Volume 12 Supplement 1

Proceedings of the 21st European Pediatric Rheumatology (PReS) Congress

Open Access

Cognitive functions and metabolic syndrome in childhood-onset systemic lupus erythematosus

  • Nailu Sinicato1,
  • Mariana Postal1,
  • Bruna Bellini1,
  • Paula Fernandes2,
  • Roberto Marini3 and
  • Simone Appenzeller1
Pediatric Rheumatology201412(Suppl 1):P323

https://doi.org/10.1186/1546-0096-12-S1-P323

Published: 17 September 2014

Introduction

Childhood-onset systemic lupus erythematosus (cSLE) have a high prevalence cognitive involvement and inflammatory mechanisms and autoantibodies were hypothesized to be involved in its pathogenesis. The underlying factor for an association between the metabolic syndrome (MetS) and cognitive decline might be a subclinical inflammation.

Objectives

To determine if cognitive functions are impaired in cSLE patients with MetS.

Methods

We performed a cross sectional study of 63 consecutive cSLE patients and 63 healthy age and sex matched controls. All individuals were assessed for anthropometric and MetS features according to International Diabetes Federation (IDF) criteria. Neurological manifestations were analyzed according to the ACR classification criteria. Cognitive evaluation was performed in all participants using Wechsler Intelligence Scale for children (WISC-III) and Wechsler Intelligence Scale for adults (WAIS), according to age and validated in Portuguese. Mood disorders were determined through Becks Depression and Anxiety Inventory in all participants. SLE patients were further assessed for clinical and laboratory SLE manifestations, disease activity [SLE Disease Activity Index (SLEDAI)], damage [Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI)] and current drug exposures. Total dose of corticosteroids and other immunosuppressant medications used since the onset of disease were calculated by data obtained by careful review of the medical charts.

Results

We observed higher hip circumference (p=0.030), waist-to-hip ratio (p<0.001) and hypertriglyceridemia (p=0.005) in cSLE patients. Controls had a higher height (p=0.003) and higher levels of HDL-c (p=0.004). MetS was present in 11 (17.4%) cSLE and in no control. Cognitive dysfunction was observed in 32 (50.8%) cSLE patients. We observed an inverse correlation with height and corticosteroid total dose adjusted by weight in cSLE patients (-0.285; p=0.022). Rey complex picture on memory subtest was correlated with body mass index (r=-0.249; p=0.05) and hypertriglyceridemia (r=0.282;p=0.028). Total cholesterol levels was correlated with Boston naming test (r=-0.258;p=0.047).

Conclusion

MetS was observed in 18% of our cohort and not associated with worse cognitive performance. However, features of MetS, such as total cholesterol, hypertriglyceridemia and obesity can influence some cognitive functions in cSLE.

Disclosure of interest

N Sinicato: None declared, M Postal: None declared, B Bellini: None declared, P Fernandes: None declared, R Marini: None declared, S Appenzeller Grant / Research Support from: FAPESP (2008/02917-0, 2011/03788-2, 2013/09480-5) CNPQ (300447/2009-4 and 471343/2011-0; 302205/2012-8; 473328/2013-5)

Authors’ Affiliations

(1)
Medicine, State University Of Campinas
(2)
Sports, State University Of Campinas
(3)
Pediatrics, State University Of Campinas

Copyright

© Sinicato et al; licensee BioMed Central Ltd. 2014

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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