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Are Lupus patients with Nephritis at greater risk of cholesterol and cardiovascular disorders? Here's what study reveals
Patients with SLE who have nephritis have increased cardiovascular risk factors and a three-fold increase in the frequency of cardiovascular mortality.
A summary of the increased cardiovascular risk linked to nephritis in individuals with systemic lupus erythematosus (SLE) is given by an examination of almost two dozen research that compared patient outcomes.
The presence of lupus nephritis (LN) was linked to a three-fold increase in the incidence of cardiovascular mortality and an increased likelihood of cardiovascular risk factors, such as dyslipidemia, diabetes, and hypertension, according to a meta-analysis of 22 studies including more than 8600 SLE patients.
The Lupus Foundation of America conducts research
The Lupus Foundation of America estimates that 1.5 million people in the US and over 5 million people globally suffer from some type of lupus, with SLE being the most frequent.
In recent decades, there has been an improvement in the long-term prognosis associated with an SLE diagnosis due to research efforts and improved management. As people with SLE live longer, cardiovascular illness is now the main cause of death for them.
To better understand how the presence of LN may affect cardiovascular risk factors and complications among patients with SLE, a team of researchers led by Desmond YH Yap, MD, Ph.D., clinical associate professor and honorary consultant at Queen Mary Hospital of The University of Hong Kong, began the current study. To achieve this, researchers planned their study as a comprehensive review and meta-analysis of articles that were written about the topic between 1947 and 2022.
Researchers searched for observational studies that reported the prevalence of cardiovascular disease and cardiovascular disease risk factors in adult SLE patients with and without nephritis. These studies included cross-sectional, cohort, prospective, and retrospective investigations. Notably, as part of the investigation, researchers carried out two meta-analyses: a proportionate meta-analysis and a meta-analysis of studies with two arms.
Results after the first research
Following their first search, the researchers found a total of 26,361 studies. Following the removal of duplicates and additional screening, 186 articles were subjected to full-text review. Twenty-two of the 58 studies that were found to be eligible for inclusion made up the final meta-analysis of 2-armed studies.
The 8675 SLE patients included in these investigations included 2295 patients with LN and 6380 patients without it. There were a variety of follow-ups (2–11 years) and a preponderance of female participants (86.7–100%) in these investigations. The studies were all carried out between 1990 and 2020, according to the investigators.
In patients with SLE with and without nephritis, the study's main objective was to compare the prevalence of myocardial infarction (MI), cerebrovascular events, hypertension, hyperlipidemia, diabetes mellitus, and plaque incidence. Variations in systolic and diastolic blood pressure, total cholesterol, LDL-C, HDL-C, and triglycerides were among the secondary outcomes of interest.
The study's several shortcomings were noted by the researchers. These included the use of sometimes imprecise outcome definitions, a dearth of information on other significant adverse cardiovascular events, such as heart failure, and a very small number of trials containing cardiovascular data on patients with and without LN. Researchers also drew attention to the inherent flaws in studying mortality and hard cardiovascular events, such as the possibility of survivorship bias.
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