included myocardial infarction [MI], angina, percutaneous transluminal coronary angioplasty, coronary artery bypass graft surgery, cerebrovascular accident [CVA], or transient ischemic attack [TIA]), were enrolled from the Chicago Lupus Database and the Pittsburgh Lupus Registry for the purposes of this study. The Chicago Lupus
Results
In all, 309 SLE women were included in the analysis from both sites; 63 women were AA, and 246 women were Caucasian. AA women were significantly younger compared with the Caucasian women (44.6 ±10.3 years vs 47.6 ±10.6 years, P < 0.05), but this difference in age was no longer significant after adjustment for study site.
Discussion
This study is the first to investigate racial differences in subclinical CVD at various vascular beds in SLE women. We found that AA women with SLE are 2 times more likely to have carotid plaque than Caucasians. In our study, the traditional risk factors that were more prevalent in AA women with lupus included higher levels of blood pressure, BMI, and lipoprotein(a). Education level was slightly lower in AAs. For lupus-related factors, AAs had more disease activity, greater disease damage, more
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Cited by (32)
Understanding Lupus Disparities Through a Social Determinants of Health Framework: The Georgians Organized Against Lupus Research Cohort
2020, Rheumatic Disease Clinics of North AmericaCitation Excerpt :Subsequently, there has also been increased recognition of the disparities in the onset, acuity, and outcomes from different ethnic groups. Patients from racial minorities are more likely to suffer from multiple comorbidities; they have a higher prevalence of depression, cardiovascular disease (CVD), and diabetes, and worse health-related quality of life (HRQL) than whites.4–10 In 1994, Dr. Graciela Alarcón from the University of Alabama at Birmingham (UAB) led a study to better understand the relationship of ethnicity to SLE outcomes.
High-density lipoprotein functionality in systemic lupus erythematosus
2020, Seminars in Arthritis and RheumatismCitation Excerpt :This occurs due to the production of autoantibodies and cytokines in SLE patients which modulate lipoprotein lipase (LPL) activity, a key enzyme in lipid metabolism, resulting in elevated levels of VLDL and TG and low levels of HDL [21, 24]. Hallmarks of CVD, such as increased concentrations of TC, LDL-C [26–28], TG [7,23,27,29–32], apolipoprotein B (apoB) [26], lipoprotein(a) [33] and decreased levels of HDL-C [23,27,28,31,34,35], have been reported in SLE patients, however, these traditional risk factors fail to fully explain the increased risk of CVD in these patients [36]. Patients with SLE flare ups have higher TC/HDLC and LDLC/HDLC ratios compared to those in the remission phase of the disease, even after adjustments based on kidney disease and treatment [37].
Assessment of subclinical atherosclerosis in systemic lupus erythematosus: A literature review and meta-analysis
2019, Revue du Rhumatisme (Edition Francaise)Assessment of subclinical atherosclerosis in systemic lupus erythematosus: A systematic review and meta-analysis
2018, Joint Bone SpineCitation Excerpt :Finally, two new biomarkers associated with an elevated CIMT rose from this review: serum osteoprotegerin [37] and serum resistin [28]. One study investigated the presence of CP in African-American women and Caucasian women, and found higher CP in the first population [38], which was explained by an increased prevalence of both SLE-related (disease activity) and classical CV risk factors (blood pressure, BMI) in this population. Valdivielso et al. [39] also identified classical CV risk factors such as BMI and waist circumference as the main factors influencing the FMD result, whereas Sincer et al. [40] found a correlation with the SLEDAI score.
Supported by grants T32-AR07611, F32-AR51681, and K23-AR054418 from the National Institutes of Health (NIH) and Mary Kirkland Center for Lupus Research and Rheuminations, Inc. (to E.R.); by grants NIH K24-AR02318, P60-AR30692, P60-AR48098, NCRR/GCRC, and M01-RR00048 (to R.R.G.); by grants NIH R01-AR046588 and K24-AR002213 (to S.M.); and by grant NIH K23 AR051044 and the American College of Rheumatology/REF Physician Scientist Development Award (to A.H.K.).
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Elisa Y. Rhew, MD, MSCI, is Assistant Professor of Medicine, Division of Rheumatology at Northwestern University, Feinberg School of Medicine. Her article is based on a presentation given at the Combined Annual Meeting of the Central Society for Clinical Research and Midwestern Section American Federation for Medical Research held in Chicago, Ill, April 2008.