DOI QR코드

DOI QR Code

Clinical characteristics of male and female Korean patients with systemic lupus erythematosus: a comparative study

  • Hwang, Jiwon (Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Lee, Jaejoon (Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Ahn, Joong Kyoung (Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Park, Eun-Jung (Department of Medicine, Jeju National University School of Medicine) ;
  • Cha, Hoon-Suk (Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Koh, Eun-Mi (Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • Received : 2014.03.05
  • Accepted : 2014.05.15
  • Published : 2015.03.01

Abstract

Background/Aims: To compare the clinical characteristics and outcomes of systemic lupus erythematosus between male and female Korean patients. Methods: A retrospective analysis was performed at a single tertiary hospital from August 1994 to May 2010. Male patients were matched with two to three female patients based on age and disease duration. Organ damage was assessed using the Systemic Lupus International Collaborating Clinics/American College of Rheumatology damage index (SLICC/ACR DI). Results: Fifty-three male patients were compared with 150 female patients. Renal disorders were found more frequently in male patients at disease onset (p < 0.001); the adjusted odds ratio (OR) demonstrated a significant sex preponderance for renal manifestations (OR, 3.26; 95% confidence interval [CI], 1.62 to 6.57). Diffuse proliferative lupus nephritis and end-stage renal disease requiring dialysis during the disease course were more prevalent in male patients (p = 0.025 and p < 0.001, respectively). The risk for requiring long-term dialysis was significantly higher in male than in female patients (OR, 4.02; 95% CI, 1.07 to 15.06), as was the mean SLICC/ACR DI ($1.55{\pm}1.35$ vs. $1.02{\pm}1.57$, respectively; p = 0.028). Conclusions: Our data demonstrate that Korean patients with lupus have characteristics similar to those of cohorts reported previously. Male patients had significantly higher incidences of renal manifestations and organ damage.

Keywords

References

  1. Mok CC, Lau CS, Chan TM, Wong RW. Clinical characteristics and outcome of southern Chinese males with systemic lupus erythematosus. Lupus 1999;8:188-196. https://doi.org/10.1191/096120399678847605
  2. Aranow C, Del Guidice J, Barland P, Weinstein A. Systemic lupus erythematosus disease severity in men and women: a case-control study. J Rheumatol 2002;29:1674-1677.
  3. Soto ME, Vallejo M, Guillen F, Simon JA, Arena E, Reyes PA. Gender impact in systemic lupus erythematosus. Clin Exp Rheumatol 2004;22:713-721.
  4. Garcia MA, Marcos JC, Marcos AI, et al. Male systemic lupus erythematosus in a Latin-American inception cohort of 1214 patients. Lupus 2005;14:938-946. https://doi.org/10.1191/0961203305lu2245oa
  5. Chang DM, Chang CC, Kuo SY, Chu SJ, Chang ML. The clinical features and prognosis of male lupus in Taiwan. Lupus 1998;7:462-468. https://doi.org/10.1191/096120398678920479
  6. Chung WK, Oh YK, Na KY, et al. The clinical and pathologic features of lupus nephritis in male. Korean J Nephrol 1994;13:879-886.
  7. Tan EM, Cohen AS, Fries JF, et al. The 1982 revised crite-ria for the classification of systemic lupus erythematosus. Arthritis Rheum 1982;25:1271-1277. https://doi.org/10.1002/art.1780251101
  8. Hochberg MC. Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 1997;40:1725.
  9. Gladman D, Ginzler E, Goldsmith C, et al. The development and initial validation of the Systemic Lupus International Collaborating Clinics/American College of Rheumatology damage index for systemic lupus erythematosus. Arthritis Rheum 1996;39:363-369. https://doi.org/10.1002/art.1780390303
  10. Tateno S, Hiki Y, Hamaguchi K, Tsuchida H, Shigematsu H, Kobayashi Y. Study of lupus nephritis in males. Q J Med 1991;81:1031-1039. https://doi.org/10.1093/qjmed/81.3.1031
  11. Koh WH, Fong KY, Boey ML, Feng PH. Systemic lupus erythematosus in 61 Oriental males: a study of clinical and laboratory manifestations. Br J Rheumatol 1994;33:339-342. https://doi.org/10.1093/rheumatology/33.4.339
  12. Andrade RM, Alarcon GS, Fernandez M, et al. Accelerated damage accrual among men with systemic lupus erythematosus: XLIV: results from a multiethnic US cohort. Arthritis Rheum 2007;56:622-630. https://doi.org/10.1002/art.22375
  13. Mongkoltanatus J, Wangkaew S, Kasitanon N, Louthrenoo W. Clinical features of Thai male lupus: an age-matched controlled study. Rheumatol Int 2008;28:339-344. https://doi.org/10.1007/s00296-007-0442-2
  14. de Carvalho JF, do Nascimento AP, Testagrossa LA, Barros RT, Bonfa E. Male gender results in more severe lupus nephritis. Rheumatol Int 2010;30:1311-1315. https://doi.org/10.1007/s00296-009-1151-9
  15. Halimi JM, Giraudeau B, Vol S, et al. Effects of current smoking and smoking discontinuation on renal function and proteinuria in the general population. Kidney Int 2000;58:1285-1292. https://doi.org/10.1046/j.1523-1755.2000.00284.x
  16. Orth SR, Stockmann A, Conradt C, et al. Smoking as a risk factor for end-stage renal failure in men with primary renal disease. Kidney Int 1998;54:926-931. https://doi.org/10.1046/j.1523-1755.1998.00067.x
  17. Vyse TJ, Kotzin BL. Genetic susceptibility to systemic lupus erythematosus. Annu Rev Immunol 1998;16:261-292. https://doi.org/10.1146/annurev.immunol.16.1.261
  18. Nimmerjahn F, Ravetch JV. Fcgamma receptors as regulators of immune responses. Nat Rev Immunol 2008;8:34-47. https://doi.org/10.1038/nri2206
  19. Yun HR, Koh HK, Kim SS, et al. FcgammaRIIa/IIIa polymorphism and its association with clinical manifestations in Korean lupus patients. Lupus 2001;10:466-472. https://doi.org/10.1191/096120301678416015
  20. Yap SN, Phipps ME, Manivasagar M, Tan SY, Bosco JJ. Human Fc gamma receptor IIA (FcgammaRIIA) genotyping and association with systemic lupus erythematosus (SLE) in Chinese and Malays in Malaysia. Lupus 1999;8:305-310. https://doi.org/10.1191/096120399678847876
  21. Botto M, Theodoridis E, Thompson EM, et al. Fc gamma RIIa polymorphism in systemic lupus erythematosus (SLE): no association with disease. Clin Exp Immunol 1996;104:264-268. https://doi.org/10.1046/j.1365-2249.1996.33740.x
  22. Ha Y, Lee KH, Jung S, Lee SW, Lee SK, Park YB. Glucocorticoid-induced diabetes mellitus in patients with systemic lupus erythematosus treated with high-dose glucocorticoid therapy. Lupus 2011;20:1027-1034. https://doi.org/10.1177/0961203311402246

