Pediatric Rheumatology Online Journal → July 2003 → Childhood Lupus→ Clinical Presentation, course and Outcomes → Abstract #94

EFFECTS ON LIPIDS IN PEDIATRIC LUPUS

A. I. Quintero-Del-Rio,^1,2 J. Fesmire,¹ L. Punaro,³ M. Reichlin.^1,2

¹Arthritis and Immunology, Oklahoma Medical Research Foundation, Oklahoma City, OK, United States; ²Medicine, Oklahoma University Medical Center, Oklahoma City, OK, United States; ³Arthritis, Texas Scottish Rite Hospital, Dallas, TX, United States

Children with systemic lupus erythematosus (SLE) constitute 4.5% of the total lupus population in the United States. This project sought to identify the abnormalities in lipid metabolism in SLE, their siblings and unrelated matched controls for age and sex. In addition, we measured the serum triglyceride and serum cholesterol in the density classes such as HDL, LDL and the corresponding lipoproteins to examine the efficiency of the lipid transport system. We evaluated 32 lupus children between the ages of 8 to 18 years old. All patients met at least four of the 11 criteria for diagnosis following the ACR criteria for lupus. Twenty-nine of 32 SLE children tested demonstrated an increase in the percentage of total triglyceride/LDL of 55.7% in comparison to 53.6% in the siblings and 43% in the unrelated matched control group; p=0.019 (AOV). Similar results were obtained when measuring the percentage of total cholesterol/LDL where the patients achieved elevations of 51.5% vs. 54% in the siblings vs. 41.5% in the matched controls; p=0.008 (AOV). HDL cholesterol measured in the lupus patients was 50.2mg/dl vs. 63.5mg/dl in the match controls; p=0.02 (AOV). The HDL triglycerides showed no statistical significance among the groups. The siblings of the lupus patients parallel the increase of the triglycerides, cholesterol and LDL implying genetic effects on these lipids. Consequently, the cholesterol clearance is much lower in the patient group in comparison to the siblings and matched control group, 30.5% vs. 33.4% vs. 39.4%. Despite the fact that the total lipids are similar between the groups it is of interest to see that the distribution between the cholesterol and triglyceride density classes are significantly different leading to triglyceride/cholesterol dysfunction in the lipid transport of lupus patients. Children may be at a higher risk of early onset of premature arteriosclerosis and its complications similar of that found in adults with SLE.