clinical significance of lipid profile in systemic lupus erythematosus patients: relation to disease activity and therapeutic

Aim of the work: To study the lipid profile in systemic lupus erythematosus (SLE) patients and correlate it with disease activity parameters. The effect of hydroxychloroquine (HCQ), steroids and azathioprine on the lipid profile was also determined. Patients and methods: The study included 48 female SLE patients. Total cholesterol, triglycerides and high density lipoprotein cholesterol (HDL-C) were measured in plasma. Low density lipoprotein cholesterol (LDL-C) and very low density lipoprotein cholesterol (VLDL) were calculated. Disease activity was assessed using the systemic lupus activity measure (SLAM). Results: The mean age of the patients was 25.7 ± 7 years. Hypercholesterolemia was present in 23 (47.9%) patients and hypertriglyceridemia in 16 (33.3%). There was no significant difference in the lipid profile of SLE patients receiving 200 or 400 mg/day HCQ. No significant difference in the lipid profile was found among patients who did not receive steroids, those who received 10 mg/day and those who received >10 mg/day. A significant difference in cholesterol and LDL-C level was present between SLE patients with (243.1 ± 84.3 mg/dl and 166.1 ± 65.7 mg/dl) and without (192.7 ± 50.6 mg/dl and 115.7 ± 44.4 mg/dl) lupus nephritis (LN) (p = 0.01, p = 0.002 respectively). SLAM significantly correlated with triglycerides and VLDL and negatively with HCQ intake (r = −0.3, p = 0.04). Conclusion: Disease activity of SLE patients affects the lipid level and its control can be helpful in treatment strategies. The use of HCQ through its reduction of disease activity added to low dose steroids may reduce the lipid profile of SLE patients. Control of hyerlipidemia can favourably affect SLE renal disease.