Cited by

  1. Impact of sex disparities on the clinical manifestations in patients with systemic lupus erythematosus : A systematic review and meta-analysis vol.95, pp.29, 2015, https://doi.org/10.1097/md.0000000000004272
  2. Sex differences in genomics in lupus: girls with systemic lupus have high interferon gene expression while boys have high levels of tumour necrosis factor-related gene expression vol.45, pp.5, 2015, https://doi.org/10.3109/03009742.2015.1132760
  3. Infection in systemic lupus erythematosus, similarities, and differences with lupus flare vol.32, pp.3, 2017, https://doi.org/10.3904/kjim.2016.234
  4. Clinicopathological study of male and female patients with lupus nephritis: a retrospective study vol.50, pp.2, 2015, https://doi.org/10.1007/s11255-017-1780-y
  5. Conventional DCs from Male and Female Lupus-Prone B6.NZM Sle1/Sle2/Sle3 Mice Express an IFN Signature and Have a Higher Immunometabolism That Are Enhanced by Estrogen vol.2018, pp.None, 2018, https://doi.org/10.1155/2018/1601079
  6. Incremental direct medical costs of systemic lupus erythematosus patients in the years preceding diagnosis: A general population-based study vol.27, pp.8, 2015, https://doi.org/10.1177/0961203318768882
  7. The Importance of Sex Stratification in Autoimmune Disease Biomarker Research: A Systematic Review vol.9, pp.None, 2015, https://doi.org/10.3389/fimmu.2018.01208
  8. Depression in systemic lupus erythematosus: gender differences in the performance of the Beck Depression Inventory (BDI), Center for Epidemiologic Studies Depression Scale (CES-D), and Hospital Anxiet vol.27, pp.2, 2018, https://doi.org/10.1177/0961203317713142
  9. Systemic lupus erythematosus among male patients in Malaysia: how are we different from other geographical regions? vol.28, pp.1, 2019, https://doi.org/10.1177/0961203318812676
  10. Clinical characteristics and survival of 413 patients with systemic lupus erythematosus in southeastern areas of South Korea: A multicenter retrospective cohort study vol.23, pp.1, 2020, https://doi.org/10.1111/1756-185x.13761
  11. Anti-Sm Antibody, Damage Index, and Corticosteroid Use Are Associated with Cardiac Involvement in Systemic Lupus Erythematosus: Data from a Prospective Registry Study vol.35, pp.21, 2015, https://doi.org/10.3346/jkms.2020.35.e139
  12. Global epidemiology of systemic lupus erythematosus vol.17, pp.9, 2015, https://doi.org/10.1038/s41584-021-00668-1