Abstract 15867: Flexibility Modifies the Age-related Arterial Stiffness in Women With Systemic Lupus Erythematosus

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Alba Hernandez Martinez ◽  
Sergio Sola-Rodriguez ◽  
Jose A Vargas-Hitos ◽  
Blanca Gavilan-Carrera ◽  
Antonio Rosales-Castillo ◽  
...  

Introduction: Systemic lupus erythematosus (SLE) is an autoimmune multisystemic disease associated with premature cardiovascular disease morbidity and mortality. Arterial stiffness is an age-dependent powerful cardiovascular risk predictor, which is elevated in SLE. The elasticity of the vascular wall and muscle flexibility are both partially determined by elastin-collagen composition, and whereas cardiorespiratory fitness seems to delay the age-related arterial stiffening in SLE, it might be speculated that flexibility (another component of physical fitness) could reduce the sympathetic nervous system dysfunction observed in patients with SLE and thus reduce arterial stiffness. However, whether higher flexibility is related to lower age-related arterial stiffness in SLE is unknown. Hypothesis: We assessed the hypothesis that flexibilitymay attenuate the negative effect of age on arterial stiffness in women with SLE. Methods: This cross-sectional study included 76 women with SLE (age 43.2, SD 13.8) with mild disease activity. Arterial stiffness was assessed with pulse wave velocity (PWV), flexibility by the back-scratch test, disease activity through SLEDAI, and cumulative organ damage with SDI, blood pressure by standardized methods and menopause status by questionnaire. Quantile regression tested the association of age, flexibility, and their interaction, with PWV (controlling for mean blood pressure, menopause, SLEDAI, SDI and corticosteroids exposure). Sample size was determined for a two-tailed test with a power of 0.8, significance p < 0.05 and effect size > 0.7 (n=34). Results: There was a back-scratchхage interaction effect on PWV ( p <0.001). For women with -20 cm in the back-scratch test (i.e. short to touch her middle fingers behind the back), PWV was 0.107 m/s higher for 1-year increase in age, whereas for women with 15 cm, PVW was 0.064 m/s higher for 1-year increase in age. Conclusion: In conclusion, higher flexibility is associated with a lower increase in age-related arterial stiffness in SLE women. Further research is needed to determine whether improving flexibility through stretching exercises reduces the arterial stiffness associated with aging.

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Rosalie Magro ◽  
Andrew A. Borg

Systemic Lupus Erythematosus (SLE) is a multisystemic autoimmune disorder. The aim of this study was to characterise the SLE patients living in Malta in order to estimate the prevalence and incidence of SLE and characterise the clinical presentation as well as identify any unmet needs. 107 SLE patients who fulfilled SLICC classification criteria were identified. These were invited to participate in the study by means of an interview, blood and urine tests, and filling of the following questionnaires: Fatigue Severity Scale (FSS), visual analogue scale (VAS) for fatigue, Hospital Anxiety and Depression Scale (HADS), VAS for pain, Pittsburgh Sleep Quality Index (PSQI), and modified Health Assessment Questionnaire (mHAQ). The estimated prevalence of SLE in Malta is 29.3 patients per 100,000 and the estimated incidence is 1.48 per 100,000 per year. 93.5% of SLE patients were female, and the mean age at diagnosis was 33.1 years. 60.8% were overweight or obese and body mass index (BMI) had a significant positive correlation with daily dose of prednisolone (R=0.177, p=0.046). 20.7% and 3.3% had a moderate and high disease activity, respectively, as measured by SLEDAI-2K. Disease activity had a significant positive correlation with functional disability measured by mHAQ (R=0.417, p<0.001). 56.5% had an abnormal level of fatigue (FSS >3.7) and 57.6% had a high level of anxiety (HADS ≥8). This study has identified a number of unmet needs of SLE patients, including obesity, uncontrolled disease activity, fatigue, and anxiety.


