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Body composition, lipid and lipoprotein levels in childhood-onset systemic lupus erythematosus

V Lilleby1, M Haugen, L Mørkrid

  • 1Department of Rheumatology, Rikshospitalet University Hospital, NO-0027 Oslo, Norway. vibke.lilleby@rikshospitalet.no

Scandinavian Journal of Rheumatology
|April 25, 2007
PubMed

Insights

Childhood-onset systemic lupus erythematosus (SLE) patients have higher body fat and lower lean mass than healthy individuals. Corticosteroid use is a key factor, contributing to an increased risk of heart disease.

Area of Science:

  • Rheumatology
  • Pediatrics
  • Endocrinology

Background:

  • Systemic lupus erythematosus (SLE) is associated with systemic inflammation, corticosteroid therapy, and reduced physical activity, all potential contributors to altered body composition.
  • Understanding body composition changes in childhood-onset SLE is crucial for managing long-term health outcomes.

Purpose of the Study:

  • To compare body composition between childhood-onset SLE patients and healthy controls.
  • To investigate the impact of disease characteristics, corticosteroid use, and lifestyle factors on body fat mass, serum lipids, and lipoproteins in pediatric SLE.

Main Methods:

  • A cross-sectional study involving 68 childhood-onset SLE patients and 68 matched healthy controls.
  • Dual-energy X-ray absorptiometry (DXA) was used to measure fat mass and lean tissue mass.
  • Multiple linear regression analysis assessed the influence of disease factors, glucocorticosteroids, disease activity, physical activity, and diet on fat mass. Serum lipid and lipoprotein levels were also measured.

Main Results:

  • SLE patients exhibited significantly higher fat mass (35.3% vs. 30.9%) and lower lean mass (39.7 kg vs. 44.4 kg) compared to controls.
  • Corticosteroid use and SLE itself were independent predictors of increased fat mass; disease activity, physical activity, and diet had minimal impact.
  • Patients displayed lower high-density lipoprotein (HDL) cholesterol and apolipoprotein A1 (apo A1) levels, and a higher apo B/apo A1 ratio, indicating a more proatherogenic lipid profile.

Conclusions:

  • Childhood-onset SLE is characterized by unfavorable body composition, with increased fat mass and decreased lean mass compared to healthy peers.
  • Corticosteroid therapy is a significant independent predictor of increased fat mass in these patients.
  • The observed proatherogenic lipid profile in SLE patients elevates their risk for coronary heart disease.
Abstract

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