Increased insulin resistance and metabolic syndrome frequency in Brazilian patients with systemic lupus erythematosus: comparison between active and inactive disease

Resumen

Patients with systemic lupus erythematosus (SLE) have higher insulin resistance (IR) and metabolic syndrome (MetS) prevalence than the general population. However, to date, IR and MetS prevalence in active and inactive disease have not been reported. The objectives of this study were to verify the frequency of IR and MetS in Brazilian patients with SLE and to analyze whether disease activity interferes with the aforementioned conditions. The study included 130 controls and 74 SLE patients. SLE patients were divided in active (36 patients) and inactive (38 patients) disease. IR frequency was verified in 51.35% in patients with SLE and 29.23% in the control group (p=0.0017, OR: 2.556, IC 95%: 1.413-4.621), whereas MetS frequency was 33.78% in patients with SLE and 13.08% in the control group (p<0.0001, OR=4.644, CI 95%: 2.644-9.625). IR was verified in 63.89% patients with active SLE and in 39.47% patients with inactive SLE (OR: 2.781, IC 95%: 1.568-4.932, p=0.0004), whereas 41.67% patients with active SLE met the criteria for MetS compared with 26.32% with inactive SLE (OR: 2.061, IC 95%: 1.133-3.748, p=0.0169). Body mass index and corticosteroids use significantly increased in the active group. This study reinforces the higher risk for developing IR and MetS in patients with SLE, especially in those with active disease, and support the role of IR and corticosteroid use as the main links between disease activity and Mets.