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A predictive model for premature atherosclerosis in systemic lupus erythematosus based on clinical characteristics

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Abstract

Objective

Systemic lupus erythematosus (SLE) is associated with a significant risk of atherosclerotic cardiovascular disease, especially in the development of premature atherosclerosis. Specific prediction models for premature atherosclerosis in SLE patients are still limited. The objective of this study was to establish a predictive model for premature atherosclerosis in SLE.

Method

The study collected clinical and laboratory data from 148 SLE patients under the age of 55, between January 2021 and June 2023. The least absolute shrinkage and selection operator logistic regression model was utilized to identify potentially relevant features. Subsequently, a nomogram was developed using multivariable logistic analysis. The performance of the nomogram was evaluated through a receiver-operating characteristic curve, calibration curve, and decision curve analysis (DCA).

Results

A total of 148 SLE patients who fulfilled the inclusion criteria were enrolled in the study, of whom 53 patients (35.81%) met the definition of premature atherosclerosis. Hypertension, antiphospholipid syndrome, azathioprine use, duration of glucocorticoid, and age of patients were included in the multivariable regression. The nomogram, based on the non-overfitting multivariable model, was internally validated and demonstrated sufficient clinical utility for assessing the risk of premature atherosclerosis (area under curve: 0.867).

Conclusions

The comprehensive nomogram constructed in this study serves as a useful and convenient tool for evaluating the risk of premature atherosclerosis in SLE patients. It is helpful for clinicians to early identify SLE patients with premature atherosclerosis and facilitates the implementation of more effective preventive measures.

Key Points

• SLE patients are at a significantly higher risk of developing premature atherosclerosis compared to the general population, and this risk persists even in cases with low disease activity. Traditional models used to evaluate and predict premature atherosclerosis in SLE patients often underestimate the risk.

• This study establishes a comprehensive and visually orientated predictive model of premature atherosclerosis in SLE patients, based on clinical characteristics.

• The scoring system allows for convenient and effective prediction of individual incidence of premature atherosclerosis, and could provide valuable information for identification and making further intervention decision.

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Data availability

Data are available upon reasonable request by any qualified researchers who engage in rigorous, independent scientific research, and will be provided following review and approval of a research proposal and Statistical Analysis Plan (SAP) and execution of a Data Sharing Agreement (DSA). All data relevant to the study are included in the article.

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Acknowledgements

We wish to acknowledge all the patients who participated in our study.

Funding

The study was supported by grants from the Beijing Natural Science Foundation (7242160) and National Natural Science Foundation of China (92374101, 81871290).

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Authors and Affiliations

  1. Department of Rheumatology and Immunology, Peking University People’s Hospital, 11 Xizhimen South Street, Beijing, 100044, China

    Ruyu Liang, Haojie Xu, Ranran Yao, Wenwen Pei, Ziye Wang, Renge Liang, Xiao Han, Yunshan Zhou, Yuan An & Yin Su

  2. Peking University People’s Hospital, Qingdao, China

    Yin Su

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  1. Ruyu Liang
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Contributions

Yin Su and Yuan An contributed to the conception and design of this study. Ruyu Liang, Haojie Xu, and Ranran Yao participated in data collection and analysis. Wenwen Pei, Ziye Wang, Renge Liang, Xiao Han, and Yunshan Zhou helped the date collection. Ruyu Liang and Haojie Xu drafted the manuscript and Ruyu Liang contributed to image processing and interpreted the data. All authors read and approved the final manuscript and consented to publish this manuscript.

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Correspondence to Yuan An or Yin Su.

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Liang, R., Xu, H., Yao, R. et al. A predictive model for premature atherosclerosis in systemic lupus erythematosus based on clinical characteristics. Clin Rheumatol 43, 1541–1550 (2024). https://doi.org/10.1007/s10067-024-06934-3

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  • DOI: https://doi.org/10.1007/s10067-024-06934-3

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