ORIGINAL ARTICLE Prevalence and features of metabolic syndrome in childhood-onset systemic lupus erythematosus Nailú Angélica Sinicato 1,2 & Mariana Postal 2 & Karina de Oliveira Peliçari 2 & Leticia Rittner 3 & Roberto Marini 4 & Simone Appenzeller 2,4 Received: 30 October 2016 /Revised: 6 March 2017 /Accepted: 12 March 2017 /Published online: 19 April 2017 # International League of Associations for Rheumatology (ILAR) 2017 Abstract To estimate the prevalence and features of metabol- ic syndrome (MetS) in childhood-onset systemic lupus erythe- matosus (cSLE), we performed a cross-sectional study of 76 consecutive cSLE patients and 54 healthy controls, age and sex matched. All individuals were assessed for anthropometric and MetS features according to World Health Organization (WHO), NCEP Adult Treatment Panel III (NCEP-ATP III), and International Diabetes Federation (IDF) criteria. The cSLE patients were further assessed for clinical and laboratory manifestations, disease activity (Systemic Lupus Erythematosus Disease Activity Index), cumulative damage (Systemic Lupus International Collaborating Clinics (SLICC)), and current and cumulative drug exposures. Sixty-nine (90.8%) patients were female with mean age of 16.8 years [standard deviation (SD) ±4.0 years]. Mean disease duration was 4.8 years (SD ± 4.1). Based on the WHO MetS criteria, MetS was observed in two (2.6%) cSLE patients. We observed high prevalence of the MetS in cSLE patients ac- cording to NCEP-ATP III MetS criteria (18.4%) (p = 0.002) and according to IDF MetS criteria (17.1%) (p = 0.003). We did not observe MetS in the control group. No difference in cSLE patients <18 and ≥18 years was observed. We observed an association between the presence of MetS and SLICC scores in cSLE <18 years and cumulative corticosteroid dose adjusted by weight in cSLE ≥18 years. This study showed that MetS is frequently observed in cSLE using NCEP-ATP III MetS criteria and IDF MetS criteria. The identification of MetS is important to indicate cardiovascular morbidity and mortality in cSLE. Keywords Childhood-onset systemic lupus erythematosus . Metabolic syndrome Introduction Systemic lupus erythematosus (SLE) is a systemic inflamma- tory disease characterized by periods of exacerbation and re- mission [1]. In approximately 10–20% of all SLE cases, the diagnosis is established during childhood [2]. Despite adult and pediatric SLE patients share similar char- acteristics, it has been suggested that childhood-onset system- ic lupus erythematosus (cSLE) patients have a more severe and aggressive disease [3]. Similar to adult SLE, improvement of mortality has been observed in cSLE over the last decades [4–6]. In SLE, late mortality is due primary to cardiovascular disease (CVD) [4]. Premature atherosclerosis and CVD be- came one of the major comorbidities in SLE and is not full explained by traditional risk factors [7]. SLE can be consid- ered an independent risk factor for CVD because of disease- specific factors [7]. The effect of metabolic derangement and the role of metabolic syndrome (MetS) on cardiovascular risk have gained increased attention in SLE [8]. MetS is a group of cardiovascular risk factors that includes central obesity, dyslipidemia, hypertension, and disturbed glu- cose metabolism [8]. MetS prevalence in SLE varied according * Simone Appenzeller appenzellersimone@yahoo.com 1 Department of Pediatrics and PostgraduateProgram of Child and Adolescent Health, Faculty of Medical Science, State University of Campinas, Campinas, Brazil 2 Rheumatology Unit, Department of Medicine, Faculty of Medical Science, State University of Campinas, Cidade Universitária, Campinas, SP, Brazil 3 Faculty of Electrical Engineering—State University of Campinas, Campinas, Brazil 4 Department of Pediatrics, Faculty of Medical Science, State University of Campinas, Campinas, Brazil Clin Rheumatol (2017) 36:1527–1535 DOI 10.1007/s10067-017-3602-0