Homocysteine levels are independently associated with damage accrual in systemic lupus erythematosus patients from a Latin-American cohort.
Clin Rheumatol
; 38(4): 1139-1146, 2019 Apr.
Article
in En
| MEDLINE
| ID: mdl-30539353
ABSTRACT
OBJECTIVE:
To determine the impact of homocysteine levels on damage accrual in systemic lupus erythematosus (SLE) patients.METHODS:
This longitudinal study was conducted in consecutive patients seen every 6 months at our Rheumatology Department since 2012. Patients with available homocysteine levels and who had at least one subsequent visit were included. Univariable and multivariable Cox regression models were done to determine if homocysteine levels were predictive of damage accrual as per the SLICC Damage Index (SDI). The multivariable model was adjusted for pertinent variables (age at diagnosis, gender, socioeconomic status, disease duration, disease activity (SLEDAI), Framingham score, antimalarial and immunosuppressive drug use, average daily dose, and exposure time to prednisone (PDN)).RESULTS:
One hundred forty-five patients were included; their mean (SD) age at diagnosis was 43.70 (12.09) years, 136 (93.8%) were female, and nearly all were Mestizo. At baseline, disease duration was 7.55 (6.73) years; patients were followed for 3.54 (1.27) years. The SLEDAI was 5.60 (4.34), and the SDI 0.97 (1.35). The average daily PDN dose was 7.30 (5.78) mg/day and the time of PDN exposure was 7.36 (6.73) years. Mean homocysteine levels were 10.07 (3.71) µmol/L. The highest tertile of homocysteine levels predicted new damage accrual in the univariable and multivariable models [HR 1.78 (95% CI, 1.042-3.039); p = 0.035 and HR 2.045 (95% CI, 1.077-3.883); p = 0.029, respectively]. Increased levels (> 15 µmol/L) were found in 12 (8.3%) patients; 75 (51.7%) patients increased ≥ 1 SDI point.CONCLUSION:
In SLE patients, homocysteine levels predicted damage accrual independently of other well-known risk factors for such occurrence.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Homocysteine
/
Lupus Erythematosus, Systemic
Type of study:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
America do sul
/
Peru
Language:
En
Journal:
Clin Rheumatol
Year:
2019
Document type:
Article
Affiliation country:
Peru