2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Aep Saepudin ◽  
Paulus Anam Ong ◽  
Syarief Hidayat ◽  
Andri Reza Rahmadi ◽  
Laniyati Hamijoyo

Background: Cognitive dysfunction was found in 55-80% Neuropsychiatry Systemic Lupus Erythematosus (NPSLE) patients. Serious concern from clinicans was needed as its impact to patient’s quality of life. Disease activity is expected to be affecting patient’s cognitive function. Previous studies regarding correlation between disease activity and cognitive dysfunction showed various results. This study aimed to evaluate the correlation between disease activity and cognitive function in SLE patients.Methods: This study is an analytical cross-sectional study. Subjects were SLE patients at the rheumatology clinic of Dr. Hasan Sadikin Hospital Bandung during June-August 2017. Subject’s evaluations included disease activity assessment using SLE disease activity index-2K (SLEDAI-2K) and cognitive function assessment using MoCA-Ina test. Data were analyzed by using Spearman Rank correlation test. Results: Mean age of the subjects was 31 ± 8 years old, most of them were senior high school graduates (65.8 %) and median length of study was 12 years. Subject’s median duration of illness was 44 months. Their MoCA-Ina median score was 25, while SLEDAI-2K median score was 6. Cognitive dysfunctions were found in more than half of subjects (52.63%), which memory domain (78.95%) was most frequently impaired. Most of subjects were patients with active SLE (63.2%). Correlation test showed there was no correlation between SLEDAI-2K score and MoCA-Ina score (rs=0.023, p=0.445).Conclusion: There was no correlation between disease activity (SLEDAI-2K score) and cognitive function (MoCA-Ina score). Keywords: Cognitive dysfunction, MoCA-Ina, Systemic lupus erythematosus, SLEDAI-2K


2021 ◽  
Vol 1 (4) ◽  
pp. 370-382
Author(s):  
Rina Kriswiastiny ◽  
Festy Ladyani Mustofa ◽  
Syuhada Syuhada ◽  
Reychan Gustiawan Putra

ABSTRACT: RELATIONSHIP OF SLE (SYSTEMIC LUPUS ERYTHEMATOSUS) ACTIVITIES BASED ON MEX-SLEDAI SCORING ON DEPRESSION IN ODAPUS COMMUNITIES BANDAR LAMPUNG Background: Depression is a clinical manifestation that can occur in patients with SLE and it is suspected that the level of SLE disease activity can affect these events (Nery, et al. 2007). Ironically, this section is a part that is often overlooked by many people, including the health sector. In fact, by understanding this point of view, cross-scientific collaborative treatment such as the Internal and Psychiatry Fields can be done to improve the treatment and quality of life of patients.Objective: To determine the relationship between SLE (Systemic lupus Erythematosus) disease activity based on MEX-SLEDAI Scoring against depression in the Odapus Community, Bandar Lampung City 2020.Methodology: The type of research used in this study is correlative analytic with cross-sectional design. The sample used in this study were patients with SLE (Systemic lupus Erythematosus) based on MEX-SLEDAI Scoring for depression in the Odapus Community, Bandar Lampung City 2020. Data analysis used the Spearman test.Results: In the activity variable SLE and depression, the P value = 0.001 (P <0.05) with a correlation value of r = 0.490 was obtained.Conclusion: There is a relationship between SLE (Systemic lupus Erythematosus) disease activity based on MEX-SLEDAI Scoring against depression in Odapus Community, Bandar Lampung City 2020 with moderate correlation strength. Keywords: Lupus, Depression, MEX-Sledai  INTISARI: HUBUNGAN AKTIFITAS PENYAKIT SLE (SYSTEMIC LUPUS ERYTHEMATOSUS)  BERDASARKAN MEX-SLEDAI SCORING TERHADAP DEPRESI DI KOMUNITAS ODAPUS KOTA BANDAR LAMPUNGLatar Belakang: Depresi merupakan manifestasi klinis yang dapat muncul pada penderita SLE dan diduga tingkat aktivitas penyakit SLE dapat mempengaruhi kejadian-kejadian tersebut (Nery, dkk. 2007). Ironisnya, bagian ini merupakan bagian yang sering luput diperhatikan oleh banyak orang, termasuk bidang kesehatan. Padahal, dengan memahami sudut pandang ini, pengobatan kolaboratif lintas keilmuan seperti Bidang Interna dengan Bidang Psikiatri dapat dilakukan untuk meningkatkan pengobatan dan kualitas hidup pasien.Tujuan: Untuk mengetahui hubungan aktifitas penyakit SLE (Systemic lupus Erythematosus) berdasarkan MEX-SLEDAI Scoring terhadap depresi di Komunitas Odapus Kota Bandar Lampung 2020.Metodologi: Jenis penelitian yang digunakan dalam penelitian ini adalah analitik korelatif dengan desain cross sectional. Sampel yang digunakan pada penelitian ini adalah penderita penyakit SLE (Systemic lupus Erythematosus) berdasarkan MEX-SLEDAI Scoring terhadap depresi di Komunitas Odapus Kota Bandar Lampung 2020. Analisa data menggunakan Uji Spearman.Hasil: Pada variabel aktifitas penyakit SLE dan depresi diperoleh nilai P value = 0,001 (P<0,05) dengan nilai korelasi r = 0,490.Kesimpulan: Terdapat hubungan aktifitas penyakit SLE (Systemic lupus Erythematosus) berdasarkan MEX-SLEDAI Scoring terhadap depresi di Komunitas Odapus Kota Bandar Lampung 2020 dengan kekuatan korelasi sedang.Kata Kunci     : Lupus, Depresi, MEX-Sledai


