Aim of the work: This study aimed to measure serum levels of homocysteine (sHcy)
and to study the presence of the metabolic syndrome (MetS) in women with systemic lupus
erythematosus (SLE) and to correlate them with disease activity, clinical status and sub-clinical
Patients and methods: This study included 30 adult SLE female patients and 20 age and sex
matched apparently healthy volunteers as the control group. Disease activity and damage were
assessed using the SLE disease activity index (SLEDAI) score and Systemic Lupus International
Collaborative Clinics (SLICC) damage index, respectively. The MetS was diagnosed according to
the National Cholesterol Education Program’s Adult Treatment Panel III (NCEP-ATPIII). Total
sHcy was measured by enzyme immunoassay. B mode ultrasound was done to measure the carotid
intima-media thickness (CIMT).
Results: The mean CIMT (0.97± 0.26 mm) and sHcy (46.96 ±22.07 lmol/L) were significantly
higher in patients compared to the controls (0.43 ±0.22 mm and 4.19 ± 1.49 lmol/L, respectively)
(p< 0.001). The mean CIMT significantly correlated (p< 0.001) with patient age (r = 0.52), disease
duration (r =0.69), SLEDAI (r =0.66), SLICC (r =0.82), sHcy (r = 0.53), total cholesterol
(r =0.51), triglycerides (r =0.77), low density lipoprotein (r = 0.53), fasting blood sugar
(r =0.75), systolic (r = 0.68) and diastolic (r =0.64) blood pressure and negatively with C3(r= 0.54), high density lipoprotein (HDL) (r =0.56), platelets (r = 0.55) and white blood
cell counts (r = 0.51). Patients with MetS had statistically significantly higher CIMT
(1.25± 0.09 mm) and sHcy (56 ±19.31 lmol/L) versus those without (0.79± 0.16 mm and
40.5 ±21.9 lmol/L, p< 0.001 and p=0.048, respectively).
Conclusion: We can conclude that SLE itself is considered a risk factor for accelerated atherosclerosis
and this is amplified by multiple factors.