Skip to main content
Top
Published in: Clinical Rheumatology 11/2009

01-11-2009 | Original Article

Study on clinical features and complications with systemic lupus erythematosus (SLE) activity in Chinese Han population

Authors: Lian Hong Li, Hai Feng Pan, Wen Xian Li, Xiang Pei Li, Jian Hua Xu, Dong Qing Ye

Published in: Clinical Rheumatology | Issue 11/2009

Login to get access

Abstract

Systemic lupus erythematosus (SLE) is a complex autoimmune disease affecting multiple organs/systems with variable activities. We performed a retrospective study to investigate the relationship of clinical characteristics and complications with SLE activity in Chinese Han population. A cohort of 1,490 SLE inpatients was evaluated for disease activity using the systemic lupus erythematosus disease activity index (SLEDAI). Chi-square test or Fisher’s exact test was used to compare differences of clinical and laboratory features between active and inactive SLE patients. Logistic regression was chosen to explore the pattern of risk factors for disease activity. We found that neuropsychiatric involvement, nephritis, arthralgia, anti-dsDNA, serositis, hypocomplementemia, oral ulcerations, erythrocyte sedimentation rate, low C3, hematological abnormalities, and systolic pressure (1.010 < odds ratio < 10.568, 1.002 < 95% confidence interval < 31.599, 0.000 < P < 0.026) were major factors associated with disease activity, but not headaches, anti-ribonucleoprotein or anti-Sm, C-reactive protein, and anemia (P > 0.05, respectively). The involvements of urinary system, respiratory system, and central nervous system were significantly more frequent in active SLE than inactive SLE (0.000 < P < 0.014), except for alimentary system (P = 0.399). Our study has comprehensively evaluated the relationship of clinical characteristics and organs/systems involvement of SLE with SLEDAI in Chinese Han population and presented a compendium of factors affecting SLE, which should be useful for better evaluating disease activity and predicting organs/systems damage in SLE for clinical assessments and managements.
Literature
1.
go back to reference Bombardier C, Gladman DD, Urowitz MB, Caron D, Chang CH (1992) Derivation of the SLEDAI. A disease activity index for lupus patients. The Committee on Prognosis Studies in SLE. Arthritis Rheum 35:630–640PubMedCrossRef Bombardier C, Gladman DD, Urowitz MB, Caron D, Chang CH (1992) Derivation of the SLEDAI. A disease activity index for lupus patients. The Committee on Prognosis Studies in SLE. Arthritis Rheum 35:630–640PubMedCrossRef
2.
go back to reference Uribe AG, Vila LM, McGwin G Jr, Sanchez ML, Reveille JD, Alarcon GS (2004) The systemic lupus activity measure-revised, the Mexican Systemic Lupus Erythematosus Disease Activity Index (SLEDAI), and a modified SLEDAI-2K are adequate instruments to measure disease activity in systemic lupus erythematosus. J Rheumatol 31:1934–1940PubMed Uribe AG, Vila LM, McGwin G Jr, Sanchez ML, Reveille JD, Alarcon GS (2004) The systemic lupus activity measure-revised, the Mexican Systemic Lupus Erythematosus Disease Activity Index (SLEDAI), and a modified SLEDAI-2K are adequate instruments to measure disease activity in systemic lupus erythematosus. J Rheumatol 31:1934–1940PubMed
3.
