Session Information
Session Type: Abstract Submissions (ACR)
Background/Purpose: Hypertension and obesity are the two most important traditional cardiovascular risk factors in the prediction of subclinical measures of atherosclerosis in SLE. Obesity is the most important associate of hsCRP in SLE, as well. We analyzed predictors of obesity in a longitudinal SLE cohort.
Methods: Body mass index (BMI) was calculated at baseline and at last visit in a longitudinal cohort. 2,016 SLE patients with 48,163 visits were analyzed. Obesity was defined as BMI > 30.
Results:
The patients were 92.6% female, with average age on 1/1/12 of 47.6 years. 37.4% were African-American and 55.6% Caucasian. The average BMI at cohort entry was 27.5±7.9 and at last visit 28.2±8.1. At cohort entry 28.1% were obese and at cohort end 32.5% were obese. 8.7% became obese and 4.4% who were obese became not obese. The table shows prediction of new obesity over cohort follow-up in a multivariate model.
|
Factor |
Coefficient |
P-value |
|
Prednisone (mgs) – maximum dose |
-0.009 |
0.0249 |
|
African-American ethnicity |
0.057 |
0.5696 |
|
Education (years) |
-0.010 |
0.7680 |
|
Private Insurance |
-0.064 |
0.5612 |
|
Age at Diagnosis |
0.009 |
0.2484 |
|
Current smoker |
0.228 |
0.0401 |
|
Current drug abuser |
0.107 |
0.6532 |
|
Discoid lupus |
0.086 |
0.4112 |
|
Alopecia |
0.081 |
0.3826 |
|
Proteinuria |
-0.043 |
0.6655 |
|
Anemia |
-0.043 |
0.6909 |
|
Lupus anticoagulant (RVVT) |
0.246 |
0.0072 |
|
Dry mouth |
-0.171 |
0.2257 |
|
Cardiac murmur |
0.193 |
0.0371 |
|
Anti-dsDNA positive |
0.008 |
0.9402 |
|
Low C4 |
0.015 |
0.8798 |
|
ESR |
0.293 |
0.0301 |
|
Hyperglycemia |
0.020 |
0.8266 |
Conclusion: New obesity developed in 8.7% during follow-up. Surprisingly, both maximum and mean (data not shown) prednisone dose had negative coefficients. The lupus anticoagulant and ESR were both predictors of obesity. Demographic factors (African-American race, lack of private insurance, smoking) were all predictive of new obesity. These data suggest that demographic variables can identify the subsets most at risk, for preemptive dietitian consulting and lifestyle intervention. However, the reason why some laboratory tests (lupus anticoagulant and ESR) are predictors is unknown. Ironically, prednisone dose was NOT a positive predictor in the multivariate model.
Disclosure:
M. Petri,
None;
S. Adusumilli,
None;
H. Fang,
None.
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