Risk Factor Associated with Carotid Intima-Media Thickness inPatients with Systemic Lupus Erythematosus

Abstract

Background: Cardiovascular complications, including atherosclerosis, are
the highest causes of mortality in systemic lupus erythematosus (SLE)
patients. The carotid artery intima-media thickness (cIMT) can effectively
indicate the condition of atherosclerosis in patients. This study was
conducted to determine the associated risk factors for cIMT in patients
with SLE. Methods: This research was conducted as a cross-sectional
study at Prof. I.G.N.G. Ngoerah Hospital, Denpasar. From January 2023
to June 2023, all SLE patients aged 18-55 for men and 18-65 for women,
without infections, cancer, asthma, stage 5 chronic kidney disease, stroke,
coronary heart disease, peripheral artery disease, or smoking history, were
included. Measurement of cIMT was performed using Doppler
ultrasonography. Statistical analysis was conducted using descriptive
statistics and Fisher exact test to assess the association between variables.
Results: 52 patients (51 women and 1 man) met the inclusion criteria were
included. The mean age was 33.67 ± 10.51 years, the duration of SLE by
the time of diagnose was 50.37 ± 40.39 months, and the disease activity
scored by MEX SLEDAI was 2.58 ± 3.24. Moreover, the bivariate analysis
showed a significant association between hypertension and cIMT in SLE
patients (p = 0.001) with an Odd Ratio (OR) of 28.77. The age at diagnosis
was also found to be significantly associated independently with cIMT (p =
0.003, OR = 14.93). This is associated with dysregulation of lectin -like
oxidized-LDL (ox-LDL) receptor-1 (LOX-1), leading to an increased risk of
atherosclerotic plaque formation. Conclusion: There is a notable
association between the occurrence of hypertension and age at diagnosis
to the elevated cIMT in SLE patients.