go back to reference Jacobi AM, Rohde W, Ventz M, Riemekasten G, Burmester GR, Hiepe F (2001) Enhanced serum prolactin (PRL) in patients with systemic lupus erythematosus: PRL levels are related to the disease activity. Lupus 10:554–561PubMedCrossRef Jacobi AM, Rohde W, Ventz M, Riemekasten G, Burmester GR, Hiepe F (2001) Enhanced serum prolactin (PRL) in patients with systemic lupus erythematosus: PRL levels are related to the disease activity. Lupus 10:554–561PubMedCrossRef
4.
go back to reference Prasad R, Ibanez D, Gladman D, Urowitz M (2006) Anti-dsDNA and anti-Sm antibodies do not predict damage in systemic lupus erythematosus. Lupus 15:285–291PubMedCrossRef Prasad R, Ibanez D, Gladman D, Urowitz M (2006) Anti-dsDNA and anti-Sm antibodies do not predict damage in systemic lupus erythematosus. Lupus 15:285–291PubMedCrossRef
5.
go back to reference Ramos-Casals M, Campoamor MT, Chamorro A, Salvador G, Segura S, Botero JC, Yague J, Cervera R, Ingelmo M, Font J (2004) Hypocomplementemia in systemic lupus erythematosus and primary antiphospholipid syndrome: prevalence and clinical significance in 667 patients. Lupus 13:777–783PubMedCrossRef Ramos-Casals M, Campoamor MT, Chamorro A, Salvador G, Segura S, Botero JC, Yague J, Cervera R, Ingelmo M, Font J (2004) Hypocomplementemia in systemic lupus erythematosus and primary antiphospholipid syndrome: prevalence and clinical significance in 667 patients. Lupus 13:777–783PubMedCrossRef
6.
go back to reference Reveille JD (2004) Predictive value of autoantibodies for activity of systemic lupus erythematosus. Lupus 13:290–297PubMedCrossRef Reveille JD (2004) Predictive value of autoantibodies for activity of systemic lupus erythematosus. Lupus 13:290–297PubMedCrossRef
7.
go back to reference Yee CS, Hussein H, Skan J, Bowman S, Situnayake D, Gordon C (2003) Association of damage with autoantibody profile, age, race, sex and disease duration in systemic lupus erythematosus. Rheumatology (Oxford) 42:276–279CrossRef Yee CS, Hussein H, Skan J, Bowman S, Situnayake D, Gordon C (2003) Association of damage with autoantibody profile, age, race, sex and disease duration in systemic lupus erythematosus. Rheumatology (Oxford) 42:276–279CrossRef
8.
go back to reference Bertoli AM, Vila LM, Apte M, Fessler BJ, Bastian HM, Reveille JD, Alarcon GS (2007) Systemic lupus erythematosus in a multiethnic US cohort LUMINA LI: anaemia as a predictor of disease activity and damage accrual. Rheumatology (Oxford) 46:1471–1476CrossRef Bertoli AM, Vila LM, Apte M, Fessler BJ, Bastian HM, Reveille JD, Alarcon GS (2007) Systemic lupus erythematosus in a multiethnic US cohort LUMINA LI: anaemia as a predictor of disease activity and damage accrual. Rheumatology (Oxford) 46:1471–1476CrossRef
9.
go back to reference Vila LM, Alarcon GS, McGwin G Jr, Bastian HM, Fessler BJ, Reveille JD (2005) Systemic lupus erythematosus in a multiethnic cohort (LUMINA): XXIX. Elevation of erythrocyte sedimentation rate is associated with disease activity and damage accrual. J Rheumatol 32:2150–2155PubMed Vila LM, Alarcon GS, McGwin G Jr, Bastian HM, Fessler BJ, Reveille JD (2005) Systemic lupus erythematosus in a multiethnic cohort (LUMINA): XXIX. Elevation of erythrocyte sedimentation rate is associated with disease activity and damage accrual. J Rheumatol 32:2150–2155PubMed
10.
