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Predictors of high sensitivity C-reactive protein levels in patients with systemic lupus erythematosus

Department of Rheumatology, Chonnam National University Medical School, Gwangju, South Korea, Division of Rheumatology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA

S. Singh

Division of Rheumatology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA

LS Magder

Division of Biostatistics and Bioinformatics, Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore, MD, USA

M. Petri

Division of Rheumatology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA, mpetri{at}jhmi.edu

Despite the increased prevalence of cardiovascular disease in patients with systemic lupus erythematosus (SLE), little is known about the role of high sensitivity C-reactive protein (hsCRP) or whether ethnicity, gender, anthropometric measures and treatment can alter hsCRP levels. We evaluated the effects of treatment and demographic, anthropometric and socio-economic variables on hsCRP levels in SLE. High sensitivity C-reactive protein levels were measured using an immunoturbidimetric assay in 610 patients from the Hopkins Lupus Cohort, who were followed-up regularly. In stepwise multiple regression analyses, body mass index (BMI) [odds ratio (OR) 1.72, 95% confidence interval (CI) 1.34—2.20, P < 0.001], African-American ethnicity (OR 1.97, 95% CI 1.22—3.19, P < 0.01), education (OR 0.60, 95% CI 0.42—0.86, P < 0.01), statin use (OR 0.38, 95% CI 0.18—0.82, P < 0.05), estrogen use (OR 3.65, 95% CI 1.19—11.22, P < 0.05), SLE Disease Activity Index score (OR 1.76, 95% CI 1.09—2.87, P < 0.05) and cumulative prednisone dose (OR 1.27, 95% CI 1.01—1.60, P < 0.05) were significant predictors of hsCRP levels. These findings suggest that hsCRP levels should be adjusted for BMI, ethnicity, education level, disease activity and medications when conducting cardiovascular risk assessment in patients with lupus. Lupus (2008) 17, 114—123.

Key Words: cardiovascular risk factors • C-reactive protein • systemic lupus erythematosus

Lupus, Vol. 17, No. 2, 114-123 (2008)
DOI: 10.1177/0961203307085878


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