2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
T Panafidina ◽  
T V Popkova ◽  
D S Novikova

Abstract Background Nephritis in systemic lupus erythematosus (SLE) is a factor contributing to early development of atherosclerosis (AS). Objectives The aim of the study is to determine differences in cardiovascular risk factors and AS in SLE pts with and without lupus nephritis (LN). Methods The study included 162 females, age 35 [26–43] years (median [interquartile range 25–75%])) with SLE (ACR,1997). We divided SLE pts on two groups, comparable in age: the 1st group is the pts with LN (n=84, 52%), the 2nd - without LN (n=78, 48%). We considered traditional factors of cardiovascular disease (CVD): (smoking, family history of CVD, blood pressure, cholesterol (total, HDL, LDL) and triglyceride (TG) levels, body mass index, diabetes mellitus) and SLE-related factors (age at onset, duration, clinical features, SLE Disease Activity Index (SLEDAI-2K) and the Systemic Lupus International Collaborating Clinics damage index (SLICC/DI), treatment with steroids); intima-media thickness (IMT) and the 10-year risk for coronary events. Carotid intima-media wall thickness of common carotid arteries was measured by high resolution B-mode ultrasound. The 10-year risk for coronary events was estimated by the Framingham risk equation. Results Median SLE duration was 8,0 [2,3–17,0] years, SLEDAI 2K – 8 [3–16], SLICC/DI score – 2 [0–3], duration of prednisone treatment – 72 [26–141] months. SLE pts from the 1st group had higher prevalence of hypertension (61% vs 36%, p<0,01), systolic blood pressure (130 [110–150] vs 120 [110–130]mm Hg, p<0,01), diastolic blood pressure (80 [70–95] vs 70 [70–80] mm Hg, p<0,05), TG concentration (136 [98–184] vs 100 [61–162] mg/dl, p<0,01), Framingham Risk Score (5 [1–30] vs 1 [1–27]%, p<0,05), SLEDAI-2K (12 [5–19] vs 4 [2–10], p<0,ehz745.08501), SLICC/DI score (2 [0–4] vs 0 [0–2], p<0,01), prednisone therapy duration (95 [26–192] vs 44 [14–98] months, p<0,05), prednisone cumulative dose (34,4 [13,6–82,5] vs 15,7 [6,2–35,2] g, p<0,001), mean IMT (0,73 [0,65–0,83] vs 0,67 [0,61–0,75] mm, p<0,01), than the pts from the 2nd group. There is no difference in CVD frequency in these groups (17% vs 8%, p=0,084). Conclusions SLE patients with and without LN had no difference in frequency of clinical manifestations of AS (CVD), but had a greater value of mean IMT, Framingham Risk Score and a higher incidence of both traditional (hypertension, TG concentration) and SLE-related (disease activity, prednisone therapy) risk factors for AS.


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