eprintid: 10184482 rev_number: 6 eprint_status: archive userid: 699 dir: disk0/10/18/44/82 datestamp: 2024-01-02 12:26:53 lastmod: 2024-01-02 12:26:53 status_changed: 2024-01-02 12:26:53 type: article metadata_visibility: show sword_depositor: 699 creators_name: Jury, Elizabeth C creators_name: Peng, Junjie creators_name: Van Vijfeijken, Alexandra creators_name: Martin Gutierrez, Lucia creators_name: Woodridge, Laurel creators_name: Wincup, Chris creators_name: Pineda-Torra, Ines creators_name: Ciurtin, Coziana creators_name: Robinson, George A title: Systemic lupus erythematosus patients have unique changes in serum metabolic profiles across age associated with cardiometabolic risk ispublished: pub divisions: UCL divisions: B02 divisions: C10 divisions: D17 divisions: G90 keywords: SLE, age, atherosclerosis, cardiometabolic, cardiovascular disease, comorbidities, lipids, metabolism, metabolomics note: This work is licensed under a Creative Commons Attribution 4.0 International License. The images or other third-party material in this article are included in the Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/ abstract: OBJECTIVES: Cardiovascular disease through accelerated atherosclerosis is a leading cause of mortality for patients with systemic lupus erythematosus (SLE), likely due to increased chronic inflammation and cardiometabolic defects over age. We investigated age-associated changes in metabolomic profiles of SLE patients and healthy controls (HCs). METHODS: Serum NMR metabolomic profiles from female SLE patients (n = 164, age = 14-76) and HCs (n = 123, age = 13-72) were assessed across age by linear regression and by age group between patients/HCs (Group-1, age ≤ 25, n = 62/46; Group-2, age = 26-49, n = 50/46; Group-3, age ≥ 50, n = 52/31) using multiple t-tests. The impact of inflammation, disease activity and treatments were assessed, and UK Biobank disease-wide association analysis of metabolites was performed. RESULTS: Age-specific metabolomic profiles were identified in SLE patients vs HCs, including reduced amino acids (Group-1), increased very-low-density lipoproteins (Group-2), and increased low-density lipoproteins (Group-3). Twenty-five metabolites were significantly altered in all SLE age groups, dominated by decreased atheroprotective high-density lipoprotein (HDL) subsets, HDL-bound apolipoprotein(Apo)A1 and increased glycoprotein acetyls (GlycA). Furthermore, ApoA1 and GlycA were differentially associated with disease activity and serological measures, as well as atherosclerosis incidence and myocardial infarction mortality risk through disease-wide association. Separately, glycolysis pathway metabolites (acetone/citrate/creatinine/glycerol/lactate/pyruvate) uniquely increased with age in SLE, significantly influenced by prednisolone (increased pyruvate/lactate) and hydroxychloroquine (decreased citrate/creatinine) treatment and associated with type-1 and type-2 diabetes by disease-wide association. CONCLUSIONS: Increasing HDL (ApoA1) levels through therapeutic/nutritional intervention, whilst maintaining low disease activity, in SLE patients from a young age could improve cardiometabolic disease outcomes. Biomarkers from the glycolytic pathway could indicate adverse metabolic effects of current therapies. date: 2023-12-04 date_type: published publisher: Oxford University Press (OUP) official_url: http://dx.doi.org/10.1093/rheumatology/kead646 oa_status: green full_text_type: pub language: eng primo: open primo_central: open_green verified: verified_manual elements_id: 2114870 doi: 10.1093/rheumatology/kead646 medium: Print-Electronic pii: 7458458 lyricists_name: Robinson, George lyricists_name: Jury, Elizabeth lyricists_name: Ciurtin, Coziana lyricists_name: Wincup, Christopher lyricists_name: Peng, Junjie lyricists_id: GROBI58 lyricists_id: EJURY42 lyricists_id: CCIUR23 lyricists_id: CWINC43 lyricists_id: JPENG40 actors_name: Flynn, Bernadette actors_id: BFFLY94 actors_role: owner full_text_status: public publication: Rheumatology article_number: kead646 event_location: England citation: Jury, Elizabeth C; Peng, Junjie; Van Vijfeijken, Alexandra; Martin Gutierrez, Lucia; Woodridge, Laurel; Wincup, Chris; Pineda-Torra, Ines; ... Robinson, George A; + view all <#> Jury, Elizabeth C; Peng, Junjie; Van Vijfeijken, Alexandra; Martin Gutierrez, Lucia; Woodridge, Laurel; Wincup, Chris; Pineda-Torra, Ines; Ciurtin, Coziana; Robinson, George A; - view fewer <#> (2023) Systemic lupus erythematosus patients have unique changes in serum metabolic profiles across age associated with cardiometabolic risk. Rheumatology , Article kead646. 10.1093/rheumatology/kead646 <https://doi.org/10.1093/rheumatology%2Fkead646>. Green open access document_url: https://discovery.ucl.ac.uk/id/eprint/10184482/1/kead646.pdf