Published: 2017-10-27

Lipid profile in systemic lupus erythematosus: study from a tertiary teaching hospital of Eastern India

Simanchala Dakua, Manoranjan Behera, Jayant Kumar Panda, Prabhat Kumar Padhi


Background: Dyslipidemia is an independent modifiable risk factor for coronary artery disease. Patients with systemic lupus erythematosus (SLE) have dyslipidemia and accelerated atherosclerosis; however, there is paucity of published data on the lipid profile in patients with SLE in Eastern India. This study was done to assess the prevalence and abnormality of lipid profile in patients with SLE admitted to a tertiary care teaching hospital in Eastern India.

Methods: This was a hospital based prospective study evaluating SLE patients admitted to a tertiary care institution in Eastern India. 101 patients with SLE admitted consecutively and 100 age and sex matched controls were enrolled for study. Fasting total cholesterol (TC), triglycerides (TG), high density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) were measured in plasma whereas very low-density lipoprotein cholesterol (VLDL-C) was calculated. Statistical analysis was done using the standard statistical techniques.

Results: Out of 101 patients of SLE, 97 were female and 4 were of male gender. The age of the patients ranged from 15 to 47 years with a mean of 27.17 (±8.4) years. Dyslipidemia was found in 58(57.4%) patients. Hypercholesterolemia was found in 23 (22.7%), hypertriglyceridemia in 55 (54.4%), raised LDL-C in 24 (23.7%) cases. Raised TC, TG, and LDL-C was found in 18 (17.8%), and raised TC, TG, LDL-C and low HDL-C was found in 9 (8.9%) cases. There was significant increase in serum cholesterol, triglyceride and VLDL-C while decrease in HDL-C in SLE patients than controls (p <0.001). Statistically no difference in lipid profile was found in between groups of SLE receiving steroid and without steroid.

Conclusions: Abnormal lipid profiles are very common in patients with SLE, though the patients are very young. Control of dyslipidemia can favourably affect cardiovascular related morbidity and mortality.




Dyslipdemia, Premature atherosclerosis, Systemic lupus erythematosus

Full Text:



Manzi S, Meilahn EN, Rairie JE, Coute CG, Medsger TA. Jansen McWilliams L, et al. Age-specific incidence rates of myocardial infarction and angina in women with systemic lupus erythematosus: comparison with the Framingham study. AM J Epidemiol. 1997;145:408-15

Urowitz MB, Gladman DD, Bruce IN. Atherosclerosis and Systemic Lupus Erythematosus. Curr Rheumatol Rep. 2000;2:19-23.

Petri M, Perez-Guthann S, Spence D, Hochberg MC. Risk factors for coronary artery disease in patients with systemic lupus erythematosus. Am J Med. 1992;93:513-9.

Petri M. Detection of coronary artery disease and the role of traditional risk factors in the Hopkin's Lupus Cohort. Lupus. 2000;9:170-5.

Borba EF, Bonfa E, Vinagre CG, Ramires JA, Maranhao RC. Chylomicron metabolism is markedly altered in systemic Lupus Erythematosus. Arthritis Rheum. 2000;43:1033-40.

Borba EF, Bonfa E. Long term beneficial effect of chloroquin diphosphate on lipoprotein profile in lupus patients with and without steroid therapy. J Rheumatol. 2001;28:780-5.

Nuttall SL, Heaton S, Piper MK, Martin U, Gordon C. Cardiovascular risk in systemic lupus erythematosus-evidence of increased oxidative stress and dyslipidemia. Rheumatology (oxford) 2003;42:758-62.

Svenungsson E, Gunnarsson I, Fei GZ. Elevated triglycerides and low levels of high-density lipoprotein as markers of disease activity in association with upregulation of the tumor necrosis factor alpha/tumor necrosis factor receptor system in systemic lupus erythematosus. Arthritis Rheum. 2003;48(9):2533-40.

Petri M, Lakata C, Magder L, Goldman D. Effect of prednisone and hydroxychloroquine on coronary artery disease risk factors in systemic lupus erythematosus: A longitudinal data analysis. Am J Med. 1994;96:254-9.

