ABSTRACT
To assess subclinical atherosclerosis in patients with juvenile onset systemic lupus erythematosus [jSLE] with the carotid intima media thickness [cIMT] and investigate their relation to osteoprotegerin and traditional risk factors. The study included 25 jSLE patients and 10 age and sex- matched controls. All patients underwent full medical history, thorough clinical examination, disease activity evaluation with SLEDAI and routine laboratory investigations. Serum osteoprotegerin was measured in both patients and controls using ELISA technique. The cIMT was measured using ultrasonography. jSLE patients had higher cIMT in relation to controls yet the difference did not reach a statistical significance [0.56 +/- 0.35 mm versus 0.45 +/- 0.18 mm, p >/= 0.05]. There was an increased incidence of dyslipidemia in our patients. Patients had significantly higher serum OPG than controls 21[11] versus 11[9] pg/ml, p<0.05]. Correlations between cIMT, traditional risk factors, SLEDAI and osteoprotegerin were statistically insignificant [p>0.05 for all]. We found an increased atherosclerotic risk in jSLE patients as evidenced by increased cIMT and dyslipidemia, which necessitates ardent screening and prompt intervention to prevent life threatening complications in later years. Also, it seems likely that elevated circulating OPG levels in patients with jSLE represent an increased production of this molecule in response to inflammation yet its role as a marker of subclinical atherosclerosis in these patients is doubtful