Circulating naive and memory CD4⁺ T cells and metabolic syndrome in patients with systemic lupus erythematosus: Data from a primarily Mestizo population

Objective. The aim of this study was to determine whether the proportions of naive and memory CD4⁺ T cell are independently associated with the metabolic syndrome (MetS) in patients with SLE. Methods. This cross-sectional study was conducted in SLE patients seen at our rheumatology department between September 2013 and April 2014. CD4⁺ T cell subpopulations were examined by flow cytometry. The association of MetS and CD4⁺ T cell subpopulations was examined by Mann-Whitney U-test and by multivariable analysis, adjusting for all possible confounding variables. Results. One hundred and seventeen patients were evaluated. Their mean age was 44.6 years (s.d. 12.6), 109 (93.2%) were female and all patients were Mestizo (mixed Caucasian and Amerindian ancestry). Fifty-two patients (44.4%) presented with MetS. Disease duration was 7.6 years (s.d. 6.8). The percentage of naive CD4⁺ T cells was 25.0 (s.d. 12.7) and memory CD4⁺ T cells was 66.7 (s.d. 13.2) and the memory:naive CD4⁺ T cell ratio was 4.3 (s.d. 5.6). In multivariable analysis, the percentage of naive CD4⁺ T cells was negatively associated with the presence of MetS [odds ratio (OR) 0.959 (95% CI 0.923, 0.997), P = 0.033], whereas the percentage of memory CD4⁺T cells and the memory:naive CD4⁺ T cell ratio were positively associated with its presence [OR 1.040 (95% CI 1.003, 1.078), P = 0.031 and OR 1.238 (95% CI 1.041, 1.472), P = 0.016, respectively]. Conclusion. In the SLE patients studied, a lower percentage of naive CD4⁺ T cells, a higher percentage of memory CD4⁺ T cells and the memory:naive CD4⁺ T cell ratio were independently associated with the presence of MetS. This association could reflect the impact of immunosenescence among SLE patients with cardiovascular morbidity.