go back to reference Vila LM, Alarcon GS, McGwin G Jr, Bastian HM, Fessler BJ, Reveille JD (2006) Systemic lupus erythematosus in a multiethnic US cohort, XXXVII: association of lymphopenia with clinical manifestations, serologic abnormalities, disease activity, and damage accrual. Arthritis Rheum 55:799–806PubMedCrossRef Vila LM, Alarcon GS, McGwin G Jr, Bastian HM, Fessler BJ, Reveille JD (2006) Systemic lupus erythematosus in a multiethnic US cohort, XXXVII: association of lymphopenia with clinical manifestations, serologic abnormalities, disease activity, and damage accrual. Arthritis Rheum 55:799–806PubMedCrossRef
11.
go back to reference Bertoli AM, Vila LM, Reveille JD, Alarcon GS (2008) Systemic lupus erythematosus in a multiethnic US cohort (LUMINA): LXI. Value of C-reactive protein as a marker of disease activity and damage. J Rheumatol 35:2355–2358PubMedCrossRef Bertoli AM, Vila LM, Reveille JD, Alarcon GS (2008) Systemic lupus erythematosus in a multiethnic US cohort (LUMINA): LXI. Value of C-reactive protein as a marker of disease activity and damage. J Rheumatol 35:2355–2358PubMedCrossRef
12.
go back to reference Hochberg MC (1997) Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 40:1725PubMedCrossRef Hochberg MC (1997) Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 40:1725PubMedCrossRef
13.
go back to reference Hayakawa I, Hasegawa M, Matsushita T, Yanaba K, Kodera M, Komura K, Takehara K, Sato S (2005) Increased cutaneous T-cell-attracting chemokine levels in sera from patients with systemic sclerosis. Rheumatology (Oxford) 44:873–878CrossRef Hayakawa I, Hasegawa M, Matsushita T, Yanaba K, Kodera M, Komura K, Takehara K, Sato S (2005) Increased cutaneous T-cell-attracting chemokine levels in sera from patients with systemic sclerosis. Rheumatology (Oxford) 44:873–878CrossRef
14.
go back to reference Wu O, Liu HH, Li WX, Zhang N, Wang Q, Li XP, Dong MX, Zhang XJ, Ye DQ (2008) Serum soluble nucleosome and the broad family of antinucleosome antibodies are associated with organ and tissue damage in systemic lupus erythematosus in a Chinese population. Clin Exp Dermatol 33:160–163PubMedCrossRef Wu O, Liu HH, Li WX, Zhang N, Wang Q, Li XP, Dong MX, Zhang XJ, Ye DQ (2008) Serum soluble nucleosome and the broad family of antinucleosome antibodies are associated with organ and tissue damage in systemic lupus erythematosus in a Chinese population. Clin Exp Dermatol 33:160–163PubMedCrossRef
15.
go back to reference Petri M, Genovese M, Engle E, Hochberg M (1991) Definition, incidence, and clinical description of flare in systemic lupus erythematosus. A prospective cohort study. Arthritis Rheum 34:937–944PubMedCrossRef Petri M, Genovese M, Engle E, Hochberg M (1991) Definition, incidence, and clinical description of flare in systemic lupus erythematosus. A prospective cohort study. Arthritis Rheum 34:937–944PubMedCrossRef
16.
go back to reference Urowitz MB, Gladman DD, Farewell VT, Stewart J, McDonald J (1993) Lupus and pregnancy studies. Arthritis Rheum 36:1392–1397PubMedCrossRef Urowitz MB, Gladman DD, Farewell VT, Stewart J, McDonald J (1993) Lupus and pregnancy studies. Arthritis Rheum 36:1392–1397PubMedCrossRef
17.
18.
go back to reference Spronk PE, Limburg PC, Kallenberg CG (1995) Serological markers of disease activity in systemic lupus erythematosus. Lupus 4:86–94PubMedCrossRef Spronk PE, Limburg PC, Kallenberg CG (1995) Serological markers of disease activity in systemic lupus erythematosus. Lupus 4:86–94PubMedCrossRef
19.
