Low Ankle-Brachial Index In Chinese Systemic Lupus Erythematosus Patient:Prevalence And Risk Factors

Background and ObjectiveSystemic Lupus Erythmatosus(SLE) is a chronic autoimmune inflammatory disease, with its hallmark of diversity of clinical presentations and the present of diverse autoantibodies, especially anti-nuclear antibody.It is a kind of chronic disease with a waving situation and most of the SLE patients had to take glucocorticoids and immuno-suppressive agents to keep the situation stable.With progression of the treatment of SLE,the survival rate of SLE patient after diagnosis of10years could reach80-90%. In1976, Urowits firstly reported the “bimodal mortality” of the mortality rate which had been observed by more and more clinicians.It described the phenomenon that first modal came in the first5years after diagnosis owing to disease activity and severe infection and another mortality modal rate came after5years owing to cardiovascular disease(CVD). Therefore more works should be done to explore the mechanism, risk factor and therapy measures about SLE with cardiovascular disease to improve the prognosis of SLE patients.It had been reported that the change of arterial function was much earlier than the structure and early intervention was the key to stop this progression to control the cardiovascular mortality. There were many measures to detect the arterial function change which had been adopt in the clinical,among which ABI was widely used to screen peripheral arterial narrowing, to decide the severity of the narrowing and value the result of revascularization. Besides more attentions were concentrated to ABI because its good accordance with cardiovascular risk.Our article took the ABI as the index to observe and the objective was to determine the relationship between low-ABI and traditional CVD risk factor and SLE-related factor.Methods and materialsThis was a cross-sectional study involving97SLE patients from Zhengzhou University1st affiliated hospital Rheumatology department from December2013to may2014, who must satisfy the2009ACR classify criteria for SLE without pregnancy, severe infection and major organ failure. The SLE patient were classified into2groups according to whether the ABI was normal or not, and at the same time documented the following variables:fasting blood glucose(FBG),blood cholesterol level,ESR, CRP, C3, C4, ANA titer, anti ds-DNA, total dosage of glucocorticoid, average glucocorticoid,the time of using glucocorticoid, antimalarials, SLE-DAI, smoking history, alcoholic history, DM, CVD family history, CVD history, menopause.Results.Almost ninety-three percent of patients were women. The mean age (SD) was36.88years old.The prevalence of low ABI was16.49%. Traditional CVD risk factors amomg SLE patients were frequent: age as a risk factor,5.15%of the patient; overweight,25.77%;smoking,6.19%; hypercholesterolemia,19.59%; diabetes mellitus,3.09%; hypertention28.87%,postmenopause21.65%. According to the result of the univariable analysis: not any traditional CVD risk factor or SLE-related factor was found to be associated with low ABI. In the multivariable analysis,no variables were found to be the independent predictors of low ABI.Conclusion.1. The prevalence of low ABI in patients with SLE was higher than expected.2. We could not identify any variables associated with low ABI in Chinese SLE patient.