AB0612 Infringement of the blood lipid spectrum in children and adolescents with sle and their predictive value for the further course of the disease

N.S. Shevchenko, L.F. Bogmat, I.M. Bessonova, V.V. Nikonova
2018 SLE, Sjögren's and APS – clinical aspects (other than treatment)   unpublished
Infringements of the lipid blood spectrum, or so-called dyslipidemia, are common in adults suffering from SLE and ranges from 36% to 60%. 1 Many researchers confirmed the accelerated development of atherosclerosis among patients and high risk of epy cardiovascular complications with deterioration of life expectancy. However, the role of prolonged storage of dyslipidemia and subclinical signs of hypercoagulability on the course of the disease is unspecified. Objectives: The aim of the study was
more » ... m of the study was to clarify the prognostic importance of the role of storage of metabolic shifts in children with SLE on the background of treatment for the course of the disease. Methods: A total of 35 people aged 7-18 years with SLE who were ill for more than one year and received complex therapy with glucocorticoids and immunosuppressive drugs were examined. The average age of the patients was 173.56 ±4.17 months; the total duration of the disease was 48.45±3.18 months. General clinical trials included the complex included autoantibodies, disease activity, drugs. Total cholesterol (TCh), triglycerides (TG), high density lipoprotein cholesterol, low-density lipoprotein cholesterol, apolipoprotein B, ApoA-I and lipoproteina were evaluated. The state of the blood coagulation system was also studied: fibrinogen of the blood, prothrombin index, thrombin time, active partial thrombin time, d-dimer, international normalised ratio. Results: The presence of atherogenic dislipoproteinemia in 60.0% of ill children and adolescents on SLE in children and adolescents, disorders in the system of hemostasis in 25.0% was established. The data on the presence of interconnection of blood triglycerides with glomerular filtration rate (r=À0.892; p<0.05) and activity of transaminases (alanine transmase) (r=0.848; p<0.05). As a result of multiple regression analysis with step-by-step exclusion of minor variables, serum creatinine serum levels in patients with SLE depend on the level of TG of blood with high predictive accuracy: blood creatinine=0,0672684 +0.0127034 * TG; R=69.79%; R 2 ;=62.34%; p<0.05. A multivariable regression analysis also proved that the level of circulating immune complexes in patients with SFV significantly depends on the level of total cholesterol, complement and TG by the formula: CIC=1,44278+0,188976 * TCh -1,51503 * complement +0,35538 * TG; R=94.25%; R 2 ;=90.02%; p<0.01. The mean indices of state of the blood coagulation system indices for children and adolescents with SLE and signs of dyslipidemia were within the norm except for fibrinogen (2.76±0.29 g/L in the presence of dyslipidemia against 3.72±0.46 g/L in patients with dyslipidemia, p<0.05). Its increase persisted in 27.78% of patients. Conclusions: Thus, violations in the lipid spectrum of blood are often formed in children and adolescents on the background of SLE with the duration of the disease for more than one year. They are not only a risk factor for atherosclerotic lesions; they are also a factor in maintaining the activity of the disease and the development of sustained kidney damage. REFERENCES: [1] Tselios K, Koumaras C, Gladman DD, Urowitz MB. Dyslipidemia in systemic lupus erythematosus: just another comorbidity? 2016 Apr;45(5):604-10. Background: Lupus enteritis, known as mesenteric vasculitis including multiple ulcers or ischaemic colitis, and protein-losing enteropathy, is a potentially lifethreatening complication of systemic lupus erythematosus (SLE). Although glucocorticoid therapy is usually effective, some patients experience recurrences or severe complications in that surgical treatment or intensive immunosuppressive therapy is required. Little evidence, however, is available with characteristics and prognostic factors of lupus enteritis. Objectives: The aim of this study is to clarify clinical characteristics and associated factors for the prognosis with lupus enteritis.
doi:10.1136/annrheumdis-2018-eular.7416 fatcat:vmrye5ey6fajjoeooi5rna3v7e