Project 172081

Premature heart disease is a significant problem in patients with lupus. We have found that a pre-diabetic state (the metabolic syndrome) is more common in SLE but the causes are unclear. This pre-diabetic state is itself an important risk factor for the development of future heart disease. We suspect that steroid therapy and inflammation related to the condition together cause this problem to develop. This study, which is based on an international collaboration and collection of a large number of patients with SLE from the onset of their disease followed forward, will examine what factors in SLE over time increase the risk of developing the metabolic syndrome. In particular, we wish to study whether certain SLE patients inherit a greater sensitivity to steroids that increase their risk of developing this pre-diabetic state. This study will allow us to understand better the risks associated with steroid therapy in SLE and to help us better target steroid doses on an individual basis. It will also help us suggest ways to reduce the risk of future heart disease in SLE.