Lack of association of glucocorticoid exposure and metabolic syndrome in SLE.

Background: The Metabolic Syndrome (MetS) is a disorder of energy utilisation and storage, associated with an increased risk of cardiovascular (CV) disease. MetS may contribute to the increased CV disease in SLE, but the prevalence, cause, and impact of MetS in SLE is poorly understood, as are the effects of glucocorticoid (GC) exposure. Objective(s): To characterise the prevalence of the features of MetS in a wellcharacterised cohort of SLE patients, and determine the effect of GC use on these parameters. Method(s): SLE patients studied as part of a single centre prospective longitudinal cohort. Disease activity (SLEDAI-2K), treatment and laboratory details were recorded at each visit. Other investigation results were collected from institution databases. MetS defined as>=3 criteria1: BMI>30kg/m2; triglycerides>1.7mmol/L; HDL-cholesterol <1.3mmol/L; blood pressure >130/85mmHg or treatment for hypertension; fasting glucose >5.6mmol/L or treatment for hyperglycaemia. Continuous variables were described as median (IQR), and compared using Kruskal-Wallis tests. Categorical variables were described as frequency and compared using Chi-squared tests. Result(s): 289 patients were included (87% female; 51% Caucasian, 29% Asian), and median age at enrolment of 37.7y. Median follow-up was 3.43y (med 15 visits). Time adjusted-mean SLEDAI (AMS) over the study period was 3.67. 81% (211) patients received GC (time-adjusted mean 4.25mg prednisolone/d) and AMS was significantly higher in GC-exposed patients (4.19 vs 1.97 [EM1], p<0.01). MetS criteria were met by 49 (17%) of patients (Table 1). Hypertriglyceridaemia and hypertension were significantly more frequent in GC-treated patients, but the prevalence of obesity and other MetS domains, or MetS overall, were not. There were significantly more patients with MetS score =0 in the GC-exposed subset (43/78 vs 76/211 p<0.01). The prevalence of obesity of 17% is lower than in the general population. There was no significant change in