Metabolic Syndrome and Its Correlates in Systemic Lupus Erythematosus Patients: A Hidden Clinical Challenge

Metabolic Syndrome (MetS), defined by the International Diabetes Federation, is a constellation of risk factors that elevate the likelihood of cardiovascular disease and diabetes. Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease with rising evidence linking it to increased risk of MetS. Early identification of MetS in SLE patients is critical for cardiovascular risk reduction.

The objective of the study was to determine the prevalence of MetS in patients diagnosed with SLE and to evaluate the clinical and demographic correlates in this population.

This observational cross-sectional study was conducted from October 2023 to March 2025. A total of 131 adult SLE patients (≥18 years), diagnosed per 2019 European League Against Rheumatism/American College of Rheumatology classification criteria, were enrolled after informed consent. Patients with malnutrition, pregnancy, infections, or trauma were excluded. Data collection included detailed history, anthropometry, systemic and musculoskeletal examination, and laboratory investigations including fasting lipid profile, glucose levels, insulin levels, erythrocyte sedimentation rate, C-reactive protein, antinuclear antibody blot, and Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) score. Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) was calculated. Statistical analysis was conducted using SPSS v26.

The mean age of participants was 46.92 ± 12.5 years; 56.5% were females. The average body mass index (BMI) was 24.3 ± 3.1 kg/m 2 and the mean waist circumference was 91.37 ± 9.6 cm. Clinical features included malar rash (56.5%), joint pain (51.1%), and fever (53.4%). A significant proportion had a history of steroid use (55%). 38.5% ( n = 51) of SLE patients met the criteria for MetS. Patients with high SLEDAI (≥10) had significantly higher BMI, blood pressure (BP), fasting glucose, triglycerides, and lower high-density lipoprotein levels compared to those with low SLEDAI (<10) ( P < 0.001). MetS was more prevalent in high SLEDAI patients (50.8% vs. 26.2%, P = 0.008).

Preliminary findings suggest a considerable burden of MetS-related risk factors among SLE patients, highlighting the need for routine screening and integrated management strategies to mitigate cardiovascular complications in this high-risk group.