Most prospective studies of bone mineral density (BMD) in systemic lupus erythematosus (SLE) patients have been of relatively short duration, with a maximum of 6 years. To describe long-term changes ...in BMD in women with SLE and identify risk factors associated with BMD loss. We retrospectively evaluated 132 adult Mexican-Mestizo women with SLE who underwent dual X-ray absorptiometry (DXA). Demographic and clinical data were collected and BMD at the lumbar spine (L1–L4) and total hip were collected at baseline and during the follow up. At baseline, the mean age of participants was 43.4 ± 12.5 years, 50.8% had osteopenia and 11% osteoporosis. The median follow-up was 13 (IQR 10.2–14.0) years. During follow up, 79% of patients used glucocorticoid (GCT). The mean percentage of changes in BMD during follow up were: − 14.03 ± 11.25% (− 1.49%/year) at the lumbar spine, and − 15.77 ± 11.57% (− 1.78%/year) at the total hip, with significant changes (
p
< 0.001 for both comparisons). Multivariate analysis showed older age, GCT use at baseline, and transition to the menopause during the follow-up were significantly associated with greater reductions in BMD. This retrospective longitudinal study found significant BMD loss at the lumbar spine and hip. Older age, menopausal transition and GCT use were independently associated with BMD decline in women with SLE.
The aim was to analyze the distribution and trends of deaths reported for rheumatoid arthritis (RA) in Mexico in 1998–2017. We carried out a cross-sectional study. Data were obtained from Dynamic ...Cubes, General Direction of Health Information, on deaths related to RA in Mexico. Seropositive RA was diagnosed using the International Classification of Diseases version 10. Variables were categorized by diagnosis, age, and gender. Time trends of age-standardized mortality rates (ASMRs) were analyzed for RA, and the annual percent change (APC) was estimated using Joinpoint trend analysis. We found 714 deaths mentioned as RA and 9,749,956 non-RA deaths between 1998 and 2017. Overall RA mortality decreased from 0.14 in 2004 to 0.04 per 100 000 in 2017 (APC: − 10.3%; 95% CI − 16.5%, − 3.3%), while the non-RA ASMR remained stable. In females, there was an initial increase of 27.3% per year through 1998–2004 and a reduction of − 11.7% per year subsequently, while in males, the APC remained stable between 1998 and 2017. The trend for RA mortality resulted in a cumulative change in the ratio of RA ASMR to non-RA ASMR of − 20.6% in females and + 3.2% in males. Although mortality attributable to RA increased from 1998 to 2004 in Mexico, it began to improve after 2004, particularly in females. Prospective, population-based data could help to identify risk factors that could be altered to improve outcomes.
Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by damage to multiple systems and a higher risk of cardiovascular disease. In addition, several studies have found that ...insulin resistance (IR) is more prevalent in SLE patients than controls, increasing the risk of prediabetes, type 2 diabetes mellitus (T2DM) and morbidity. The objective of this review article was to summarize the most relevant evidence about the relationship among IR, T2DM and SLE, including the effects of proinflammatory states, acute-phase proteins, pro-inflammatory cytokines, and pharmacological SLE treatment. A better understanding of the mechanisms involved in these comorbidities will allow better treatment strategies.
To investigate the risk of DM and evaluate the impact of SLE therapies on the risk of developing DM in patients with SLE.
Electronic database searches of PubMed, Embase, Cochrane Library, and Web of ...Science were performed from inception to February 2023. Cohort and cross-sectional studies that analyzed the risk of DM in patients with SLE were included. The associations between diabetes and antirheumatic agents, such as antimalarials and glucocorticoids, were analyzed in cohort studies. Data were pooled using fixed- or random-effects meta-analysis to estimate pooled odd ratios (OR), relative risks (RR), and 95% confidence intervals (CIs). This study was registered with PROSPERO (CRD42023402774).
A total of 37 studies (23 cross-sectional and 14 cohort studies) involving 266 537 patients with SLE were included. The pooled analyses from cross-sectional studies and cohort studies did not show an increased risk of DM in SLE patients (OR = 1.05, 95% CI 0.87-1.27; p = 0.63 and RR = 1.32, 95% CI 0.93-1.87; p= 0.12, respectively). However, several cohort studies consistently demonstrated a reduced risk of diabetes with antimalarials, while glucocorticoid use has been associated with an increased risk of developing diabetes. Age, sex, hypertension, and immunosuppressants have not been identified as risk factors for DM in SLE patients.
Although there was no increased risk of DM in patients with SLE compared with controls, HCQ users or adherents had a decreased risk, whereas glucocorticoid users had an increased risk.
Objective
The aim of this study was to determine the frequency of
Helicobacter pylori
in SLE patients and to compare clinical characteristics and gastroduodenal lesions in patients with and without
...H. pylori
infection.
