JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE) ›› 2021, Vol. 41 ›› Issue (2): 180-186.doi: 10.3969/j.issn.1674-8115.2021.02.009

• Clinical research • Previous Articles     Next Articles

Association between body mass index and myocardial involvements in patients with systemic lupus erythematosus

Ze-hao FENG(), Ye-zi CHAI, Xuan SU, Bao-hang-xing SUN, Qi-ming LIU, Meng JIANG(), Jun PU()   

  1. Department of Cardiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
  • Received:2020-05-06 Online:2021-02-28 Published:2021-02-28
  • Contact: Meng JIANG,Jun PU;;
  • Supported by:
    National Natural Science Foundation of China(81971570);Shanghai Shenkang Hospital Development Center Three-year Action Plan: Promoting Clinical Skills and Innovation in Municipal Hospital(16CR3020A);Shanghai Municipal Education Commission—Gaofeng Clinical Medicine Grant Support(20172014);Shanghai Pudong Municipal Health Commission-Joint Research Project(PW2018D-03);Medical-Engineering Cross Research Foundation of Shanghai Jiao Tong University(YG2019ZDA13)

Abstract: Objective

·To explore the association between body mass index (BMI) and myocardial involvement in patients with systemic lupus erythematosus (SLE).


·Fifty-four healthy participants and sixty-one patients with SLE who were admitted to the Department of Cardiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine were prospectively recruited from July 2014 to November 2016 and then underwent cardiac magnetic resonance (CMR) and echocardiography examination. SLE patients were grouped according to the quartile of the BMI index, and then CMR morphology, function and histology indicators of each group were compared. The relationship between BMI and extracellular volume fraction (ECV) was explored by using multivariate linear analysis.


·Compared with normal BMI group (18.73?23.00 kg/m2) and high BMI group (>23.00 kg/m2), low BMI group (≤18.72 kg/m2) had higher median ECV (34.33% vs 30.52% vs 31.44%,P=0.007) after being adjusted for age and disease duration. The incidences of right ventricular hypertrophy (33.3%), pulmonary hypertension (26.7%) and edema (6.7%) were lower in low normal BMI group (18.73?20.20 kg/m2) than those in the low BMI group, high normal BMI group (20.21?23.00 kg/m2) and high BMI group. There was a strong correlation between BMI and ECV in long standing SLE patients. When BMI was less than 23.00 kg/m2, it showed a negative correlation (r=-0.597, P=0.009), and a positive correlation (r=0.739, P=0.023) when over 23.00 kg/m2. However, there was no significant correlation between ECV, left ventricular (LV) ejection fraction, LV end-systolic volume and BMI in control group. In the multivariable linear regression, BMI in patients with SLE was associated with elevated ECV independently after being adjusted for age, usage of immunosuppressor and pulmonary artery pressure (BMI>23.00 kg/m2: β=-0.457, P=0.006. BMI≤23.00 kg/m2: β=0.766, P=0.001).


·Cardiac involvement in SLE is closely related to BMI. Low BMI patients should be careful with the cardiac injury. Maintaining BMI at normal low level (18.73?20.20 kg/m2) and avoiding overweight (≤23.00 kg/m2) may be necessary to myocardial protection.

Key words: systemic lupus erythematosus (SLE), body mass index (BMI), cardiac magnetic resonance (CMR), extracellular volume fraction (ECV)

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