Associations of physical activity, sedentary time, and fitness with cardiovascular risk and atherosclerosis over 3 years in women with systemic lupus erythematosus

Introduction

Cardiovascular (CV) diseases are among the main causes of death in systemic lupus erythematosus (SLE). Physical activity (PA) and fitness are potential protective factors against the progression of CV risk factors and atherosclerosis.

Aim

To analyze trends over time in PA, sedentary time (ST) and physical fitness and their associations of with traditional and novel markers of CV risk and subclinical atherosclerosis in women with SLE over a 3-year follow-up period.

Methods

In this exploratory study, 77 White Hispanic women with SLE (43.3 ± 13.8 years) with mild disease activity were followed after 3 years (n = 44). HDL and LDL cholesterol (blood samples), BMI and muscle mass (stadiometer and bioimpedance device), blood pressure (BP), pulse wave velocity (PWV, Mobil-O-Graph® monitor), carotid plaques and intima–media thickness (General Electric Medical Systems, LOGQ-6 model) were assessed. PA and ST were measured using triaxial accelerometers. Physical fitness was assessed with the back-scratch, handgrip strength, 30-s chair stand, and 6-min walk, tests.

Results

After 3 years, LDL-c (estimated mean change [est] = 13.77 mg/dL) and PWV (0.13 m/s) increased while diastolic BP (−2.80 mmHG) decreased (all, p < 0.05). In mixed models, 6-min walk test was positively associated with HDL-c (est = 0.07); back scratch (est = 0.33) and chair-stand (est = 1.19) tests were positively associated with systolic BP (all, p < 0.05). No other trends or associations over time were identified (all, p > 0.05).

Conclusions

PA, ST, fitness, and most studied CV risk factors remained stable over time, with only marginal changes in LDL-c, PWV, and diastolic BP. Overall, PA and ST were not longitudinally associated with CV risk factors and subclinical atherosclerosis and contradictory weak associations were found for physical fitness.