go back to reference Boey ML, Peebles CL, Tsay G, Feng PH, Tan EM (1988) Clinical and autoantibody correlations in Orientals with systemic lupus erythematosus. Ann Rheum Dis 47:918–923PubMedCrossRef Boey ML, Peebles CL, Tsay G, Feng PH, Tan EM (1988) Clinical and autoantibody correlations in Orientals with systemic lupus erythematosus. Ann Rheum Dis 47:918–923PubMedCrossRef
20.
go back to reference Hoet RM, Koornneef I, de Rooij DJ, van de Putte LB, van Venrooij WJ (1992) Changes in anti-U1 RNA antibody levels correlate with disease activity in patients with systemic lupus erythematosus overlap syndrome. Arthritis Rheum 35:1202–1210PubMedCrossRef Hoet RM, Koornneef I, de Rooij DJ, van de Putte LB, van Venrooij WJ (1992) Changes in anti-U1 RNA antibody levels correlate with disease activity in patients with systemic lupus erythematosus overlap syndrome. Arthritis Rheum 35:1202–1210PubMedCrossRef
21.
go back to reference Satoh M, Yamagata H, Watanabe F, Nakayama S, Ogasawara T, Tojo T, Akizuki M (1995) Development of anti-Sm and anti-DNA antibodies followed by clinical manifestation of systemic lupus erythematosus in an elderly woman with long-standing Sjogren’s syndrome. Lupus 4:63–65PubMedCrossRef Satoh M, Yamagata H, Watanabe F, Nakayama S, Ogasawara T, Tojo T, Akizuki M (1995) Development of anti-Sm and anti-DNA antibodies followed by clinical manifestation of systemic lupus erythematosus in an elderly woman with long-standing Sjogren’s syndrome. Lupus 4:63–65PubMedCrossRef
22.
go back to reference Yasuma M, Takasaki Y, Matsumoto K, Kodama A, Hashimoto H, Hirose S (1990) Clinical significance of IgG anti-Sm antibodies in patients with systemic lupus erythematosus. J Rheumatol 17:469–475PubMed Yasuma M, Takasaki Y, Matsumoto K, Kodama A, Hashimoto H, Hirose S (1990) Clinical significance of IgG anti-Sm antibodies in patients with systemic lupus erythematosus. J Rheumatol 17:469–475PubMed
23.
go back to reference Kurien BT, Scofield RH (2006) Autoantibody determination in the diagnosis of systemic lupus erythematosus. Scand J Immunol 64:227–235PubMedCrossRef Kurien BT, Scofield RH (2006) Autoantibody determination in the diagnosis of systemic lupus erythematosus. Scand J Immunol 64:227–235PubMedCrossRef
24.
go back to reference Brunner HI, Jones OY, Lovell DJ, Johnson AM, Alexander P, Klein-Gitelman MS (2003) Lupus headaches in childhood-onset systemic lupus erythematosus: relationship to disease activity as measured by the systemic lupus erythematosus disease activity index (SLEDAI) and disease damage. Lupus 12:600–606PubMedCrossRef Brunner HI, Jones OY, Lovell DJ, Johnson AM, Alexander P, Klein-Gitelman MS (2003) Lupus headaches in childhood-onset systemic lupus erythematosus: relationship to disease activity as measured by the systemic lupus erythematosus disease activity index (SLEDAI) and disease damage. Lupus 12:600–606PubMedCrossRef
25.
go back to reference Alarcon GS, McGwin G Jr, Bastian HM, Roseman J, Lisse J, Fessler BJ, Friedman AW, Reveille JD (2001) Systemic lupus erythematosus in three ethnic groups. VII [correction of VIII]. Predictors of early mortality in the LUMINA cohort. LUMINA Study Group. Arthritis Rheum 45:191–202PubMedCrossRef Alarcon GS, McGwin G Jr, Bastian HM, Roseman J, Lisse J, Fessler BJ, Friedman AW, Reveille JD (2001) Systemic lupus erythematosus in three ethnic groups. VII [correction of VIII]. Predictors of early mortality in the LUMINA cohort. LUMINA Study Group. Arthritis Rheum 45:191–202PubMedCrossRef
