ARTHRITIS & RHEUMATOLOGY
Vol. 66, No. S3, March 2014, p S106
A74: Nutritional and Metabolic Assessment in
Girls With Systemic Lupus Erythematosus
Roberta Salomão, Virgı́nia Ferriani, Luciana Carvalho, José Cesar Rosa,
Maria Olı́mpia Almada, Mariana Mathias, and Jacqueline Monteiro
Background/Purpose: Cardiovascular disease
(CVD), specifically from atherosclerosis, is one of major
cause of morbidity and mortality in SLE. Given their
lifelong exposure to atherogenic risk factors, children
and adolescents with SLE are at particularly high risk of
developing premature atherosclerosis and are therefore
ideal candidates for primary prevention. Nutritional and
metabolic status and inflammatory biomarkers have
been consistently associated with the presence of CVD
in multiple studies from different populations. The aim
of our study was to evaluate nutritional status, homocys-
teine, vitamin B12, folate, lipoproteins, TNF-alfa, high-
sensitivity C-reactive protein (hs-CRP) concentrations
and food intake in pediatric SLE patients and in healthy
controls.
Methods: Nineteen girls with SLE (group 1) and
thirty-nine healthy girls (group 2) with the same age
range were included in the study. SLE activity was
assessed using SLEDAI. Clinical and nutritional evalu-
ation including weight, height, waist circumference and
body mass index (BMI) was performed. Plasma homo-
cysteine, vitamin B12, folate, TNF-alfa, and hs-CRP
concentrations were analyzed by chemiluminescent tech-
nique, lipoproteins were measured using colorimetric
method and cholesterol by enzymatic standard method.
Food intake was assessed using a 24 hour-recall ques-
tionnaire validated for our population and analyzed
using the software DietWin version 1997–2002.
Results: The average age of SLE patients and
controls was 15.5 and 14.6, varying from 12 to 18 and 10
to 18 y, respectively. There were no significant differ-
ences regarding age (p ⫽ 0,117), pubertal stage (breast
University of São Paulo (USP-RP), Ribeirão Preto, Brazil.
S106
DOI 10.1002/art.38490
© 2014, American College of Rheumatology
p ⫽ 0,158 and pubis p ⫽ 0,578) and nutritional status
(p ⫽ 0,107) between groups. The majority of SLE
patients (16/19) had active disease and have been receiv-
ing prednisone for a mean period of 5 years. Body mass
index, waist circumference and systolic blood pressure
(SBP) values were statistically higher in SLE group when
compared to healthy girls: 24.6 ⫻ 20.9 kg/m2, p ⫽ 0.003;
79.7 ⫻ 72.6 cm, p ⫽ 0.004 and 107.5 ⫻ 101.7 mmHG,
p ⫽ 0.044, respectively, but height was statistically lower
(1.55 ⫻ 1.61 m, p ⫽ 0.012). Homocysteine, vitamin B12,
TNF-␣ and hs-CRP levels were higher in SLE subjects
when compared to healthy controls: 8.6 ⫻ 7.3 mmol/L,
p ⫽ 0.023; 616.9 ⫻ 444.0 pmol/L, p ⫽ 0.008; 8.7 ⫻ 7.1
pg/ml, p ⫽ 0.022; 4.4 ⫻ 0.8 mg/L, p ⫽ 0.002, respectively.
Plasma folate and HDL-cholesterol were lower in SLE
patients compared to controls: 12.2 ⫻ 14.0 ng/ml, p ⫽
0.022 and 37.6 ⫻ 44.1 mg/dL, p ⫽ 0.008, respectively).
There were no significant differences in energy, macro-
nutrients, vitamin B12, folate and pyridoxine intake
between groups.
Conclusion: Increased risk factors to cardiovas-
cular disease such as high BMI, WC, SBP, homocys-
teine, TNF-alpha and C-reactive protein, in addition to
low folate and HDL levels, were found in this group
of SLE patients when compared to healthy controls,
and food intake was comparable in both groups. Our
results may signalize future cardiovascular complications
in SLE pediatric patients and possible associations be-
tween nutritional status and risk factors.
This study is sponsored by FAPESP (number
2011/16141-7).
Disclosure: R. Salomão, None; V. Ferriani, None; L. Carvalho, None;
J. C. Rosa, None; M. O. Almada, None; M. Mathias, None; J. Monteiro, None.