Sella EM, Sato EI, Leite WA, Oliveira Filho JA, Barbieri A. Myocardial perfusion scintigraphy and coronary disease risk factors in systemic lupus erythematosus. Ann Rheum Dis. 2003;62:1066-70.

Bellomio V, Spindler A, Lucero E, Berman A, Santana M, Moreno C, et al. SLE: mortality and survival in Argentina, a multicentre study. Lupus. 2000;9:377-81.

Hochberg MC. Updating the American College of Rheumatology criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 1997;40:1725.

Kakati S, Doley B, Devee A, Dihingia P, Sharma PK. Serum lipid profiles in patients with systemic lupus Erythematosus. J Indian Rheumatol Assos. 2003;11:5-7.

Mikdashi J, Handwerger B, Langenberg P, Miller M, Kittner S. Baseline disease activity, hyperlipidemia, and hypertension are predictive factors for ischemic stroke and stroke severity in systemic lupus erythematosus. Stroke. 2007; 38:281-5.

Abdalla MA, EI Desouki SM, Ahmed AS. Clinical significance of lipid profile in systemic lupus erythematosus patients: Relation to disease activity and therapeutic potential of drugs. The Egyptian Rheumatologist. 2017;39:93-8.

Borba EF, Bonfa E, Vinagre CG. Mechanisms of dyslipoproteinemias in systemic lupus erythematosus. Clinical and Developmental Immunology. 2006;13(2-4):203-9.

Sabio JM, Zamora-Pasadas M, Jimenez-Jaimez J, Albadalejo F, Vargas-Hitos J, et al. Metabolic syndrome in patients with systemic lupus erythematosus from Southern Spain; Lupus. 2008; 17(9):849-59.

Semb H, Peterson J, Tavernier J. Multiple effects of tumor necrosis factor on lipoprotein lipase in vivo. J Biol Chem. 1987;262:8390-4.

Gabay C, Kushner I. Acute-phase proteins and other systemic responses to inflammation. N Engl J Med. 1999;340(6):448-54.

Spronk PE, Ter Borg EJ, Limburg PC. Plasma concentration of IL-6 in systemic lupus erythematosus; an indicator of disease activity? Clin Exp lmmunol. 1992;90:106-10.

Svenungsson E, Fei GZ, Jensen-Urstad K. TNF-α: A link between hypertriglyceridemia and inflammation in SLE patients with cardiovascular disease. Lupus. 2003;12(6):454-61.

Reichlin M, Fesmire J, Quintero-Del-Rio AI. Autoantibodies to lipoprotein lipase and dyslipidemia in systemic lupus erythematosus. Arthritis Rheum. 2010;6(11):2957-63.

de Carvalho JF, Borba EF, Viana VST, Bueno C, Leon EP, Bonfa E. Anti-lipoprotein lipase antibodies. A new player in the complex atherosclerotic process in systemic lupus erythematosus? Arthritis and Rheum. 2004;50(11):3610-5.

Beaumont JL, Beaumont V. Autoimmune hyperlipidemia. Atherosclerosis 1977;26:405-18.

Das S. Disorders of Lipid Metabolism. In: Sainani GS(Ed-in-Chief). API Textbook of Medicine. Mumbai, Association of Physicians of India. 6th Edn. 1999:190-6.

Chung CP, Avalos I, Oeser A, Gebretsadik T, Shintani A, Raggi P, Stein CM. High prevalence of the metabolic syndrome in patients with systemic lupus erythematosus: association with disease characteristics and cardiovascular risk factors Ann Rheum Dis. 2007;66(2):208-14.

Bruce IN, Urowitz MB, Gladman DD, Hallett DC. Natural history of hypercholesterolemia in systemic lupus erythematosus. J Rheumatol. 1999;26(10):2137-43.

Sholter DE, Armstrong PW. Adverse effects of corticosteroids on the cardiovascular system. Can J Cardiol. 2000;16:505-11.

Ilowite NT, Samuel P, Ginzler E. Dyslipoproteinemia in pediatric systemic lupus erythematosus. Arthritis Rheum 1988;31:859-63.