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Inicio Medicina Clínica (English Edition) Study of the metabolic syndrome severity index as a predictive factor of a major...
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Vol. 163. Issue 2.
Pages 62-69 (July 2024)
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Vol. 163. Issue 2.
Pages 62-69 (July 2024)
Original article
Study of the metabolic syndrome severity index as a predictive factor of a major of cardiovascular event in premenopausal women with systemic lupus erythematosus
Estudio del índice de gravedad del síndrome metabólico como factor predictivo de un episodio cardiovascular mayor en mujeres premenopáusicas con lupus eritematoso sistémico
Elsy Aidé García-Villegasa, Cruz Vargas-de-Leónb,c, Antonio Rafael Villa-Romerod, Itzelly Ibarra Valdovinosa, Horacio Márquez-Gonzáleze,f,
Corresponding author
a Departamento de Vigilancia Epidemiológica, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
b División de Investigación, Hospital Juárez de México, Mexico City, Mexico
c Sección de Estudios de Posgrado, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City, Mexico
d Salud Pública, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
e Investigación Clínica, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
f Departamento de Cardiopatías Congénitas, Hospital de Cardiología Centro Médico Nacional Siglo XXI, Mexico City, Mexico
Article information
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Figures (1)
Tables (2)
Table 1. Anthropometric, biochemical, clinical and metabolic syndrome characteristics of SLE patients with and without a MACE at baseline 2001 (n = 238).
Table 2. Association between severity of metabolic syndrome and development of MACE in SLE patients.
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Abstract
Background

Patients with Systemic Lupus Erythematosus (SLE) have an increased risk of metabolic syndrome (MS) and cardiovascular disease (CVD). MS is evaluated binary, limiting the understanding of each component's severity individually. Therefore, severity scores for MS that evaluate them separately have been developed. This study aims to determine the prognosis between MS severity and the occurrence of major adverse cardiovascular events (MACE) in SLE patients.

Methods

10-year follow-up cohort study. Premenopausal >18-year-old women with a previous diagnosis of SLE were included. Patients with recent cardiovascular (CV) events, pregnancy, thyroid disease, and liposuction were excluded. The variables of interest were CV events, the confounding variables, and the MS severity indexes were examined. Hazard ratios and Kaplan–Meier survival curves were estimated through Cox regression.

Results

238 women were analyzed; 22 presented MACE, and 216 did not. MS prevalence, measured according to Consensus and ATPII criteria, was higher in MACE patients (50% and 40,95%, respectively). The MetSx-IMC severity index was higher within the MACE group. COX analysis showed an increase in the MetSX-IMC associated with the risk of suffering MACE in a 1,107 ratio.

Conclusions

The MetSx-IMC severity index, contrary to the binary approaches, is suggested to evaluate MS as a predictor of MACE in SLE patients. Offering improved and more accurate prognosis in patients at risk of developing MCE.

Keywords:
Systemic lupus erythematosus
Metabolic syndrome
Cardiovascular disease
Severity index
Resumen
Antecedentes

Los pacientes con lupus eritematoso sistémico (LES) tienen mayor riesgo de síndrome metabólico (SM) y enfermedad cardiovascular. El SM se evalúa de forma binaria, limitando la comprensión de la gravedad de los componentes por separado. Por lo anterior, se han desarrollado puntajes de gravedad de SM evaluándose individualmente. Este estudio tiene como objetivo determinar el pronóstico entre la gravedad de SM y el desarrollo de evento cardiovascular mayor (ECM) en pacientes con LES.

Metodología

estudio de cohorte con seguimiento de 10 años, incluyendo mujeres premenopáusicas >18 años con LES. Se excluyeron pacientes con ECV, embarazo, enfermedad tiroidea y liposucción. La variable de interés fue ECV, y se examinaron las variables confusoras y los índices de gravedad de SM. Se estimaron las curvas de supervivencia de Kaplan–Meier y los cocientes de Hazard (HR) a través de la regresión de Cox.

Resultados

Se analizaron 238 mujeres: 22 presentaron ECM y 216 no. La prevalencia de SM, evaluada según los criterios de Consenso y ATPIII, fue mayor en pacientes con ECM (50% y 40,9%, respectivamente). El índice de gravedad MetSx-IMC fue más alto en el grupo de ECM. El análisis de COX, demostró incremento en el MetSx-IMC, asociándose al aumento del riesgo de experimentar ECM en un factor de 1,107.

Conclusiones

El índice de gravedad MetSx-IMC, contrario a los enfoques binarios, se sugiere para evaluar el SM como predictor de ECM en pacientes con LES. Ofreciendo mayor capacidad pronóstica y precisa de pacientes en riesgo de desarrollar ECM.

Palabras clave:
Lupus eritematoso sistémico
Síndrome metabólico
Enfermedad cardiovascular
índice de gravedad

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