Dyslipidemia in systemic lupus erythematosus.

Autor: Szabó MZ; Department of Clinical Immunology, Adult and Pediatric Rheumatology, National Institute of Rheumatology and Physiotherapy, Budapest, Hungary. szabo.melinda@orfi.hu., Szodoray P; Institute of Immunology, Rikshospitalet, Oslo University, Oslo, Norway., Kiss E; Department of Clinical Immunology, Adult and Pediatric Rheumatology, National Institute of Rheumatology and Physiotherapy, Budapest, Hungary.; IIIrd Department of Internal Medicine, Semmelweis University, Budapest, Hungary.
Jazyk: angličtina
Zdroj: Immunologic research [Immunol Res] 2017 Apr; Vol. 65 (2), pp. 543-550.
DOI: 10.1007/s12026-016-8892-9
Abstrakt: Cardiovascular disease is one of the major causes of morbidity and mortality in patients with systemic lupus erythematosus (SLE). Accelerated atherosclerosis is related to traditional (age, hypertension, diabetes mellitus, dyslipidemia, obesity, smoking, and positive family history) and non-traditional, disease-related factors. Traditional risk factors are still more prominent in patients with lupus, as both hypertension and hypercholesterinemia were independently associated with premature atherosclerosis in several SLE cohorts. In this work, the authors summarize the epidemiology of dyslipidemia in lupus patients and review the latest results in the pathogenesis of lipid abnormalities. The prevalence of dyslipidemia, with elevations in total cholesterol (TC), low-density lipoprotein (LDL), triglyceride (TG), and apolipoprotein B (ApoB), and a reduction in low-density lipoprotein (LDL) levels are about 30% at the diagnosis of SLE rising to 60% after 3 years. Multiple pathogenetic mechanism is included, C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) can suppress HDL and increase TG, auto-antibodies can cause the injury of the endothelium, lipoprotein lipase (LPL) activity can be reduced by circulating inflammatory mediators and antibodies, and increased oxidative stress may trigger a wide range of pro-atherogenic lipid modifications. As a major risk factor, dyslipidemia should be treated aggressively to minimize the risk of atherosclerosis and cardiovascular events. Randomized controlled trials with statins are controversial in the detention of atherosclerosis progression, but can be favorable by inhibiting immune activation that is the arterial wall and by decreasing lupus activity.
Databáze: MEDLINE
Externí odkaz: