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Laboratory markers of cardiovascular risk in pediatric SLE: the APPLE baseline cohort.

Publication ,  Journal Article
Ardoin, SP; Schanberg, LE; Sandborg, C; Yow, E; Barnhart, HX; Mieszkalski, KL; Ilowite, NT; von Scheven, E; Eberhard, A; Levy, DM; Kimura, Y ...
Published in: Lupus
October 2010

As part of the Atherosclerosis Prevention in Pediatric Lupus Erythematosus (APPLE) Trial, a prospective multicenter cohort of 221 children and adolescents with systemic lupus erythematosus (SLE) (mean age 15.7 years, 83% female) underwent baseline measurement of markers of cardiovascular risk, including fasting levels of high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglycerides (TG), lipoprotein A (Lpa), homocysteine and high-sensitivity C-reactive protein (hs-CRP). A cross-sectional analysis of the baseline laboratory values and clinical characteristics of this cohort was performed. Univariable relationships between the cardiovascular markers of interest and clinical variables were assessed, followed by multivariable linear regression modeling. Mean levels of LDL, HDL, Lpa, TG, hs-CRP and homocysteine were in the normal or borderline ranges. In multivariable analysis, increased Systemic Lupus Erythematosus Disease Activity Index (SLEDAI), prednisone dose, and hypertension (HTN) were independently associated with higher LDL levels. Higher hs-CRP and creatinine clearance were independently related to lower HDL levels. Higher body mass index (BMI), prednisone dose, and homocysteine levels were independently associated with higher TG levels. Only Hispanic or non-White status predicted higher Lpa levels. Proteinuria, higher TG and lower creatinine clearance were independently associated with higher homocysteine levels, while use of multivitamin with folate predicted lower homocysteine levels. Higher BMI, lower HDL, and longer SLE disease duration, but not SLEDAI, were independently associated with higher hs-CRP levels. The R(2) for these models ranged from 7% to 23%. SLE disease activity as measured by the SLEDAI was associated only with higher LDL levels and not with hs-CRP. Markers of renal injury (HTN, proteinuria, and creatinine clearance) were independently associated with levels of LDL, HDL, and homocysteine, highlighting the importance of renal status in the cardiovascular health of children and adolescents with SLE. Future longitudinal analysis of the APPLE cohort is needed to further examine these relationships.

Duke Scholars

Published In

Lupus

DOI

EISSN

1477-0962

Publication Date

October 2010

Volume

19

Issue

11

Start / End Page

1315 / 1325

Location

England

Related Subject Headings

  • Young Adult
  • Triglycerides
  • Risk Factors
  • Placebos
  • Lupus Erythematosus, Systemic
  • Lipoproteins, LDL
  • Lipoproteins, HDL
  • Lipoprotein(a)
  • Humans
  • Female
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Ardoin, S. P., Schanberg, L. E., Sandborg, C., Yow, E., Barnhart, H. X., Mieszkalski, K. L., … APPLE investigators. (2010). Laboratory markers of cardiovascular risk in pediatric SLE: the APPLE baseline cohort. Lupus, 19(11), 1315–1325. https://doi.org/10.1177/0961203310373937
Ardoin, S. P., L. E. Schanberg, C. Sandborg, E. Yow, H. X. Barnhart, K. L. Mieszkalski, N. T. Ilowite, et al. “Laboratory markers of cardiovascular risk in pediatric SLE: the APPLE baseline cohort.Lupus 19, no. 11 (October 2010): 1315–25. https://doi.org/10.1177/0961203310373937.
Ardoin SP, Schanberg LE, Sandborg C, Yow E, Barnhart HX, Mieszkalski KL, et al. Laboratory markers of cardiovascular risk in pediatric SLE: the APPLE baseline cohort. Lupus. 2010 Oct;19(11):1315–25.
Ardoin, S. P., et al. “Laboratory markers of cardiovascular risk in pediatric SLE: the APPLE baseline cohort.Lupus, vol. 19, no. 11, Oct. 2010, pp. 1315–25. Pubmed, doi:10.1177/0961203310373937.
Ardoin SP, Schanberg LE, Sandborg C, Yow E, Barnhart HX, Mieszkalski KL, Ilowite NT, von Scheven E, Eberhard A, Levy DM, Kimura Y, Silverman E, Bowyer SL, Punaro L, Singer NG, Sherry DD, McCurdy D, Klein-Gitelman M, Wallace C, Silver R, Wagner-Weiner L, Higgins GC, Brunner HI, Jung LK, Imundo L, Soep JB, Reed AM, APPLE investigators. Laboratory markers of cardiovascular risk in pediatric SLE: the APPLE baseline cohort. Lupus. 2010 Oct;19(11):1315–1325.
Journal cover image

Published In

Lupus

DOI

EISSN

1477-0962

Publication Date

October 2010

Volume

19

Issue

11

Start / End Page

1315 / 1325

Location

England

Related Subject Headings

  • Young Adult
  • Triglycerides
  • Risk Factors
  • Placebos
  • Lupus Erythematosus, Systemic
  • Lipoproteins, LDL
  • Lipoproteins, HDL
  • Lipoprotein(a)
  • Humans
  • Female