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Atherosclerosis in SLE: a potential role for serum parathormone levels

OBJECTIVE: A link between bone metabolism and cardiovascular (CV) disease has been suggested mainly in the general population. In the current study we explored whether altered bone metabolism influence CV risk in patients with SLE. METHODS: In 138 consecutive patients with SLE, atherosclerosis was a...

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Autores principales: Giannelou, Mayra, Skarlis, Charalampos, Stamouli, Aikaterini, Antypa, Eleni, Moutsopoulos, Haralampos M, Mavragani, Clio P
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7484862/
https://www.ncbi.nlm.nih.gov/pubmed/32913010
http://dx.doi.org/10.1136/lupus-2020-000393
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author Giannelou, Mayra
Skarlis, Charalampos
Stamouli, Aikaterini
Antypa, Eleni
Moutsopoulos, Haralampos M
Mavragani, Clio P
author_facet Giannelou, Mayra
Skarlis, Charalampos
Stamouli, Aikaterini
Antypa, Eleni
Moutsopoulos, Haralampos M
Mavragani, Clio P
author_sort Giannelou, Mayra
collection PubMed
description OBJECTIVE: A link between bone metabolism and cardiovascular (CV) disease has been suggested mainly in the general population. In the current study we explored whether altered bone metabolism influence CV risk in patients with SLE. METHODS: In 138 consecutive patients with SLE, atherosclerosis was assessed by the presence of plaque and/or arterial wall thickening in carotid/femoral arteries by ultrasound. Bone mineral density (BMD) levels and hip/spinal cord fractures together with classical CV disease and osteoporosis risk factors including serum 25(OH) vitamin D(3) and parathormone (PTH) levels were recorded in all patients. Serum osteoprotegerin (OPG) and receptor activator of nuclear factor kappa-Β ligand were quantitated by commercial ELISA. Statistical analysis included both univariate and multivariate models. RESULTS: Abnormal PTH serum concentrations (>65 pg/mL)—but not 25(OH) vitamin D(3) serum levels—were identified as a risk factor for both plaque formation and arterial wall thickening in patients with SLE (ORs (95% CIs): 8.2 (1.8 to 37.4) and 3.9 (1.3 to 11.8), respectively). This association remained significant following adjustment for vitamin D(3) levels and classical CV risk factors. Moreover, an independent association between osteoporosis with plaque formation and arterial wall thickening was detected following adjustment for total steroid dose, premature menopause and disease duration (ORs (95% CIs): 5.3 (1.1 to 26.2) and 3.5 (1.1 to 11.4), respectively). An inverse correlation between femoral neck BMD values and intima–medial thickness scores was also observed (r: −0.42, p=0.008). CONCLUSIONS: These findings further strengthen the concept of shared pathophysiological mechanisms between atherogenesis and altered bone metabolism in autoimmune populations, revealing heightened PTH levels as a potential marker for atherosclerosis among patients with SLE.
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spelling pubmed-74848622020-09-18 Atherosclerosis in SLE: a potential role for serum parathormone levels Giannelou, Mayra Skarlis, Charalampos Stamouli, Aikaterini Antypa, Eleni Moutsopoulos, Haralampos M Mavragani, Clio P Lupus Sci Med Co-Morbidities OBJECTIVE: A link between bone metabolism and cardiovascular (CV) disease has been suggested mainly in the general population. In the current study we explored whether altered bone metabolism influence CV risk in patients with SLE. METHODS: In 138 consecutive patients with SLE, atherosclerosis was assessed by the presence of plaque and/or arterial wall thickening in carotid/femoral arteries by ultrasound. Bone mineral density (BMD) levels and hip/spinal cord fractures together with classical CV disease and osteoporosis risk factors including serum 25(OH) vitamin D(3) and parathormone (PTH) levels were recorded in all patients. Serum osteoprotegerin (OPG) and receptor activator of nuclear factor kappa-Β ligand were quantitated by commercial ELISA. Statistical analysis included both univariate and multivariate models. RESULTS: Abnormal PTH serum concentrations (>65 pg/mL)—but not 25(OH) vitamin D(3) serum levels—were identified as a risk factor for both plaque formation and arterial wall thickening in patients with SLE (ORs (95% CIs): 8.2 (1.8 to 37.4) and 3.9 (1.3 to 11.8), respectively). This association remained significant following adjustment for vitamin D(3) levels and classical CV risk factors. Moreover, an independent association between osteoporosis with plaque formation and arterial wall thickening was detected following adjustment for total steroid dose, premature menopause and disease duration (ORs (95% CIs): 5.3 (1.1 to 26.2) and 3.5 (1.1 to 11.4), respectively). An inverse correlation between femoral neck BMD values and intima–medial thickness scores was also observed (r: −0.42, p=0.008). CONCLUSIONS: These findings further strengthen the concept of shared pathophysiological mechanisms between atherogenesis and altered bone metabolism in autoimmune populations, revealing heightened PTH levels as a potential marker for atherosclerosis among patients with SLE. BMJ Publishing Group 2020-09-10 /pmc/articles/PMC7484862/ /pubmed/32913010 http://dx.doi.org/10.1136/lupus-2020-000393 Text en © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/ http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Co-Morbidities
Giannelou, Mayra
Skarlis, Charalampos
Stamouli, Aikaterini
Antypa, Eleni
Moutsopoulos, Haralampos M
Mavragani, Clio P
Atherosclerosis in SLE: a potential role for serum parathormone levels
title Atherosclerosis in SLE: a potential role for serum parathormone levels
title_full Atherosclerosis in SLE: a potential role for serum parathormone levels
title_fullStr Atherosclerosis in SLE: a potential role for serum parathormone levels
title_full_unstemmed Atherosclerosis in SLE: a potential role for serum parathormone levels
title_short Atherosclerosis in SLE: a potential role for serum parathormone levels
title_sort atherosclerosis in sle: a potential role for serum parathormone levels
topic Co-Morbidities
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7484862/
https://www.ncbi.nlm.nih.gov/pubmed/32913010
http://dx.doi.org/10.1136/lupus-2020-000393
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