Abstract
Objective:To determine the frequency of dyslipidemia in patients with lupus nephritis and its association with the degree of proteinuria.Methods:This cross-sectional analytic study included 65 patients who fulfilled the ACR (American College of Rheumatology) criteria for SLE and had renal involvement, presenting to the Division of Rheumatology, Fatima Memorial Hospital (FMH), and Lahore from 21st Sep 2016 to 20th Dec 2016. After 12 hours overnight fast their blood samples were assessed for total cholesterol (TC), triglycerides (TG), high density lipoprotein (HDL) and low density lipoprotein (LDL). Patient demographic variables (age, sex) and disease characteristics (disease duration, degree of proteinuria, steroid dose) were noted. Patients were categorized into two groups on the basis of degree of proteinuria: having proteinuria >1gm or ≤ 1gm. Data was analyzed using SPSS version 22. Individual lipid profiles were correlated with the degree of proteinuria.Results:Most common lipid abnormality found in our study was hypertriglyceridemia (58.5%). Total Cholesterol and LDL-C was high in 55.4% and 30.8% subjects respectively. Low HDL was found in 21.5% subjects. Increased frequency of dyslipidemia was noticed in those subjects who had proteinuria >1gm (P value < 0.05).Conclusion:Dyslipidemia was observed in a high frequency in patients with lupus nephritis and was strongly associated with their degree of proteinuria.
Highlights
Systemic lupus erythematosus (SLE) is the prototypic autoimmune disease characterized by multisystem involvement and the production of an array of autoantibodies.[1]
Proteinuria >1gm was present in 55.4% (n=36), while 44.6% (n=29) had proteinuria
Frequency of patients with high total cholesterol (TC), TG’s, low density lipoprotein (LDL) was found to be significantly lower in sub-groups of patients with proteinuria ≤ 1gm and none of the patients in this sub-group had high density lipoprotein (HDL)
Summary
Systemic lupus erythematosus (SLE) is the prototypic autoimmune disease characterized by multisystem involvement and the production of an array of autoantibodies.[1] SLE may involve any organ mainly skin, joints, kidneys, heart, lungs and central nervous system.[2] Most of the patients are young females with F/M ratio of 15.5:1.3 Presenting features may vary from skin and joint involvement to organ and life-threatening complications like lupus nephritis (33%).[3]. Most studies reveal that relative risk of myocardial infarction exceeds 5 to 8 times compared to general population.[4] Studies have shown that the prevalence of dyslipidemia in lupus patients ranges from 36% at diagnosis to 60% or even higher after 3 years.[5] Patients with SLE have an elevated plasma TG, LDL- C, Apoprotein B, and decreased HDL-C.6. Patients with SLE have an elevated plasma TG, LDL- C, Apoprotein B, and decreased HDL-C.6 Elevated TG levels in SLE patients are in part attributable to anti-lipoprotein lipase (anti-LPL), which are present in 47% of patients.[7]
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