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High Prevalence of Metabolic Syndrome in South African Systemic Lupus Erythematosus Patients

Avela Ntombenkosi Nkabane, Bridget Hodkinson

Introduction: Patients with systemic lupus erythematosus (SLE) are at increased risk of metabolic syndrome (MetS) and its complications. In absence of published studies from sub- Saharan Africa, we investigated the prevalence and associations of MetS amongst recent-onset SLE patients.

Methods: A cross-sectional study of recent onset (<5 years disease duration) SLE patients meeting the Systemic Lupus International Collaborating Clinics (SLICC) SLE classification criteria. MetS was defined by Joint Interim Statement criteria. Clinical, demographic data, a Functional Assessment of Chronic Illness Therapy score and the 36-Item Short-Form Healthy Survey were completed.

Results: 75 SLE patients were included in the study, 65 (86.7%) were female, and 68.0% were of mixed ethnic, the mean age was 37.1 (11.7) years and the mean disease duration was 30.8 (23.6) months. The mean Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) score was 0.9 (1.6). Prevalence of MetS was 40.0%, age and body mass index were the only significant features associated with MetS (p=0.003 and 0.001 respectively). Increased waist circumference (WC) was the most frequently observed feature, present in 92.9% of patients with MetS patients. Patients with an elevated WC were 32.5 times more likely to have MetS.

Conclusion: This study shows a high prevalence of MetS amongst South Africans with recently diagnosed SLE. This calls for aggressive strategies to reduce the prevalence of MetS and atherosclerotic cardiovascular disease. Waist circumference is a useful and cost-effective screening tool to identify SLE patients at risk of MetS.