ABSTRACT
To investigate lipid metabolism, inflammation and lupus-related factors as risk factors for occurrence of carotid atherosclerosis in premenopausal women with systemic lupus erythematosus [SLE]. Thirty premenopausal women with systemic lupus erythematosus [SLE] were included in this study. Their age ranged from 18 to 45 years. All of them were subjected to full history taking, thorough clinical examination, laboratory investigations, disease activity assessment using SLE disease activity index [SLEDAI] and assessment of SLE-related disease damage according to the systemic lupus international collaborating clinics [SLICC] damage index. Duplex ultrasonography was used to measure the intima-media thickness [IMT] and carotid plaques. Eleven out of the 30 SLE patients [36.6%] had carotid arteriosclerosis. Among those patients, the risk factors those associated with occurrence of carotid arteriosclerosis included dyslipoproteinemia where OR and 95% CI for higher levels of total cholesterol, low density lipoproteins [LDL] and lipoprotein-alpha LP[alpha] were 1.019 [1.003-1.036], 1.19 [1.08-1.31] and 1.023[1.005-1.033], respectively, higher levels of inflammatory markers where OR and 95% CI for C-reactive protein and fibrinogen were 1.70[1.07-1.90] and 1.40[1.01-1.60], respectively and some of lupus-related factors where OR and 95%CI for duration of disease, SLICC damage score, cumulative dose of prednisone and duration of prednisone use were 1.65 [1.07-2.25], 1.80 [1.29-1.99], 1.09 [1.03-1.16] and 2.19 [1.38-3.80], respectively. The prevalence of carotid atherosclerosis in premenopausal women with SLE was 36.6%. Among these patients, a statistically significant association was found between occurrence of carotid atherosclerosis and dyslipoproteinemia, inflammation, and some lupus-related factors [duration of disease, SLICC damage score, cumulative dose of prednisone and duration of prednisone use]