The Role of Plasma Lipoprotein and Carotid Doppler in Detecting Premature Atherosclerosis Among Iraqi Patients with Systemic Lupus Erythematosus


ABSTRACT:BACKGROUND:Cardio vascular involvement is fatal and critical complication of the systemic lupus erythematosus. Serum lipid profile and carotid Doppler studies can be used to evaluate premature atherosclerosis among patients with systemic lupus erythematosus .OBJECTIVE:The purpose of this study was to detect premature atherosclerosis among Iraqi patients with systemic lupus erythematosus by estimation of fasting serum lipid profiles and Doppler Carotid studies.PATIENTS AND METHODS:Fifty Iraqi patients (45 females and 5 males) who fulfilled the American College of Rheumatology (ACR) 1997 revised criteria for classification of SLE were studied . Another 50 healthy (45 females and 5 males) individuals matched for age and sex were collected from relatives and accompanying persons with patients attending the Rheumatology Clinic and studied serving a control group.Full history was taken and complete clinical examination was done for all patients and control group .The levels of serum cholesterol , low and high density lipoprotein and triglycerides were estimated and Doppler studies for common carotid arteries were done for individuals in both groups.The patients were classified according to clinical presentation to four groups:Group 1: Patients with mucocutaneous and musculoskeletal manifestation only.Group 2 : Patients with mucocutanous,musculoskeletal manifestation and serositis.Group 3: Patients with mucocutanous, musculoskeletal, serositis and lupus nephritis without cerebritis.Group 4: Patients with Mucocutanous , musculoskeletal, serositis and lupus cerebritis without nephritis.RESULTS:There were no significant differences in total cholesterol level in group 1 patients compared to control group, but there were significant differences in group 2,3,4 patients compared to control group.There were significant differences in cholesterol, low density lipoproteins (LDL),high density lipoproteins (HDL),and triglyceride (TG) levels between SLE patients compared to control group which is positively correlated with disease duration .There were no significant differences in intimal media thickness(IMT)in group1and2 compared to control group but there were significant differences in IMT in group 3 and 4 compared to control group and the significant differences in IMT were positively correlated with disease duration.CONCLUSION:The results showed that SLE patients mostly have hyperlipidemia as well as ultrasonic markers of atherosclerosis.