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Predictors of high sensitivity C-reactive protein levels in patients with systemic lupus erythematosus
1Department of Rheumatology, Chonnam National University Medical School, Gwangju, South Korea.
Insights
High sensitivity C-reactive protein (hsCRP) levels in systemic lupus erythematosus (SLE) patients are influenced by body mass index, ethnicity, education, and medications. Adjusting for these factors is crucial for accurate cardiovascular risk assessment in SLE.
Area of Science:
- Rheumatology
- Cardiology
- Biomarkers
Background:
- Cardiovascular disease (CVD) is a significant concern in systemic lupus erythematosus (SLE).
- The role of high-sensitivity C-reactive protein (hsCRP) in SLE-related CVD risk is not fully understood.
- Factors influencing hsCRP levels in SLE patients require further investigation.
Purpose of the Study:
- To evaluate the impact of demographic, anthropometric, socioeconomic, and treatment variables on hsCRP levels in SLE patients.
- To identify key predictors of hsCRP in this population.
- To inform cardiovascular risk assessment strategies in SLE.
Main Methods:
- Prospective study of 610 SLE patients from the Hopkins Lupus Cohort.
- hsCRP levels measured using an immunoturbidimetric assay.
- Stepwise multiple regression analysis to identify significant predictors of hsCRP.
Main Results:
- Body mass index (BMI), African-American ethnicity, and SLE Disease Activity Index score were positively associated with higher hsCRP levels.
- Lower education level was associated with higher hsCRP.
- Statin and estrogen use, and cumulative prednisone dose were also significant predictors.
- hsCRP levels were significantly influenced by a combination of patient characteristics and treatments.
Conclusions:
- hsCRP levels in SLE patients are multifactorial, influenced by BMI, ethnicity, education, disease activity, and specific medications.
- Adjusting hsCRP values for these variables is essential for accurate cardiovascular risk stratification in SLE.
- These findings have implications for clinical practice and patient management regarding CVD risk in lupus.
Abstract:
Despite the increased prevalence of cardiovascular disease in patients with systemic lupus erythematosus (SLE), little is known about the role of high sensitivity C-reactive protein (hsCRP) or whether ethnicity, gender, anthropometric measures and treatment can alter hsCRP levels. We evaluated the effects of treatment and demographic, anthropometric and socio-economic variables on hsCRP levels in SLE. High sensitivity C-reactive protein levels were measured using an immunoturbidimetric assay in 610 patients from the Hopkins Lupus Cohort, who were followed-up regularly. In stepwise multiple regression analyses, body mass index (BMI) [odds ratio (OR) 1.72, 95% confidence interval (CI) 1.34-2.20, P < 0.001], African-American ethnicity (OR 1.97, 95% CI 1.22-3.19, P < 0.01), education (OR 0.60, 95% CI 0.42-0.86, P < 0.01), statin use (OR 0.38, 95% CI 0.18-0.82, P < 0.05), estrogen use (OR 3.65, 95% CI 1.19-11.22, P < 0.05), SLE Disease Activity Index score (OR 1.76, 95% CI 1.09-2.87, P < 0.05) and cumulative prednisone dose (OR 1.27, 95% CI 1.01-1.60, P < 0.05) were significant predictors of hsCRP levels. These findings suggest that hsCRP levels should be adjusted for BMI, ethnicity, education level, disease activity and medications when conducting cardiovascular risk assessment in patients with lupus.