Methods
Adult SLE patients were selected and subjected to endoscopy. Gastroduodenal lesions were examined by endoscopy and biopsy (antrum and corpus). Biopsies were evaluated by hematoxylin and eosin and Giemsa staining. Immunochromatographic membrane-based assay using amplification was used to test for
H. pylori
antigen (coproantigen) in stool samples in all participants. Clinical characteristics and gastroduodenal lesions were compared between patients with and without
H. pylori
infection.
Results
A total of 118 SLE patients were included (mean age 44.7 ± 11.7 years, mean disease duration 11.6 ± 6.0 years), of whom 101 (85.6%) were receiving non-steroidal anti-inflammatory drugs (NSAIDs). The coproantigen test was positive in 32 (27.1%) patients.
H. pylori
was present in twenty six patients (22.0%) in the gastric biopsy. The frequency of gastric erosions and gastric ulcers were 55.1% and 0.8%, respectively. Gastric erosions were less frequent in SLE patients with
H. pylori
infection than those without H.
pylori
(43.5.7% vs. 62.5%;
p
= 0.04). The age, disease duration, disease activity, chronic damage, gastroprotective drugs, and immunosuppressive therapy did not differ between the two groups.
Conclusions
We found a high frequency of
H. pylori
infection in SLE patients. The severity of SLE and reception of gastroprotective therapy do not seem to be related to
H. pylori i
nfection. Immunosuppressive therapy may not be protective against
H. pylori
infection in SLE patients.
Key Points
•
In patients with systemic lupus erythematosus (SLE), the frequency of Helicobacter pylori infection was 39% and gastric erosions were frequent.
•
Disease activity, chronic damage, gastroprotective drugs, and immunosuppressive therapy may not affect the prevalence of H. pylori infection in SLE patients.
We carried out a systematic review (SR) of adherence in diagnostic and prognostic applications of ML in SLE using the Transparent Reporting of a multivariable prediction model for Individual ...Prognosis Or Diagnosis (TRIPOD) Statement.
A SR employing five databases was conducted from its inception until December 2021. We identified articles that evaluated the utilization of ML for prognostic and/or diagnostic purposes. This SR was reported based on the PRISMA guidelines. The TRIPOD statement assessed adherence to reporting standards. Assessment for risk of bias was done using PROBAST tool.
We included 45 studies: 29 (64.4%) diagnostic and 16 (35.5%) prognostic prediction- model studies. Overall, articles adhered by between 17% and 67% (median 43%, IQR 37–49%) to TRIPOD items. Only few articles reported the model's predictive performance (2.3%, 95% CI 0.06–12.0), testing of interaction terms (2.3%, 95% CI 0.06–12.0), flow of participants (50%, 95% CI; 34.6–65.4), blinding of predictors (2.3%, 95% CI 0.06–12.0), handling of missing data (36.4%, 95% CI 22.4–52.2), and appropriate title (20.5%, 95% CI 9.8–35.3). Some items were almost completely reported: the source of data (88.6%, 95% CI 75.4–96.2), eligibility criteria (86.4%, 95% CI 76.2–96.5), and interpretation of findings (88.6%, 95% CI 75.4–96.2). In addition, most of model studies had high risk of bias.
The reporting adherence of ML-based model developed for SLE, is currently inadequate. Several items deemed crucial for transparent reporting were not fully reported in studies on ML-based prediction models.
Review registration. PROSPERO ID# CRD42021284881. (Amended to limit the scope).
Objective
A protective function of vitamin D in metabolic syndrome (MetS) has been described. The objective of the present study was to examine the relationship between serum 25‐hydroxyvitamin D ...(25(OH)D) concentrations and MetS in non‐diabetic systemic lupus erythematosus (SLE) women.
Methods
Cross‐sectional analyses of the relationship between concentrations of 25(OH)D, MetS, and its components were made in 160 non‐diabetic SLE women. MetS was defined according to National Cholesterol Education Program Adult Treatment Panel III criteria. Serum 25(OH)D was measured by chemiluminescent immunoassay. Serum 25(OH)D concentrations were categorized into quartiles (<16.6, 16.6‐21.1, 21.2‐26.3, ≥26.4 ng/mL).
Results
A total of 79 (49.3%) SLE women had MetS. Without adjusting for body mass index (BMI) or smoking, the odds of having MetS decreased according to increasing quartiles of 25(OH)D concentrations (P for trend = .03). The odds ratio (OR) of having MetS was 0.4 (95% confidence interval: 0.2‐0.9, P = .04) for the highest vs the lowest quartile of 25(OH)D concentrations when adjusted by age. The crude OR of having elevated hypertriglyceridemia decreased according to increasing quartiles of 25(OH)D concentrations (P for trend = .036). However, further adjustments for BMI and smoking removed the inverse association between 25(OH)D concentrations and MetS and its individual components.
Conclusion
In non‐diabetic SLE women with mild activity, 25(OH)D concentrations are not associated with MetS and its components.
