Arthritis & Rheumatism, Volume 60,
October 2009 Abstract Supplement
The 2009 ACR/ARHP Annual Scientific Meeting
Philadelphia October 16-21, 2009.
Low Physical Activity Is Associated with Proinflammatory High-Density Lipoprotein and Increased Subclinical Atherosclerosis in Women with Systemic Lupus Erythematosus
Volkmann1, Elizabeth R., Grossman2, Jm, Sahakian1, Lori J., Skaggs1, Brian J., FitzGerald3, John D., Ragavendra3, Nagesh, Charles-Schoeman3, Christina
Division of Rheumatology, David Geffen School of Medicine at UCLA, Los Angeles, CA,
UCLA, LA, CA,
David Geffen School of Medicine at UCLA, Los Angeles, CA,
UCLA, Los Angeles, CA,
Harbor-UCLA Medical Center, Torrance, CA
Discovering ways to decrease cardiovascular disease in patients with Systemic Lupus Erythematosus (SLE) remains a substantial challenge in clinical practice. The present study investigates the impact of physical activity on subclinical atherosclerosis and on dysfunctional, proinflammatory high-density lipoprotein (piHDL), which may increase risk for atherosclerosis in SLE.
Patients (242 women) fulfilling the ACR 1997 criteria for SLE participated in this cross-sectional study. Carotid plaque and intima-media thickness (IMT), antioxidant function of HDL, and traditional cardiac risk factors were measured. Disease activity and organ damage were assessed using the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) and the Systemic Lupus International Collaborating Clinics/ACR Damage Index (SLICC/ACR), respectively. Physical activity was evaluated from self-reports by calculating the metabolic equivalent-minutes (METs) per week and by the physical function component of the Medical Outcomes Study Short Form-36 (SF-36). Data were analyzed using bivariate and multivariate regression analyses.
Number of METs per week spent performing strenuous exercise was negatively correlated with IMT (r= -.30, P = 0.002) and number of plaques (r= -.30, P = 0.0001). Physical function as assessed by the SF-36 was also negatively correlated with IMT (r=.14, P = 0.03) and number of plaques (r= -.14, P = 0.04). In multivariate analyses, number of strenuous exercise METs was significantly associated with IMT (t=-2.2, P= 0.028) and number of plaques (t=-2.5, P= 0.014) when controlling for markers of SLE disease activity and damage, but not after controlling for traditional cardiac risk factors. Low physical activity, defined as < 225 total METs per week, was associated with presence of piHDL in multivariate analysis, controlling for both traditional cardiac risk factors and markers of SLE disease activity and damage, (OR 2.0, P = 0.03). Neither total METs per week, nor SF-36 physical function correlated with SLEDAI score, cumulative or current prednisone dose, or use of hydroxychloroquine.
Low physical activity is associated with increased subclinical atherosclerosis and with piHDL in patients with SLE. Increased strenuous exercise may potentially reduce the risk of atherosclerosis in SLE.
To cite this abstract, please use the following information:
Volkmann, Elizabeth R., Grossman, Jm, Sahakian, Lori J., Skaggs, Brian J., FitzGerald, John D., Ragavendra, Nagesh, et al; Low Physical Activity Is Associated with Proinflammatory High-Density Lipoprotein and Increased Subclinical Atherosclerosis in Women with Systemic Lupus Erythematosus [abstract]. Arthritis Rheum 2009;60 Suppl 10 :1567