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Published on: November 1, 2015
High sensitivity C-reactive protein in systemic lupus erythematosus: relation to disease activity, clinical
E V Barnes1, S Narain, A Naranjo
1Department of Medicine, Division of Rheumatology & Clinical Immunology, University of Florida, Gainesville, FL 32610-0221, USA.
Insights
High sensitivity C-reactive protein (hs-CRP) does not effectively track disease activity in systemic lupus erythematosus (SLE). However, hs-CRP may help assess cardiovascular risk in SLE patients, with antimalarials potentially reducing this risk.
Area of Science:
- Rheumatology
- Immunology
- Cardiovascular Medicine
Background:
- High sensitivity C-reactive protein (hs-CRP) is utilized in assessing rheumatic disease activity.
- Its specific utility in systemic lupus erythematosus (SLE) for disease activity, severity, and cardiovascular risk assessment remains uncertain.
Purpose of the Study:
- To investigate the role of hs-CRP in evaluating disease activity, severity, and cardiovascular risk in SLE patients.
- To determine the correlation between hs-CRP levels and established cardiovascular risk factors within the SLE cohort.
Main Methods:
- Serum samples from 213 SLE patients (601 visits) and 134 controls were analyzed for hs-CRP using nephelometry.
- Demographic data, medication history, and laboratory parameters were collected.
- Disease activity was quantified using the SLE Disease Activity Index (SLEDAI).
Main Results:
- hs-CRP levels showed no association with SLEDAI scores, ACR SLE criteria, or specific organ involvement.
- hs-CRP levels significantly correlated with cardiovascular risk factors: body weight, hypertension, and apolipoprotein A-I.
- An inverse correlation was observed between hs-CRP levels and the use of antimalarial medications.
Conclusions:
- hs-CRP is not a reliable marker for assessing disease activity in SLE.
- hs-CRP may hold value in evaluating cardiovascular risk in SLE patients.
- Antimalarial use might contribute to reduced cardiovascular risk in individuals with SLE.
Abstract:
Measurement of high sensitivity C-reactive protein (hs-CRP), has been used in the assessment of disease activity in numerous rheumatic conditions including systemic lupus erythematosus (SLE). However, the utility of hs-CRP measurement in patients with lupus is uncertain. This study examined if hs-CRP can be used to assess disease activity, severity and cardiovascular risk in SLE. Serum samples from 601 visits of 213 SLE patients and 134 controls were analysed for hs-CRP by nephelometry. Detailed demographic data were obtained from all subjects and medication history and key laboratory parameters were collected. Disease activity was assessed using the SLEDAI. High sensitivity CRP was not associated with disease activity (SLEDAI), number of ACR SLE criteria or presence of any particular organ involvement. hs-CRP levels were significantly correlated with standard cardiovascular risk factors including body weight (P = 0.0002), hypertension (P = 0.001), and apolipoprotein A-I (P < 0.0001). Interestingly an inverse correlation was seen between hs-CRP levels and antimalarial use (P = 0.0018). Our results suggest that measurement of hs-CRP, though not valuable as marker of disease activity in SLE may be of some use in the assessment of cardiovascular risk. We speculate that antimalarials may help to reduce cardiovascular risk in patients with SLE.
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