Patients With Systemic Lupus Erythematosus Show an Increased Arterial Stiffness That is Predicted by IgM Anti–β 2 ‐Glycoprotein I and Small Dense High‐Density Lipoprotein Particles

Objective To investigate the metabolic and immunologic factors associated with the presence of central arterial stiffness as measured by the augmentation index ( AI x). Methods We conducted a cross‐sectional study of 69 female patients with systemic lupus erythematosus ( SLE ) compared with a control group of 34 healthy women. The anthropometrical variables, the vascular studies, and the analytic data were obtained the same day. The AI x was assessed by peripheral arterial tonometry. The analysis of lipoprotein populations was performed using nuclear magnetic resonance ( NMR ) spectroscopy. Results Arterial stiffness was increased in patients with SLE compared with control subjects (mean ± SD 20.30 ± 21.54% versus 10.84 ± 11.51%; P = 0.0021). Values for the AI x were correlated with the Framingham risk score (r = 0.481, P < 0.001), carotid intima‐media thickness (r = 0.503, P < 0.001), systolic blood pressure (r = 0.270, P < 0.001), and age (r = 0.365, P < 0.001). Patients receiving antimalarial drugs had a lower AI x (mean ± SD 11.74 ± 11.28% versus 24.97 ± 20.63%; P = 0.024). The AI x was correlated with the atherogenic lipoproteins analyzed by NMR . The immunologic variables associated with the AI x were C4 (r = 0.259, P = 0.046) and IgM anti–β 2 ‐glycoprotein I (IgM anti‐β 2 GPI ) (r = 0.284, P = 0.284). In the multivariate analysis, age (β = 0.347, 95% confidence interval [95% CI ] 0.020–0.669, P = 0.035), IgM β 2 GPI (β = 0.321, 95% CI 0.024–0.618, P = 0.035) and small dense high‐density lipoprotein ( HDL ) particles (β = 1.288, 95% CI 0.246–2.329, P = 0.017) predicted the AI x. Conclusion SLE patients had increased arterial stiffness compared with healthy control subjects. Arterial stiffness was decreased in patients treated with antimalarial drugs. Age, IgM β 2 GPI , and the number of small dense HDL particles predicted the AI x.