ACR Meeting Abstracts

ACR Meeting Abstracts

  • Home
  • Meetings Archive
    • 2023 ACR/ARP PRSYM
    • ACR Convergence 2022
    • ACR Convergence 2021
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018 ACR/ARHP Annual Meeting
    • 2017-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • View and print all favorites
    • Clear all your favorites
  • Meeting Resource Center

Abstract Number: 613

The Influence Of Cumulative Dose Of Corticosteroids On The Presence Of Carotid Atherosclerosis In Patients With Longstanding Systemic Lupus Erythematosus

Maria Rubino1, Ellie Aghdassi2, Sun Makosso-Kallyth3, Stacey Morrison4, Lihi Eder5 and Paul R. Fortin6,7, 1Internal Medicine, Université Laval, Quebéc, QC, Canada, 2University Health Network Research Institute and Department of Public Health, University of Toronto, Toronto, ON, Canada, 3Centre de Recherche CHU de Québec, Québec, QC, Canada, 4Div Rheumatology Rm MP-10-304, The Toronto Western Hospital, Toronto, ON, Canada, 5Rheumatology, University of Toronto, Toronto Western Hospital, Toronto, ON, Canada, 6Rheumatology, Division of Rheumatology, Université Laval, Québec, QC, Canada, 7Rheumatology, Laval University, Division of Rheumatology, Centre de Recherche du CHU de Québec and Department of Medicine, Quebec City, QC, Canada

Meeting: 2013 ACR/ARHP Annual Meeting

Keywords: atherosclerosis and corticosteroids, Lupus

  • Tweet
  • Email
  • Print
Session Information

Session Title: Systemic Lupus Erythematosus - Clinical Aspects I - Renal, Malignancy, Cardiovascular Disease

Session Type: Abstract Submissions (ACR)

Background/Purpose:

The purpose of this study is to determine the relationship between cumulative corticosteroid dose (CCD) with presence of carotid plaques (CP), total plaque area (TPA) and carotid intima media thickness (CIMT) in a population of women with longstanding systemic lupus erythematosus (SLE).

Methods:

A retrospective cohort study, in which women with SLE followed by the University of Toronto Lupus Clinic and whom had undergone a carotid Doppler were included. Outcome variables looked at were CP, TPA and CIMT.  Measured variables included were disease related factors, CCD and traditional atherosclerotic risk factors. Statistical analyses were performed using the SAS software, version 9.3. Depending on the nature of the variable, the appropriate statistical models were used to perform univariate, bivariate (Student’s T-test or Chi-Square or Wilcoxon) and multivariate (logistic or linear regression) analyses. The Baron and Kenny’s procedure was used to assess the mediating effect of CCD and the restricted cubic spline model was used to investigate the possible U-shaped relationship of CCD.

Results:

One hundred and twelve participants were included in this study.  All participants were female, their disease duration was 19 (SD=12) years and their baseline characteristics are presented in Table 1.  CP was found in 37 % of the participants and the mean CIMT was of 0.611 mm (± SD 0.1).  In the univariate regression models CCD significantly predicted presence of CP (P = 0.0106), as well as TPA (P = 0.0062) and CIMT (P = 0.0169).  In the multivariate models (Table 2) CCD was not a significant determinant of carotid atherosclerosis.  Age, was the most influential variable in all our multivariable regression models. Other predictors were hypertension in the CP model, hypertension and diabetes in the TPA model.  CCD was found to mediate the relationship between diabetes and CP as well as between diabetes and TPA. Non-linear relationships were not found between CCD and each of the outcome variables.

Conclusion:

Cumulative corticosteroid dose was not a statistically significant determinant of carotid atherosclerosis in this cohort of SLE patients after adjusting for other relevant clinical variables.

Table 1:  Baseline Characteristics

Characteristic

Total Population           (N = 112)

Presence of Carotid Plaque

 (N = 42)

Absence of  Carotid Plaque

 (N = 70) 

Median (IQR)

Median (IQR)

Median (IQR)

Age (years)***

50.6 (38.9 – 59.8)

57.8 (53.0 – 65.3)

44.2 (30.7 – 54.0)

Disease Duration (years) **

16.1 (9.1-26.4)

21.6 (12.2 – 34.8) 

14.2 (7.9 -23.4)

SLICC/ACR SDI *

1 (0 – 3)

2 (1 – 4) 

1 (0 -2)

Cumulative Corticosteroid Dose (g)*

28.73  (5.04 – 64.20)

45.91 (15.90 – 80.87)

22.41 (2.77 – 45.08)

BMI (kg/m2)

23.63 (20.85 – 27.77)

23.57 (20.72 – 29.05)

23.74 (20.9 – 27.12)

Total Cholesterol (mmol/L)*

4.32 (3.87 – 4.79)

4.42 (4.02 – 4.81)

4.12 (3.59 – 4.71)

Percentage (%)

Percentage (%)

Percentage (%)

Diabetes*

5.4

11.9

1.4

Hypertension** 

30.4

47.6

20.0

Family History

55.4

63.4

51.4

Post-Menopause***

63.4

97.6

42.9

Smoking** 

32.1

50.0

24.1

Comparing between groups with and without plaques:  *p=0.05 – 0.01, **p=0.01 – 0.0001, ***p<0.0001

Table 2:  Multiple Logistic and Linear Regression Models for Carotid Plaques, Total Plaque Area and Carotid Intima Media Thickness

CP (logistic regression)

TPA (linear regression)

CIMT (linear regression)

Risk Factor

Odds Ratio (95 % CI)

Parameter Estimate

Parameter Estimate

Age (years)

1.099 (1.010 – 1.196)*

0.0046**

4.1456***

SLICC/ACR SDI 

1.257 (0.915 – 1.726)

0.0103

n/a

Disease Duration (years)

n/a

-0.0023

-1.4795

Cumulative Corticosteroid Dose (g)

1.0 (1.0 -1.0)

0.0000004

0.0001274

BMI (kg/m2)

0.941 (0.844 – 1.048)

n/a

0.01847

Total Cholesterol (mmol/L)

2.230 (0.882 – 5.640)

0.0183

n/a

Diabetes

<0.001 (˂0.001 - ˃999.999)

-0.2147**

n/a

Hypertension

0.177 (0.047 – 0.672)*

-0.0657*

-24.7054

Post-Menopause

0.136 (0.009 – 2.070)

0.0133

-28.2580

Smoking

0.318 (0.094 – 1.077)

-0.0260

n/a

Only the variables that were significant in the bivariate analysis were included in the final models. *p=0.05 – 0.01, **p=0.01 – 0.0001, ***p<0.0001


Disclosure:

M. Rubino,
None;

E. Aghdassi,
None;

S. Makosso-Kallyth,
None;

S. Morrison,
None;

L. Eder,
None;

P. R. Fortin,
None.

  • Tweet
  • Email
  • Print

« Back to 2013 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/the-influence-of-cumulative-dose-of-corticosteroids-on-the-presence-of-carotid-atherosclerosis-in-patients-with-longstanding-systemic-lupus-erythematosus/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts during your browser session by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

© COPYRIGHT 2023 AMERICAN COLLEGE OF RHEUMATOLOGY

Wiley

  • Home
  • Meetings Archive
  • Advanced Search
  • Meeting Resource Center
  • Online Journal
  • Privacy Policy
  • Permissions Policies
  • Cookie Preferences