Lipoprotein subfractions and cardiovascular disease in systemic lupus erythematosus

Authors

• SR Sakhardande
• MM Purmalek
• M Sampson
• A Joshi
• Y Temesgen-Oyelakin
• AM Fike
• T Salahuddin
• B Natarajan
• J Lerman
• Z Manna
• A Dey
• M Davis
• M Chen
• SA Hasni
• NN Mehta
• AT Remaley
• MJ Kaplan

Abstract

Background: The implementation of nuclear magnetic resonance (NMR) analysis has allowed for the analysis of lipoprotein particle counts/size as well as serum glycoprotein acetylation (GlycA) levels. We assessed the correlation of lipoprotein profiles and GlycA with vascular function, arterial inflammation, coronary plaque and lupus disease activity. Methods: Clinical and demographic characteristics, lupus disease activity (SLEDAI, SLICC), Framingham risk score, and metabolic parameters were recorded at each visit. SLE and matched healthy controls underwent vascular function and anatomical assessments by measuring peripheral arterial tonometry of the microvasculature (Endopat), arterial stiffness using a cardio-ankle vascular index (CAVI) and Sphygmocor, aortic inflammation by FDG-PET/CT, and quantification of plaque by CTA. Lipoprotein profile and GlycA levels were obtained by NMR analysis. Results: Lupus and control individuals did not differ in FRS but had higher insulin resistance and BMI. HDL particle count, medium HDL and IDL were decreased in SLE than controls whereas medium VLDL particle counts and Glyc A were significantly increased in SLE as compared to controls. Within the SLE patients, GlycA levels significantly correlated with damage accrual, insulin resistance, aortic inflammation, and arterial resistance. In unadjusted linear regression models, increased GlycA levels were associated with arterial stiffness in SLE than controls and this remained significant after adjusting for FRS, BMI and insulin resistance. Conclusion: In this preliminary analysis, individuals with SLE demonstrate increases in GlycA and a proatherogenic lipoprotein profile. Future longitudinal analysis will assess the clinical implications of these findings and role of these tests as biomarkers of CVD in SLE.

Scientific Focus Area: Immunology

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