Organ Damage and Associated Factors in Chinese Patients With Systemic Lupus Erythematosus

IF 2.4 4区医学 Q2 RHEUMATOLOGY

International Journal of Rheumatic Diseases Pub Date : 2025-05-06 DOI:10.1111/1756-185X.70268

Jiaying Zhang, Liujun Wang, Dai Gao, Yong Fan, LanLan Ji, Zhuoli Zhang

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Abstract

Objective

To explore organ damages and factors associated with the occurrence of organ damages in Chinese patients with systemic lupus erythematosus (SLE).

Methods

A cross-sectional study was performed in SLE patients with a disease duration of over 6 months at enrollment. The demographics, clinical characteristics, and medication history were collected. The profile of organ damage measured by the SLE damage index (SDI) at enrollment was displayed. The factors associated with the occurrence of organ damage were analyzed by logistic regression analysis.

Results

Three hundred and fifty patients were enrolled in this study. Their mean age was 38.8 ± 13.1 years, and the median disease duration was 7.0 (2.0, 14.0) years. There were 124 (35.5%) patients with organ damage at enrollment. The damage was most frequently located in ocular (12.8%), followed by musculoskeletal (9.4%), gonads (5.7%), neuropsychiatric (4.8%), and lungs (4.6%). The top five prevalent manifestations were cataract (10.5%), avascular osteonecrosis (6.5%), premature gonadal failure (5.7%), pulmonary hypertension (3.4%) and chronic alopecia (3.4%). In logistic analysis, age (OR = 1.06, 95% CI 1.03, 1.08, p < 0.001), disease duration (OR = 1.09, 95% CI 1.05, 1.13, p < 0.001), current/past use of mycophenolate (OR = 2.66, 95% CI 1.49, 4.75, p = 0.001), SLE disease activity index 2000 (SLEDAI-2K) at enrollment (OR = 1.06, 95% CI 1.00, 1.11, p = 0.035) were independent risk factors of organ damage, while current/past use of hydroxychloroquine (OR = 0.20, 95% CI 0.06, 0.66, p = 0.009) was an independent protective factor.

Conclusion

Organ damage is frequent in Chinese SLE patients. Disease duration, SLEDAI-2K at enrollment, and use of mycophenolate were risk factors, while use of hydroxychloroquine was a protective factor of organ damage. Optimized management is imperative to protect ocular, musculoskeletal, and gonads from damage in clinical practice in the future.

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中国系统性红斑狼疮患者的器官损害及其相关因素

目的探讨中国系统性红斑狼疮（SLE）患者器官损害及器官损害发生的相关因素。方法在入组时病程超过6个月的SLE患者中进行横断面研究。收集患者的人口统计学、临床特征和用药史。显示入组时SLE损伤指数（SDI）测量的器官损伤概况。采用logistic回归分析与器官损害发生相关的因素。结果本研究共纳入350例患者。平均年龄38.8±13.1岁，中位病程7.0（2.0,14.0）年。入组时有124例（35.5%）患者有器官损害。损伤最常发生在眼部（12.8%），其次是肌肉骨骼（9.4%）、性腺（5.7%）、神经精神（4.8%）和肺部（4.6%）。排在前五位的常见表现为白内障（10.5%）、无血管性骨坏死（6.5%）、性腺功能过早衰竭（5.7%）、肺动脉高压（3.4%）和慢性脱发（3.4%）。在logistic分析中，年龄（OR = 1.06, 95% CI 1.03, 1.08, p < 0.001）、病程（OR = 1.09, 95% CI 1.05, 1.13, p < 0.001）、目前/过去使用霉酚酸酯（OR = 2.66, 95% CI 1.49, 4.75, p = 0.001）、入组时SLE疾病活度指数2000 (sledaii - 2k) （OR = 1.06, 95% CI 1.00, 1.11, p = 0.035）是器官损害的独立危险因素，而目前/过去使用羟氯喹（OR = 0.20, 95% CI 0.06, 0.66, p = 0.01）是器官损害的独立危险因素。P = 0.009)是独立的保护因素。结论中国SLE患者器官损害较为常见。病程、入组时SLEDAI-2K和使用霉酚酸盐是危险因素，而使用羟氯喹是器官损害的保护因素。优化管理是必要的，以保护眼，肌肉骨骼和性腺在未来的临床实践中免受损害。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Rheumatic Diseases RHEUMATOLOGY-

CiteScore

3.70

自引率

4.00%

发文量

362

审稿时长

1 months

期刊介绍： The International Journal of Rheumatic Diseases (formerly APLAR Journal of Rheumatology) is the official journal of the Asia Pacific League of Associations for Rheumatology. The Journal accepts original articles on clinical or experimental research pertinent to the rheumatic diseases, work on connective tissue diseases and other immune and allergic disorders. The acceptance criteria for all papers are the quality and originality of the research and its significance to our readership. Except where otherwise stated, manuscripts are peer reviewed by two anonymous reviewers and the Editor.