Background/Purpose: To study the level of high-sensitivity C-reactive protein (hsCRP) and its relationship with disease activity, damage and cardiovascular risk factors in patients with systemic lupus erythematosus (SLE).

Methods: Consecutive patients who fulfilled ³4 ACR criteria for SLE but did not have concurrent infection were recruited.  Blood was assayed for hsCRP and markers of SLE activity.  Clinical activity, organ damage of SLE (SLE damage index; SDI) and cardiovascular risk factors were also assessed.  Linear regression was performed for the relationship among hsCRP, SLE activity, damage and cardiovascular risk factors.

Results:

303 consecutive SLE patients were invited for this study but 14 were excluded because of evidence of active infection.  Two hundred and eight-nine SLE patients were finally studied (94% women; age 39.0±13.1 years; SLE duration 7.8±6.7 years).  The mean SLEDAI score was 4.9±5.6 and clinically active SLE was present in 122(42%) patients.  The mean hsCRP level was 4.87±12.7mg/L, and 28(23%) patients with active SLE had undetectable hsCRP (<0.3mg/L).  In contrast, 51 patients (80%) who did not have clinical or serological activity (SLEDAI score = 0; N=64) had undetectable hsCRP.  Linear regression revealed a significant correlation between hsCRP and musculoskeletal (Beta=0.21), hematological (Beta=0.19), serosal (Beta=0.46) and clinical SLEDAI score (Beta=0.24), adjusting for age, sex, body mass index, creatinine and the use of various medications (p<0.005 in all).  Levels of hsCRP correlated significantly with anti-dsDNA titer (Beta=0.33; p<0.001) but not with complement C3 (Beta=0.07; p=0.26).  Significantly more patients with hsCRP>3.0mg/L were men and chronic smokers, and had diabetes mellitus, dyslipidemia (higher atherogenic index and total / HDL cholesterol ratio) and history of arterial thrombosis.  HsCRP level correlated significantly with SDI scores in the pulmonary and endocrine system after adjustment for similar covariates.

Conclusion:

hsCRP level is detectable in 77% of SLE patients with clinically active disease and correlates with SLEDAI scores, particularly serositis and in the musculoskeletal and hematological systems.  Elevated hsCRP in SLE is associated with certain cardiovascular risk factors and history of arterial thromboembolism.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/high-sensitivity-c-reactive-protein-disease-activity-and-cardiovascular-risk-factors-in-systemic-lupus-erythematosus/