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- Title
Impact of Disease Duration on Vascular Surrogates of Early Atherosclerosis in Childhood-Onset Systemic Lupus Erythematosus.
- Authors
Barsalou, Julie; Bradley, Timothy J.; Tyrrell, Pascal N.; Slorach, Cameron; Ng, Lawrence W. K.; Levy, Deborah M.; Silverman, Earl D.
- Abstract
Objective To determine whether longer disease duration negatively impacts carotid intima-media thickness (CIMT), flow-mediated dilation (FMD), and pulse wave velocity (PWV) in a cohort of patients with childhood-onset systemic lupus erythematosus (SLE), and to compare CIMT, FMD, and PWV in patients with childhood-onset SLE with those in healthy children and explore determinants of vascular test results in childhood-onset SLE. Methods Cross-sectional analysis was performed in a prospective longitudinal cohort of patients with childhood-onset SLE at the latest followup visit. Clinical and laboratory data were collected for patients with childhood-onset SLE. CIMT, FMD, and PWV were measured using standardized protocols in patients with childhood-onset SLE and healthy children. Correlations between disease duration and results of the 3 vascular tests were performed. Vascular data in patients with childhood-onset SLE were compared with those in healthy children. Multivariable linear regression was used to identify determinants of CIMT, FMD, and PWV in childhood-onset SLE. Results Patients with childhood-onset SLE (n = 149) and healthy controls (n = 178) were enrolled. The median age of the patients was 17.2 years (interquartile range [IQR] 15.7-17.9 years), and their median disease duration was 3.2 years (IQR 1.8-4.9 years). The median age of the healthy children was 14.7 years (IQR 13.1-15.9 years). Longer disease duration correlated with worse FMD (r = −0.2, P = 0.031) in patients with childhood-onset SLE. Patients with childhood-onset SLE had smaller (better) CIMT, higher (better) FMD, and similar PWV compared with healthy controls. Linear regression analysis explained <24% of the variation in vascular test results in patients with childhood-onset SLE, suggesting that other variables should be explored as important determinants of CIMT, FMD, and PWV. Conclusion In this cohort of 149 patients with childhood-onset SLE, patients did not have worse CIMT, FMD, or PWV than did healthy controls. Longer disease duration was associated with worse FMD, suggesting progressive endothelial dysfunction over time.
- Subjects
ATHEROSCLEROSIS; VASODILATION; CARDIOVASCULAR system physiology; CHILDREN'S health; STATISTICAL correlation; ELECTROCARDIOGRAPHY; LONGITUDINAL method; REGRESSION analysis; RESEARCH evaluation; RESEARCH funding; STATISTICS; SYSTEMIC lupus erythematosus; DATA analysis; STATISTICAL reliability; INTER-observer reliability; CROSS-sectional method; DISEASE duration; DATA analysis software; DESCRIPTIVE statistics; CAROTID intima-media thickness; DISEASE complications
- Publication
Arthritis & Rheumatology, 2016, Vol 68, Issue 1, p237
- ISSN
2326-5191
- Publication type
Article
- DOI
10.1002/art.39423