Background/Purpose: Metabolic syndrome is a recently defined clustering of cardiovascular risk (CV) factors associated with insulin resistance (IR) and an increased risk of CV disease. Systemic lupus erythematosus (SLE) patients have an increased prevalence of IR which may contribute to the development accelerated atherosclerosis in these patients. In this study we aimed to establish if IR is associated with increased risk of subclinical atherosclerosis in SL.

Methods: Seventy-two Northern Spanish women with SLE and 72 age and sex matched controls were studied. Traditional CV risk factors were recorded according to a standardized protocol. Carotid ultrasonography was done by a MyLab 70 scanner (Esaote; Genoa, Italy), equipped with 7–12 MHz linear transducer and the automated software guided technique radiofrequency—Quality Intima Media Thickness in real-time (QIMT, Esaote, Maastricht, Holland) to determine carotid intima-media thickness (cIMT) and plaques, according to the Mannheim Carotid Intima-Media Thickness Consensus. IR was evaluated using the homeostasis model assessment (HOMA-IR) and quantitative insulin-sensitivity check index (QUICKI).

Results:

There were no statistically significant differences in the frequency of smoking, hypertension, dyslipidemia, diabetes mellitus, body mass index, or personal and family history of CV events between SLE patients and controls. Nevertheless, cIMT was significantly higher in SLE patients than in controls (0.654 ± 0.128 mm versus 0.588

±0.097 mm, p= 0.001). This difference remained statistically significant after adjustment for age and body mass index. Moreover, the frequency of carotid plaques was also increased in SLE patients (47% versus 27% in controls; p=0.023), being bilateral in 22% of patients and 13% of controls. The statistically significant difference persisted after adjusting for traditional CV risk factors. However, no correlation between HOMA-IR or QUICKI and cIMT was observed in SLE patients (r=0.06 and 0.034, respectively). Although SLE patients with plaques had higher levels of HOMA-IR (1.45± 1.01) and lower levels of QUICKI (0.35± 0.06) than those without plaques (1.15±0.65 and 0.36± 0.04, respectively), no statistically significant differences were observed.

Conclusion: The increased frequency of subclinical atherosclerosis observed in Northern Spanish SLE patients is not associated with metabolic syndrome features including IR.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/insulin-resistance-is-not-associated-with-increased-risk-of-subclinical-atheromatosis-in-patients-with-systemic-lupus-erythematosus-from-northern-spain/