| Summary: | Systemic lupus erythematosus (SLE) patients have a higher frequency of cardiovascular risk factors such as high C-reactive protein (CRP) levels than the general population. CRP is considered a cardiovascular disease marker that could be related to SLE clinical disease activity. This study aimed to assess the association between CRP with cardiometabolic risk and clinical disease activity in SLE patients. A comparative cross-sectional study was conducted in 176 female SLE patients and 175 control subjects (CS) with median ages of 38 and 33 years, respectively; SLE patients were classified by the 1997 SLE-ACR criteria, and the clinical disease activity by the Mexican-SLEDAI (Mex-SLEDAI). CRP and lipid profile (triglycerides, cholesterol, HDL-C, and LDL-C) were quantified by turbidimetry and colorimetric-enzymatic assays, respectively. SLE patients had higher CRP levels than CS (SLE: 5 mg/L vs. CS = 1.1 mg/L; <i>p</i> < 0.001). In SLE patients, CRP levels ≥ 3 mg/L were associated with a higher risk of cardiometabolic risk status assessed by LAP index (OR = 3.01; IC: 1.04–8.7; <i>p</i> = 0.04), triglycerides/HDL-C index (OR = 5.2; IC: 2.1–12.8; <i>p</i> < 0.001), Kannel index (OR = 3.1; IC: 1.1–8.1; <i>p</i> = 0.03), Castelli index (OR = 6.6; IC: 2.5–17.8; <i>p</i> < 0.001), and high clinical disease activity (OR = 2.5: IC: 1.03–6.2; <i>p</i> = 0.04; and β coefficient = 5.8; IC: 2.5–9.4; R<sup>2</sup> = 0.15; <i>p</i> = 0.001). In conclusion, high CRP levels were associated with high cardiometabolic risk and clinical disease activity in SLE patients.
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