Cheuk Yin Wong, Becky M Y Ma, Danting Zhang, Wynn Cheung, Tak Mao Chan, Desmond Y H Yap
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Patients with SLE with LN showed significantly higher risk of hypertension (HT) (OR=4.93, 95% CI=3.17 to 7.65, p<0.00001, I<sup>2</sup>=56%), hyperlipidaemia (OR=11.03, 95% CI=4.20 to 28.95, p<0.00001, I<sup>2</sup>=0%) and diabetes mellitus (DM) (OR=1.88, 95% CI=1.09 to 3.25, p=0.02, I<sup>2</sup>=32%) compared with those without LN. Patients with LN showed numerically higher prevalence of myocardial infarction (OR=1.35, 95% CI=0.53 to 3.45, p=0.52, I<sup>2</sup>=78%) and cerebrovascular accident (OR=1.64, 95% CI=0.79 to 3.39, p=0.27, I<sup>2</sup>=23%) than general patients with SLE. The incidence rates of CV mortality are also increased in patients with SLE with LN compared with those without LN (11.7/1000 patient-years vs 3.6/1000 patient-years).</p><p><strong>Conclusion: </strong>Patients with SLE with LN show increased risk of CV risk factors including DM, HT and hyperlipidaemia. 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Patients with SLE with LN showed significantly higher risk of hypertension (HT) (OR=4.93, 95% CI=3.17 to 7.65, p<0.00001, I<sup>2</sup>=56%), hyperlipidaemia (OR=11.03, 95% CI=4.20 to 28.95, p<0.00001, I<sup>2</sup>=0%) and diabetes mellitus (DM) (OR=1.88, 95% CI=1.09 to 3.25, p=0.02, I<sup>2</sup>=32%) compared with those without LN. Patients with LN showed numerically higher prevalence of myocardial infarction (OR=1.35, 95% CI=0.53 to 3.45, p=0.52, I<sup>2</sup>=78%) and cerebrovascular accident (OR=1.64, 95% CI=0.79 to 3.39, p=0.27, I<sup>2</sup>=23%) than general patients with SLE. The incidence rates of CV mortality are also increased in patients with SLE with LN compared with those without LN (11.7/1000 patient-years vs 3.6/1000 patient-years).</p><p><strong>Conclusion: </strong>Patients with SLE with LN show increased risk of CV risk factors including DM, HT and hyperlipidaemia. 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引用次数: 0
摘要
简介：肾脏受累会如何影响系统性红斑狼疮患者的心血管风险因素和并发症？目前仍不清楚肾脏受累会如何影响系统性红斑狼疮患者的心血管（CV）风险因素和并发症：我们使用PubMed、EMBASE、MEDLINE和Scopus进行了一项系统回顾和荟萃分析，以确定1947年至2022年间发表的、评估伴有或不伴有狼疮性肾炎（LN）的系统性红斑狼疮患者心血管风险因素和并发症的研究：共评估了58项研究，其中22项双臂研究（n=8675）纳入双臂荟萃分析，45项研究（n=385 315）纳入比例荟萃分析。与无LN的患者相比，伴有LN的系统性红斑狼疮患者患高血压（HT）（OR=4.93，95% CI=3.17至7.65，P2=56%）、高脂血症（OR=11.03，95% CI=4.20至28.95，P2=0%）和糖尿病（DM）（OR=1.88，95% CI=1.09至3.25，P=0.02，I2=32%）的风险明显更高。与一般系统性红斑狼疮患者相比，LN患者的心肌梗死（OR=1.35，95% CI=0.53至3.45，P=0.52，I2=78%）和脑血管意外（OR=1.64，95% CI=0.79至3.39，P=0.27，I2=23%）发病率更高。与无LN的系统性红斑狼疮患者相比，伴有LN的系统性红斑狼疮患者的心血管疾病死亡率也有所上升（11.7/1000患者年 vs 3.6/1000患者年）：结论：伴有LN的系统性红斑狼疮患者出现心血管疾病风险因素（包括糖尿病、高血压和高脂血症）的风险增加。早期识别和优化控制这些心血管风险因素可降低心血管疾病和其他非心血管并发症的风险：CRD42022314682。
Cardiovascular risk factors and complications in patients with systemic lupus erythematosus with and without nephritis: a systematic review and meta-analysis.
Introduction: It remains unclear how the presence of renal involvement will affect the cardiovascular (CV) risk factors and complications in patients with SLE.
Methods: We conducted a systematic review and meta-analysis using PubMed, EMBASE, MEDLINE and Scopus to identify studies published between 1947 and 2022 that evaluate the CV risk factors and complications in patients with SLE with or without lupus nephritis (LN).
Results: 58 studies were evaluated, with 22 two-arm studies (n=8675) included in two-arm meta-analysis and 45 studies (n=385 315) included in proportional meta-analysis. Patients with SLE with LN showed significantly higher risk of hypertension (HT) (OR=4.93, 95% CI=3.17 to 7.65, p<0.00001, I2=56%), hyperlipidaemia (OR=11.03, 95% CI=4.20 to 28.95, p<0.00001, I2=0%) and diabetes mellitus (DM) (OR=1.88, 95% CI=1.09 to 3.25, p=0.02, I2=32%) compared with those without LN. Patients with LN showed numerically higher prevalence of myocardial infarction (OR=1.35, 95% CI=0.53 to 3.45, p=0.52, I2=78%) and cerebrovascular accident (OR=1.64, 95% CI=0.79 to 3.39, p=0.27, I2=23%) than general patients with SLE. The incidence rates of CV mortality are also increased in patients with SLE with LN compared with those without LN (11.7/1000 patient-years vs 3.6/1000 patient-years).
Conclusion: Patients with SLE with LN show increased risk of CV risk factors including DM, HT and hyperlipidaemia. Early identification and optimal control of these CV risk factors may reduce the risk of CV disease and other non-CV complications.
期刊介绍：
Lupus Science & Medicine is a global, peer reviewed, open access online journal that provides a central point for publication of basic, clinical, translational, and epidemiological studies of all aspects of lupus and related diseases. It is the first lupus-specific open access journal in the world and was developed in response to the need for a barrier-free forum for publication of groundbreaking studies in lupus. The journal publishes research on lupus from fields including, but not limited to: rheumatology, dermatology, nephrology, immunology, pediatrics, cardiology, hepatology, pulmonology, obstetrics and gynecology, and psychiatry.
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