The presence of proinflammatory high-density lipoprotein in women with systemic lupus erythematosus was significantly associated with carotid plaque (OR 16.1; P<0.001) and higher intima-media thickness.
Observational (n=276)
Is the presence of dysfunctional proinflammatory HDL associated with increased risk of subclinical atherosclerosis in women with systemic lupus erythematosus?
Dysfunctional proinflammatory HDL is strongly associated with subclinical atherosclerosis in women with SLE, suggesting its potential utility as a risk marker.
Effect estimate: OR 16.1
Absolute Event Rate: 86.7% vs 40.7%
p-value: p=<0.001
OBJECTIVE: Women with systemic lupus erythematosus (SLE) have an increased risk of atherosclerosis. Identification of at-risk patients and the etiology underlying atherosclerosis in SLE remain elusive. The antioxidant capacity of normal high-density lipoproteins (HDLs) is lost during inflammation, and these dysfunctional HDLs might predispose individuals to atherosclerosis. The aim of this study was to determine whether dysfunctional proinflammatory HDL (piHDL) is associated with subclinical atherosclerosis in SLE. METHODS: Carotid artery ultrasound was performed in 276 women with SLE to identify carotid plaques and measure intima-media thickness (IMT). The antioxidant function of HDL was measured as the change in oxidation of low-density lipoprotein after the addition of HDL cholesterol. Two antiinflammatory HDL components, paraoxonase 1 and apolipoprotein A-I, were also measured. RESULTS: Among the SLE patients, 48.2% were determined to have piHDL on carotid ultrasound, while 86.7% of patients with plaque had piHDL compared with 40.7% of those without plaque (Por=20 gm (OR 2.9, P=0.04), and African American race (OR 8.3, P=0.001). CONCLUSION: Dysfunctional piHDL greatly increases the risk of developing subclinical atherosclerosis in SLE. The presence of piHDL was associated with an increased prevalence of carotid plaque and with a higher IMT. Therefore, determination of piHDL may help identify patients at risk for atherosclerosis.
McMahon et al. (Thu,) conducted a observational in Systemic lupus erythematosus (SLE) (n=276). Proinflammatory high-density lipoprotein (piHDL) vs. Absence of piHDL was evaluated on Presence of piHDL in patients with versus without carotid plaque (OR 16.1, p=<0.001). The presence of proinflammatory high-density lipoprotein in women with systemic lupus erythematosus was significantly associated with carotid plaque (OR 16.1; P<0.001) and higher intima-media thickness.
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