Abstract

Background Systemic lupus erythematosus (SLE) is a chronic autoimmune disease associated with increased cardiovascular risk, partly due to dyslipidemia. This study aimed to evaluate the lipid profiles of Saudi Arabian patients with SLE and examine the impact of hydroxychloroquine (HCQ) and steroid use on these profiles, with a particular focus on patients with lupus nephritis. Methods A retrospective observational study was conducted at King Saud Medical City, Riyadh, Saudi Arabia, including SLE patients treated at the hospital's rheumatology clinic between July 2023 and December 2023. Patients aged 15-80 years diagnosed with SLE per the American College of Rheumatology revised criteria were included. Exclusion criteria comprised menopausal or pregnant women, individuals with significant comorbid conditions, and those on specific medications. Lipid profiles, including total cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides, and very low-density lipoprotein (VLDL) cholesterol, were analyzed, and correlations with disease activity parameters were assessed using STATA software (StataCorp LLC, College Station, TX, US). Statistical analyses included Wilcoxon signed-rank tests and Spearman rank correlations. Results The study included 138 SLE patients (84.5% females, mean age 37.13 ± 12.9 years). Lipid profiles showed varied results: mean total cholesterol was 4.48 mmol/L, LDL 2.56 mmol/L, HDL 1.32 mmol/L, triglycerides 1.40 mmol/L, and VLDL 0.63 mmol/L. HCQ use was associated with higher, albeit not statistically significant, lipid levels. Steroid use did not show significant effects on lipid levels. Patients with lupus nephritis had higher triglyceride and VLDL levels compared to those without nephritis (p = 0.02). No significant differences were observed in lipid profiles between patients with and without anti-double-stranded DNA (dsDNA) antibodies. Significant correlations were found between triglycerides and C-reactive protein (CRP), creatinine, and erythrocyte sedimentation rate (ESR). Conclusion This study highlights the complex relationship between SLE, dyslipidemia, and treatment. While HCQ use did not significantly alter lipid profiles, lupus nephritis was associated with worse lipid abnormalities. These findings underscore the need for ongoing monitoring and targeted management of lipid profiles in SLE patients to mitigate cardiovascular risk.