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Inicio Medicina Clínica (English Edition) Prognostic value of metabolic syndrome for the development of cardiovascular dis...
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Vol. 144. Issue 7.
Pages 289-296 (April 2015)
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Vol. 144. Issue 7.
Pages 289-296 (April 2015)
Original article
Prognostic value of metabolic syndrome for the development of cardiovascular disease in a cohort of premenopausal women with systemic lupus erythematosus
Estimación del valor pronóstico del síndrome metabólico para el desarrollo de enfermedad cardiovascular en una cohorte de mujeres premenopaúsicas con lupus eritematoso sistémico
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Elsy Aidé García-Villegasa, Israel Lerman-Garberb, Luis Felipe Flores-Suárezc, Carlos Aguilar-Salinasb, Horacio Márquez Gonzálezd,
Corresponding author
, Antonio Rafael Villa-Romeroe
a Departamento de Vigilancia Epidemiológica, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México, D.F., México
b Departamento de Endocrinología y Metabolismo, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México, D.F., México
c Clínica de Vasculitis, Instituto Nacional de Enfermedades Respiratorias, México, D.F., México
d Departamento de Cardiopatías Congénitas, Hospital de Cardiología Centro Médico Nacional Siglo XXI, México, D.F., México
e Salud Pública, Facultad de Medicina, Universidad Nacional Autónoma de México, México, D.F., México
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Jose Gabriel Erdozain, Guillermo Ruiz Irastorza
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Figures (2)
Tables (4)
Table 1. Anthropometric, biochemical and clinical characteristics of premenopausal patients with SLE in the basal evaluation 2001 (n=238).
Table 2. Anthropometric, biochemical, clinical, dietetic and medical characteristics of patients with and without Metabolic Syndrome in 2001.
Table 3. Prevalence of MS and its components in the total population: women with and without CVD.
Table 4. Multivariate analysis Cox proportional hazards for the probability of developing CVD with the explanatory variables.
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Abstract
Background and objective

Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease of unknown etiology. In lupus patients there is an increased cardiovascular risk due to an accelerated atherogenesis. Furthermore, Metabolic Syndrome (MS) adds an independent risk for developing Cardiovascular Disease (CVD) in the population. Therefore, it is important to determine whether lupus patients have an increased risk of developing Cardiovascular Disease in the presence of MS.

To estimate the prognostic value of MS in the incidence of cardiovascular events in a cohort of premenopausal patients with SLE.

Methodology

Cohort study in 238 patients was carried out. Clinical, biochemical, dietetic and anthropometric evaluations were performed. Patients were classified according to the prevalence of MS in 2001. There was a patient follow-up from 2001 to 2008. In 2008, after studying the records, we obtained the “cases” (patients with CVD) and the “no cases” (patients without CVD).

Results

The basal prevalence of MS in the cohort was of 21.8% (ATPIII). The MS component with the highest prevalence in the population studied in 2001 was low HDL-Cholesterol (<50mg/dL) with a prevalence of 55.0%. The cumulative incidence of CVD in the group with MS was 17.3% and in the group without MS it was 7.0% with a Relative Risk (RR) of 2.48 (1.12–5.46) and p<0.05. In the multivariable analysis it was noted that MS is a predictive factor of CVD.

Conclusions

We observed the prognostic value of MS for an increased risk of cardiovascular damage in premenopausal patients with lupus.

Keywords:
Systemic Lupus Erythematosus
Metabolic Syndrome
Insulin resistance
Cardiovascular disease
Resumen
Fundamento y objetivo

El Lupus eritematoso sistémico (LES) es una enfermedad crónica, autoinmune, de etiología desconocida que afecta principalmente a mujeres en edad reproductiva. En pacientes con lupus existe un elevado riesgo cardiovascular debido a un proceso aterogénico acelerado. Aunado a esto, el síndrome metabólico (SM) representa un riesgo independiente para el desarrollo de enfermedad cardiovascular (ECV) en población general.

Estimar el valor pronóstico del síndrome metabólico en la incidencia de eventos cardiovasculares en una cohorte de pacientes premenopáusicas con LEG.

Metodología

Estudio de cohorte en 238 pacientes. Se realizaron evaluaciones clínicas, bioquímicas, dietéticas y antropométricas. Se clasificó a las pacientes con respecto a la presencia de síndrome metabólico en 2001. A partir del 2001 se inició seguimiento de las pacientes hasta el 2008 cuando a partir de la revisión de los expedientes se obtuvo a los “casos” (pacientes con enfermedad cardiovascular) y los “no casos” (pacientes sin enfermedad cardiovascular).

Resultados

La prevalencia basal de síndrome metabólico en la cohorte fue 21.8% (ATPIII). El componente del SM con mayor prevalencia en la población estudiada en el 2001 fue el colesterol-HDL bajo (<50mg/dL) con una prevalencia de 55.0%. La incidencia acumulada de ECV en el grupo con síndrome metabólico (SM) fue de 17.3% y en el grupo sin SM fue de 7.0% con un riesgo relativo (RR) de 2.48 (1.12-5.46) y una p<0.05. En el análisis multivariado se observó que el SM es un factor predictivo de enfermedad cardiovascular.

Conclusiones

El SM es un factor riesgo de daño cardiovascular en pacientes premenopáusicas con lupus.

Palabras clave:
Lupus eritematoso sistémico
Síndrome metabólico
Resistencia a la insulina
Enfermedad cardiovascular

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