Prevalence and Associated Factors of Metabolic Syndrome in Patients With Systemic Lupus Erythematosus: A Cross-Sectional Study
TL;DR
MetS was common among patients with SLE and was independently associated with several demographic, disease-related, treatment-related, and lifestyle factors, which underscore the importance of routine metabolic screening and comprehensive assessment of metabolic abnormalities as part of the clinical management of patients with SLE.
Abstract
Background: Significant cardiovascular morbidity is associated with systemic lupus erythematosus (SLE), which is also associated with the development of metabolic syndrome (MetS). Objective: This study aimed to determine the prevalence of MetS and identify its associated factors among patients with SLE. Methodology: This hospital-based cross-sectional study was conducted from January 2024 to December 2025. A total of 427 adults diagnosed with SLE according to the 2019 EULAR/ACR classification criteria were recruited using consecutive sampling. Demographic, clinical, biochemical, and disease-related data were collected and analyzed using IBM SPSS Statistics for Windows, Version 25.0 (Released 2017; IBM Corp., Armonk, NY, USA). Categorical variables were compared using the chi-square test, continuous variables using the independent-samples t-test, and multivariable logistic regression was performed to identify factors independently associated with MetS. Results: Among the 427 patients with SLE, 39.34% met the diagnostic criteria for MetS. The most frequent MetS components were low high-density lipoprotein (HDL) cholesterol, central obesity, hypertension, hypertriglyceridemia, and elevated fasting plasma glucose. In the multivariable logistic regression analysis, older age, obesity (BMI ≥ 30 kg/m²), longer disease duration, lupus nephritis, physical inactivity (defined as <150 minutes of moderate-intensity physical activity per week), a family history of diabetes mellitus, and corticosteroid use were independently associated with higher odds of MetS, whereas hydroxychloroquine use was independently associated with lower odds of MetS. Conclusion: MetS was common among patients with SLE and was independently associated with several demographic, disease-related, treatment-related, and lifestyle factors. These findings underscore the importance of routine metabolic screening and comprehensive assessment of metabolic abnormalities as part of the clinical management of patients with SLE. Given the cross-sectional design of the study, the observed associations should not be interpreted as causal, and prospective longitudinal studies are warranted to clarify temporal relationships and validate these findings.