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Background and aims

Since accelerated atherosclerosis has been reported in systemic lupus erythematosus (SLE), predictive biomarkers of cardiovascular disease (CVD) are needed. Among non-traditional risk factors, bone mineral density (BMD) has been related to CVD. However, its role in SLE remains controversial. This study aims to analyze the associations of subclinical atherosclerosis with traditional and non-traditional CV risk factors.

Methods and results

In a cross-sectional study, atherosclerosis burden was compared between 112 female SLE patients and 31 controls. Plaque number and carotid intima-media wall thickness (cIMT) were assessed by ultrasonography. In a retrospective study, BMD determinations obtained 5-years before the ultrasonography assessment were analyzed in a subgroup of 62 patients. Plaque frequency was increased in SLE, even in patients without CV events or carotid wall thickening. cIMT was increased in patients with CVD, positively correlated with body mass index (BMI). Interestingly, a paradoxical effect of BMI on carotid parameters was observed. Whereas underweight patients (BMI < 20) showed increased prevalence of carotid plaques with low cIMT, those with BMI > 30 showed higher cIMT and plaque burden. Overweight patients (25 < BMI<30) exhibited both elevated cIMT and plaque number. BMI was an independent predictor of BMD. In our retrospective study, patients with either clinical or subclinical CVD exhibited lower BMD levels than their CV-free counterparts. A low lumbar spine BMD independently predicted CVD development after adjusting for confounders.

Conclusion

SLE was associated with a higher subclinical atherosclerosis burden, a bimodal effect being observed for BMI. Decreased BMD can be a CV risk biomarker in SLE.  相似文献   
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Background and aimsEvidence regarding the impact of regional body fat distribution on low-grade inflammation is limited. The current study examined the association of central and peripheral body fat distribution and low-grade inflammation levels in young adults, considering collinearity between variables.Methods and resultsA cross-sectional analysis of 809 adults (aged 27 years) was conducted as part of the EPITeen cohort, Porto, Portugal. Regional body fat was measured by dual-energy X-ray absorptiometry scan (DXA) and serum high-sensitivity C-reactive protein (hsCRP) was measured in a fasting blood sample. OLS (ordinary least squares) and LASSO (least absolute shrinkage and selection operator) regression models were fitted to estimate the association of trunk and peripheral fat with hsCRP, stratified by sex. Using OLS regression, trunk fat in females was positively associated with ln(hsCRP) (β1 = 0.064, 95% CI 0.018; 0.109). The effect of peripheral fat on ln(hsCRP) was shown not to be significantly different from trunk fat (β2 = −0.011, 95% CI −0.110; 0.089), but no statistically significant association was observed (β3 = 0.053, 95% CI −0.004; 0.110) between peripheral fat and ln(hsCRP). In males, trunk fat also showed a positive association with ln(hsCRP) (β1 = 0.104, 95% CI 0.055; 0.154), and the effect of peripheral fat on ln(hsCRP) was shown to be significantly different from trunk fat (β2 = −0.124, 95% CI −0.237;−0.011). However, the association between peripheral fat and ln(hsCRP) did not reach statistical significance (β3 = −0.020, 95% CI −0.086; 0.046). The results of OLS were confirmed by LASSO regression.ConclusionA higher fat deposited in the trunk was positively associated with hsCRP, whereas no statistically significant effect was observed for peripheral fat.  相似文献   
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The psychoanalytic treatment of psychotic patients is often difficult through a sole reliance on associative speech. Psychotic subjects might not be apt at pursuing the course of regression induced by associative speech or this regression might lead them to psychic areas where de‐symbolization is so extensive that only delusion or dissociation are available to them. A medium has often been suggested so that the representation of the drive and the formalization of infantile sexuality may unfold more safely and efficiently. Two modalities of use of a malleable medium will be considered in this paper: Gisela Pankow's clay modelling and psychoanalytic psychodrama as it has developed in France, Belgium and Switzerland since the end of the 1950s.  相似文献   
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BackgroundUniversity students aged between 18 and 25 undergo several physical changes as a result of transition from adolescence to adulthood. Students do not always accept those changes and sometimes develop dissatisfaction towards their figures. In such cases, it is still not clear how actual body weight status can be affected by socio-cultural factors such as body image perception. The objective of this study was to determine the link between anthropometric status and body image perception among university students.MethodsTwo hundred and forty six (246) university students from the Faculty of Sciences and Technologies within the Beni Mellal-Khenifra region in Morocco, aged 20–24 years were interviewed using face-to-face questionnaires. Anthropometric measurements and Body Mass Index were collected. Body image perception was assessed by Figure Rating Scale, and body size dissatisfaction was calculated as Feel minus Ideal Discrepancy (FID). Data were described using means and proportions. The Student t-test and the chi-square test have been used to assess the statistical significance of group differences.ResultsUnderweight students represented 16.7% of the investigated sample, while 11.4% suffered from overweight and obesity, higher in females students (14.4%) than in males (7.9%). Regarding body image perception, 43.9% of participants considered themselves underweight; whereas only 4.2% considered themselves overweight with no significant differences related to gender. Of note, the total prevalence of body image dissatisfaction was around 69.8%. Finally, among overweight/obese students, 88.9% of females and 71.4% of males expressed the wish to become thinner while 28.6% of the overweight/obese males wanted to get heavier.ConclusionThe results of this study indicate a high rate of body image dissatisfaction and a tendency of participants to underestimate their body weight. This behavior may be a reflection of a real influence of social and psychological factors occurring during this critical period and may make university students vulnerable to many risk-taking behaviors. Thus, there is a need for suitable interventional programs and innovative strategies to ensure the understanding of the health consequences of overweight and obesity and to prevent associated comorbidities.  相似文献   
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