26.
go back to reference Chen YE, Korbet SM, Katz RS, Schwartz MM, Lewis EJ (2008) Value of a complete or partial remission in severe lupus nephritis. Clin J Am Soc Nephrol 3:46–53PubMedCrossRef Chen YE, Korbet SM, Katz RS, Schwartz MM, Lewis EJ (2008) Value of a complete or partial remission in severe lupus nephritis. Clin J Am Soc Nephrol 3:46–53PubMedCrossRef
27.
go back to reference Korbet SM, Lewis EJ, Schwartz MM, Reichlin M, Evans J, Rohde RD (2000) Factors predictive of outcome in severe lupus nephritis. Lupus Nephritis Collaborative Study Group. Am J Kidney Dis 35:904–914PubMedCrossRef Korbet SM, Lewis EJ, Schwartz MM, Reichlin M, Evans J, Rohde RD (2000) Factors predictive of outcome in severe lupus nephritis. Lupus Nephritis Collaborative Study Group. Am J Kidney Dis 35:904–914PubMedCrossRef
28.
go back to reference Duran-Barragan S, Ruvalcaba-Naranjo H, Rodriguez-Gutierrez L, Solano-Moreno H, Hernandez-Rios G, Sanchez-Ortiz A, Ramos-Remus C (2008) Recurrent urinary tract infections and bladder dysfunction in systemic lupus erythematosus. Lupus 17:1117–1121PubMedCrossRef Duran-Barragan S, Ruvalcaba-Naranjo H, Rodriguez-Gutierrez L, Solano-Moreno H, Hernandez-Rios G, Sanchez-Ortiz A, Ramos-Remus C (2008) Recurrent urinary tract infections and bladder dysfunction in systemic lupus erythematosus. Lupus 17:1117–1121PubMedCrossRef
29.
30.
go back to reference Sitia S, Atzeni F, Sarzi-Puttini P, Di Bello V, Tomasoni L, Delfino L, Antonini-Canterin F, Di Salvo G, De Gennaro Colonna V, La Carrubba S et al (2009) Cardiovascular involvement in systemic autoimmune diseases. Autoimmun Rev 8:281–286PubMedCrossRef Sitia S, Atzeni F, Sarzi-Puttini P, Di Bello V, Tomasoni L, Delfino L, Antonini-Canterin F, Di Salvo G, De Gennaro Colonna V, La Carrubba S et al (2009) Cardiovascular involvement in systemic autoimmune diseases. Autoimmun Rev 8:281–286PubMedCrossRef
31.
go back to reference FitzGerald JD, Grossman JM (1999) Validity and reliability of retrospective assessment of disease activity and flare in observational cohorts of lupus patients. Lupus 8:638–644PubMedCrossRef FitzGerald JD, Grossman JM (1999) Validity and reliability of retrospective assessment of disease activity and flare in observational cohorts of lupus patients. Lupus 8:638–644PubMedCrossRef
32.
go back to reference Thumboo J, Lee HY, Fong KY, Chan SP, Chapman CA, Leong KH, Feng PH, Thio ST, Boey ML (2000) Accuracy of medical record scoring of the SLICC/ACR damage index for systemic lupus erythematosus. Lupus 9:358–362PubMedCrossRef Thumboo J, Lee HY, Fong KY, Chan SP, Chapman CA, Leong KH, Feng PH, Thio ST, Boey ML (2000) Accuracy of medical record scoring of the SLICC/ACR damage index for systemic lupus erythematosus. Lupus 9:358–362PubMedCrossRef
Metadata
Title
Study on clinical features and complications with systemic lupus erythematosus (SLE) activity in Chinese Han population
Authors
Lian Hong Li
Hai Feng Pan
Wen Xian Li
Xiang Pei Li
Jian Hua Xu
Dong Qing Ye
Publication date
01-11-2009
Publisher
Springer-Verlag
Published in
Clinical Rheumatology / Issue 11/2009
Print ISSN: 0770-3198
Electronic ISSN: 1434-9949
DOI
https://doi.org/10.1007/s10067-009-1240-x

Other articles of this Issue 11/2009

Clinical Rheumatology 11/2009 Go to the issue
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.