Cardiometabolic Index and Uric Acid Level in Pediatric Systemic Lupus Erythematosus and Relationship to Disease Activity

Background: In pediatric systemic lupus erythematosus (SLE) patients, elevated cardiometabolic index (CMI), hyperuricemia (HUA) and dyslipidemia have been associated with higher disease activity and flare risk. These markers may serve as early indicators of lupus disease activity and severity. Aim: to assess the CMI and serum uric acid (SUA) in Pediatric SLE patients and their relationship to disease activity. Patients and Methods: A retrospective case-control study was conducted at Minia University Hospital in Egypt from May to November 2024, involving 45 pediatric patients diagnosed with SLE and 45 healthy children. The SLE group was divided into normouricemic and hyperuricemic subgroups based on SUA levels, and disease activity was classified using the SLE Disease Activity Index (SLEDAI) into three categories: no flare (SLEDAI ≤3), mild/moderate flare (SLEDAI >3–12), and severe flare (SLEDAI >12). Results: Pediatric SLE patients showed higher anthropometric measures and lipid profiles, with elevated triglycerides, increased triglyceride/HDL-C ratio, and reduced HDL-C, especially in severe flare cases. Severe cases had higher CMI, with 86.7% classified as high-risk. Severe flares also had higher uric acid, urea, and albumin/creatinine ratios. Patients with high-risk UTI (Human Unborn Appetite) had lower C3/C4 levels, higher anti-dsDNA positivity, and elevated SLEDAI scores. SLEDAI score correlated positively with uric acid, CRP, CMI, and anti-dsDNA. Conclusions: The study found that Susceptibility to Atherosclerosis (SUA) and C-Myocardial Inflammation (CMI) are valuable markers for predicting renal involvement and disease activity in pediatric SLE, with elevated SUA linked to lupus nephritis features and higher CMI indicating atherogenic lipid changes and inflammation.