ORIGINAL ARTICLE   

Panminerva Medica 2020 June;62(2):75-82

DOI: 10.23736/S0031-0808.19.03748-0

Copyright © 2019 EDIZIONI MINERVA MEDICA

language: English

The impact of obesity on disease activity, damage accrual, inflammation markers and cardiovascular risk factors in systemic lupus erythematosus

María CORREA-RODRÍGUEZ ^{1, 2}, Gabriela POCOVI-GERARDINO ^{1, 3} ✉, José-Luis CALLEJAS RUBIO ^{1, 4}, Raquel RÍOS FERNÁNDEZ ^{1, 4}, María MARTÍN AMADA ⁵, María CRUZ CAPARRÓS ⁶, Norberto ORTEGO-CENTENO ^{1, 4}, Blanca RUEDA-MEDINA ^{1, 2}

¹ Institute of Biomedical Research (IBS), Granada, Spain; ² Nursing Department, Faculty of Health Sciences, University of Granada, Granada, Spain; ³ Faculty of Health Sciences, University of Granada, Granada, Spain; ⁴ Systemic Autoimmune Diseases Unit, San Cecilio University Hospital, Granada, Spain; ⁵ Systemic Autoimmune Diseases Unit, Hospital of Jaén, Jaén, Spain; ⁶ Systemic Autoimmune Diseases Unit, Hospital de Poniente, El Ejido, Spain; ⁷ School of Medicine, University of Granada, Granada, Spain

BACKGROUND: We aimed to evaluate the relationships between obesity metrics including Body Mass Index (BMI), waist to height ratio (WtHR) and fat mass percentage, and disease activity, damage accrual, inflammation markers and traditional cardiovascular risk factors in SLE patients.
METHODS: A cross-sectional study was conducted on a sample of 275 patients (90.5% females; mean age 46.37±13.85 years). Disease activity was assessed with the SLE disease activity index (SLEDAI-2K), and disease-related organ damage was assessed using the SLICC/ACR damage index (SDI). Biochemical variables of lipids profile, high-sensitivity C-reactive protein (hs-CRP), homocysteine (Hcy), anti-dsDNA titers and complement components C3 and C4 serum levels were measured. Blood pressure and ankle-brachial index (ABI) were also calculated.
RESULTS: Significant differences were observed between normal-weight, overweight and obese patients in SLEDAI (2.60±2.48 vs. 2.71±2.65 vs. 3.84±3.02; P=0.004), SDI (0.76±1.10 vs. 1.09±1.24 vs. 1.57±1.54; P=0.002), hsCRP (2.15±2.93 vs. 3.24±3.63 vs. 5.30±5.63 mg/dL; P<0.001), complement C3 level (99.92±24.45 vs. 111.38±27.41 vs. 123.16±28.96 mg/dL; P<0.001), triglycerides serum levels (85.99±41.68 vs. 102.35±50.88 vs. 129.12±61.59 mg/dL; P<0.001) and systolic blood pressure (112.28±16.35 vs. 124.25±17.94 vs. 132.78±16.71 mmHg; P=0.001) after adjusting for age and sex.
CONCLUSIONS: Patients with SLE who are obese have worse disease activity and damage accrual, higher levels of inflammation markers hs-CRP and C3 complement, increased triglycerides serum levels and systolic blood pressure levels in comparison with overweight or normal weight SLE patients, supporting that optimizing weight in SLE patients should be a potential target to improve SLE outcomes.

KEY WORDS: Systemic lupus erythematosus; Obesity; Disease progression; Risk factors