NÃveis de homocisteÃna plasmÃtica em pacientes com lupus eritematoso sistÃmico

AUTOR(ES)
DATA DE PUBLICAÇÃO

2005

RESUMO

Cardiovascular involvement due to early atherosclerosis are a major cause of morbidity and mortality in patients with Systemic Lupus Erythematosus (SLE) and the traditional risk factors do not fully explain the raised risk in this population. Homocysteine (Hcy) is an intermediary amino acid formed during methionine metabolism. There is a positive association between high levels of Hcy and cardiovascular risk. In this study the levels of plasmatic Hcy in SLE patients and its relationship with patientâs gender and age, duration of disease, ACR (American College of Rheumatology) criteria number, disease activity by SLEDAI (Systemic Lupus Erythematosus Disease Activity Index), dose and duration of corticosteroid (CE), serum creatinine levels, thromboembolic events occurrence, systemic arterial hypertension (SAH) and smoking was determinate. A case series study was carried out with 54 patients attending the Rheumatology Outpatient Clinics of Hospital das ClÃnicas - Universidade Federal de Pernambuco, from August until October 2004, with the determination of plasmatic Hcy done by FPIA (Fluorescence Polarization Immunoassay) method in Axsym analyzer (Abbott Laboratory). The majority of the patients was female (N = 49), the mean age was 31,67 years (18 to 53 years) and the mean time of diagnosis, 63,20 months (4 to 216 months). ACR criteria for SLE varied from four to eight items per patient, with mean of 5,1 criteria, and only five patients (9,3%) had active disease by SLEDAI. A total of 49 patients (90,7%) were in use of CE, the mean use duration was 43,67 months (one to 216 months) and 36 patients (66,7%) were in use of antimalaric drugs. Three patients had thromboembolic event before entering the study. Results showed that high levels of Hcy were present in 9,3% of the patients, with mean of 11,85 μmol/l (5,47 to 35,80 μmol/l) and ACR criteria number were significantly associated with Hcy levels (p=0,0059). Influence of other independent variables has not been demonstrated. The mean levels of Hcy were higher in patients with thromboembolic event (20,88 μmol/l) than in those without it before entering the study (11,32 μmol/l). In conclusion, high levels of Hcy were found in 9,3% of studied patients and are associated with the number of ACR criteria

ASSUNTO(S)

homocisteÃna homocysteine doenÃa cardiovascular systemic lupus erythematosus medicina lupus eritematoso sistÃmico cardiovascular disease

ACESSO AO ARTIGO

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