Medical Student Research Fellowship for Summer 2009
Mentor: Marilynn Punaro, MD; Tracey Wright, MD
Department: Pediatrics; Division of Rheumatology
Room number: CMC F5053
Mail Code: 9063
Phone number: 214-456-7288
E-mail: email@example.com, firstname.lastname@example.org
Project title: Risk Factors for Premature Atherosclerosis in Pediatric Systemic Lupus Erythematosus
Human subjects IRB approved project number (where applicable): pending
Animal subjects IRB approved project number (where applicable):
Project Type (patient-based research, animal-based research, or basic research; this characterization is only to permit a general classification for grouping similar types of projects)
Brief Description of Project:
Systemic lupus erythematosus (SLE) is a severe and chronic multi-system autoimmune
disease that may result in major organ dysfunction. Approximately 20% of cases
are diagnosed in childhood. Infection and renal disease initially resulted in
mortality rates of approximately 50% at 10 years. With improved and aggressive
therapies over the past several decades, the 10 year survival rate is now estimated
at 93%. However, improved survival rates have focused attention on long-term
health and function, and have led to the discovery of the accelerated onset
of cardiovascular disease in SLE.
Multiple studies have shown the increased risk of cardiovascular disease in SLE is not fully explained by the Framingham risk factor model which includes hypertension, elevated cholesterol, low high-density lipoprotein cholesterol, diabetes mellitus, smoking, and older age. In the general population, the definition of traditional cardiovascular risk factors has expanded to include central obesity, glucose intolerance and insulin resistance, even in the absence of diabetes mellitus. This cluster of risk factors which includes central obesity, dyslipidemia, hypertension, and altered glucose metabolism constitutes the metabolic syndrome. The metabolic syndrome has been estimated to occur in 18-32% of adult SLE.
We will create a database of cardiovascular risk factors and lipid profiles collected prospectively from pediatric SLE patients who receive care in Dallas, Texas. The database will be used to determine the prevalence of risk factors for premature atherosclerosis in pediatric SLE. From this data, we will also determine which risk model (Framingham Risk Model versus the Metabolic Syndrome Risk Model) appropriately characterizes the risk factors in our cohort. The medical student will perform chart abstraction and enter data into a secure Microsoft Access database. The medical student will also perform basic statistical analysis to characterize the risk factors.
Previous Research Activities or Publications with Medical Students:
Dr. Punaro was a co-recipient of the Medical Student Clinical Preceptorship Award from the American College of Rheumatology / Research and Education Foundation in 2006.