Background/Purpose: The MetS prevalence is increased in SLE patients, in particular in those of Hispanic origin and it is associated with a higher risk for cardiovascular disease and early mortality. Renal lupus seems to increase the risk for MetS. The aim of the study was to determine whether active renal disease is associated with the presence of the MetS in SLE patients after considering other possible risk factors.

Methods: This cross-sectional study was conducted in consecutive SLE patients seen in our Rheumatology Department from January 2012 to June 2013. An interview, medical records review, physical examination and laboratory tests were performed. SLE was defined using the ACR criteria; MetS was defined according to the 2009 consensus statement of the International Diabetes Foundation. Disease activity was ascertained using the SLEDAI and disease damage with the SLICC/ACR damage index (SDI). Active renal disease was defined as haematuria greater than five red blood cells/high power field, excluding other causes; pyuria greater than five white blood cells/ high power field, excluding infections; cast including granular o red blood cells; and/or new/recent increase of more than 500 mg/24h protein. Use of prednisone was recorded as current dose and total time of exposure. Antimalarials use was recorded as current, past or never. Traditional cardiovascular risk factors like uric acid and C-reactive protein levels and tobacco use were evaluated. The association of MetS and active renal disease and variables from the different domains was examined by Chi-square or Students’ t tests, as appropriate. This was followed by multivariable analysis with a stepwise backward selection procedure. All analyses were performed using SPSS 16.0.

Results: Two-hundred and six patients were evaluated; their average (SD) age was 42.0 (12.6) years, 192 (93.2%) were female; almost all patients were mestizo (mixed Caucasian and Amerindian ancestral backgrounds). Three (1.5%) and 38 patients (18.4%) were current or past smokers, respectively. Disease duration was 7.2 (6.3) years. The SLEDAI was 5.8 (4.8) and the SDI 0.9 (1.3). The current dose of prednisone was 8.2 (5.7) mg/d and the total time of exposure to prednisone was 7.2 (6.1) years; 159 (77.2%) and 31 (15.0%) were current and former users of antimalarials, wheareas 16 (7.8%) were never users. Active renal disease was present in 27 (13.1%) patients. C-reactive protein and uric acid levels were 5.2 (10.0) mg/l and 4.6 (1.5) mg/dl, respectively. Eighty five or  41.3% patients presented the MetS. In the univariable analysis, active renal disease but not disease activity was associated with the MetS as were older age, higher SDI and higher uric acid levels; active renal disease (OR 3.41, 95% CI 1.09 to 10.61) remained associated in the multivariable analysis and so were; older age (OR 1.05, 95% CI 1.02 to 1.08) and higher uric acid levels (OR 1.34, 95% CI 1.00 to 1.80).

Conclusion: The prevalence of the MetS was high in our population, and it was associated with active renal disease. A better control of renal disease activity is desirable to reduce the increased cardiovascular risk these SLE patients have.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/active-renal-disease-is-associated-with-the-presence-of-the-metabolic-syndrome-mets-in-peruvian-patients-with-systemic-lupus-erythematosus-sle/