Low physical activity is associated with proinflammatory high‐density lipoprotein and increased subclinical atherosclerosis in women with systemic lupus erythematosus

Objective

To investigate the association between physical activity, functional activity of high‐density lipoprotein (HDL), and subclinical cardiovascular disease in patients with systemic lupus erythematosus (SLE).

Methods

A total of 242 SLE patients (all women) participated in this cross‐sectional study from February 2004 to February 2008. Carotid plaque and intima‐media thickness (IMT), antioxidant function of HDL, and traditional cardiac risk factors were measured. Physical activity was assessed from self‐reports by calculating the metabolic equivalents (METS) per week and by the physical function domain of the Medical Outcomes Study Short Form 36 (SF‐36). Data were analyzed using bivariate and multivariate regression analyses.

Results

Number of METS per week spent performing strenuous exercise was negatively correlated with IMT (r = ?0.4, P = 0.002) and number of plaques (r = ?0.30, P = 0.0001). Physical function as assessed by the SF‐36 was also negatively correlated with IMT (r = ?0.14, P = 0.03) and number of plaques (r = ?0.14, P = 0.04). In multivariate analyses, number of strenuous exercise METS was significantly associated with IMT (t = ?2.2, P = 0.028) and number of plaques (t = ?2.5, P = 0.014) when controlling for markers of SLE disease activity and damage, but not after controlling for traditional cardiac risk factors. Low physical activity, defined as <225 total METS per week, was associated with the presence of proinflammatory HDL (P = 0.03).

Conclusion

Low physical activity is associated with increased subclinical atherosclerosis and proinflammatory HDL in patients with SLE. Increased strenuous exercise may reduce the risk of atherosclerosis in SLE.