Patients With Systemic Lupus Erythematosus Show an Increased Arterial Stiffness That is Predicted by IgM Anti–β2‐Glycoprotein I and Small Dense High‐Density Lipoprotein Particles

• Published in: Arthritis care & research (2010) Vol. 71; no. 1; pp. 116 - 125
• Main Authors: Parra, Sandra, Lopez‐Dupla, Miguel, Ibarretxe, Daiana, las Heras, Mercedes, Amigó, Nuria, Català, Alba, Benavent, Marc, Garcés, Esperanza, Navarro, Alvaro, Castro, Antoni
• Format: Journal Article
• Language: English
• Published: Atlanta Wiley Subscription Services, Inc 01-01-2019
• Subjects: Age; Blood pressure; Data processing; Glycoprotein I; Glycoproteins; High density lipoprotein; Immunoglobulin M; Lipoproteins; Lupus; Multivariate analysis; NMR; Nuclear magnetic resonance; Spectroscopy; Systemic lupus erythematosus
• ISSN: 2151-464X; 2151-4658
• DOI: 10.1002/acr.23594

Objective
To investigate the metabolic and immunologic factors associated with the presence of central arterial stiffness as measured by the augmentation index (AIx).
Methods
We conducted a cross‐sectional study of 69 female patients with systemic lupus erythematosus (SLE) compared with a control group of 34 healthy women. The anthropometrical variables, the vascular studies, and the analytic data were obtained the same day. The AIx was assessed by peripheral arterial tonometry. The analysis of lipoprotein populations was performed using nuclear magnetic resonance (NMR) spectroscopy.
Results
Arterial stiffness was increased in patients with SLE compared with control subjects (mean ± SD 20.30 ± 21.54% versus 10.84 ± 11.51%; P = 0.0021). Values for the AIx were correlated with the Framingham risk score (r = 0.481, P < 0.001), carotid intima‐media thickness (r = 0.503, P < 0.001), systolic blood pressure (r = 0.270, P < 0.001), and age (r = 0.365, P < 0.001). Patients receiving antimalarial drugs had a lower AIx (mean ± SD 11.74 ± 11.28% versus 24.97 ± 20.63%; P = 0.024). The AIx was correlated with the atherogenic lipoproteins analyzed by NMR. The immunologic variables associated with the AIx were C4 (r = 0.259, P = 0.046) and IgM anti–β2‐glycoprotein I (IgM anti‐β2GPI) (r = 0.284, P = 0.284). In the multivariate analysis, age (β = 0.347, 95% confidence interval [95% CI] 0.020–0.669, P = 0.035), IgM β2GPI (β = 0.321, 95% CI 0.024–0.618, P = 0.035) and small dense high‐density lipoprotein (HDL) particles (β = 1.288, 95% CI 0.246–2.329, P = 0.017) predicted the AIx.
Conclusion
SLE patients had increased arterial stiffness compared with healthy control subjects. Arterial stiffness was decreased in patients treated with antimalarial drugs. Age, IgM β2GPI, and the number of small dense HDL particles predicted the AIx.