The differential panorama of clinical features of lupus erythematosus patients with different onset ages: a cross-sectional multicenter study from China

作者全名："Yu, Yangyiyi; Jin, Hui; Zhou, Shihang; Zhao, Ming; Wu, Haijing; Long, Hai; Fu, Siqi; Wu, Ruifang; Yin, Heng; Liao, Jieyue; Luo, Shuangyan; Liu, Yu; Zhang, Qing; Zhang, Peng; Tan, Yixin; Huang, Xin; Li, Fen; Lin, Guanghui; Lu, Qianjin"

作者地址："[Yu, Yangyiyi; Jin, Hui; Zhou, Shihang; Zhao, Ming; Wu, Haijing; Long, Hai; Fu, Siqi; Wu, Ruifang; Yin, Heng; Liao, Jieyue; Luo, Shuangyan; Liu, Yu; Zhang, Qing; Zhang, Peng; Tan, Yixin; Huang, Xin; Lu, Qianjin] Cent South Univ, Xiangya Hosp 2, Dept Dermatol, Hunan Key Lab Med Epigen, Changsha, Peoples R China; [Jin, Hui; Zhao, Ming; Lu, Qianjin] Chinese Acad Med Sci & Peking Union Med Coll, Inst Dermatol, Nanjing, Peoples R China; [Jin, Hui; Zhao, Ming; Lu, Qianjin] Chinese Acad Med Sci, Key Lab Basic & Translat Res Immune Mediated Skin, Nanjing, Peoples R China; [Jin, Hui; Zhao, Ming; Lu, Qianjin] Jiangsu Key Lab Mol Biol Skin Dis & STIs, Nanjing, Peoples R China; [Zhou, Shihang] Chongqing Med Univ, Affiliated Hosp 2, Dept Dermatol, Chongqing, Peoples R China; [Li, Fen; Lin, Guanghui] Cent South Univ, Xiangya Hosp 2, Dept Rheumatol & Immunol, Changsha, Peoples R China"

通信作者："Lu, QJ (通讯作者)，Cent South Univ, Xiangya Hosp 2, Dept Dermatol, Hunan Key Lab Med Epigen, Changsha, Peoples R China.; Lu, QJ (通讯作者)，Chinese Acad Med Sci & Peking Union Med Coll, Inst Dermatol, Nanjing, Peoples R China.; Lu, QJ (通讯作者)，Chinese Acad Med Sci, Key Lab Basic & Translat Res Immune Mediated Skin, Nanjing, Peoples R China.; Lu, QJ (通讯作者)，Jiangsu Key Lab Mol Biol Skin Dis & STIs, Nanjing, Peoples R China."

来源：CLINICAL RHEUMATOLOGY

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001008697700001

JCR分区：Q2

影响因子：2.9

年份：2023

卷号：42

期号：9

开始页：2353

结束页：2367

文献类型：Article

关键词：Connective tissue disease; Cross-sectional study; Lupus; Lupus erythematosus

摘要："Objectives This study aims to compare the differences among patients of different onset ages in various subtypes of lupus erythematosus (LE) and to draw a panorama of the clinical characteristics of patients with different onset ages.Method Subjects were recruited from the Lupus Erythematosus Multicenter Case-control Study in Chinese populations (LEMCSC), grouped by the age of onset (childhood-onset: onset < 18 years, adult-onset: onset 18-50 years, late-onset: onset > 50 years). The data collected included demographic characteristics, LE-related systemic involvement, LE-related mucocutaneous manifestations, and laboratory results. All included patients were assigned into three groups: systemic LE (SLE) group (with systemic involvement, with or without mucocutaneous lesions), cutaneous LE (CLE) group (patients who were accompanied by any type of LE-specific cutaneous manifestations), and isolated cutaneous LE (iCLE) group (patients who were in CLE group without systemic involvements). Data were analyzed using R version 4.0.3.Results A total of 2097 patients were involved, including 1865 with SLE and 232 with iCLE. We also identified 1648 patients with CLE among them, as there was some overlap between the SLE population and CLE population (patients with SLE and LE-specific cutaneous manifestations). Later-onset lupus patients seemed to be less female predominance (p < 0.001) and have less systemic involvement (except arthritis), lower positive rates of autoimmune antibodies, less ACLE, and more DLE. Moreover, childhood-onset SLE patients presented a higher risk of LE family history (p = 0.002, vs adult-onset SLE). In contrast to other LE-nonspecific manifestations, the self-reported photosensitivity history decreased with the age of onset in SLE patients (51.8%, 43.4%, and 39.1%, respectively) but increased in iCLE patients (42.4%, 64.9%, and 89.2%, respectively). There was also a gradual increase in self-reported photosensitivity from SLE, CLE, to iCLE in both adult-onset and late-onset lupus patients.Conclusions A negative correlation was suggested between the age of onset and the likelihood of systemic involvement, except for arthritis. As the age of onset increases, patients have a greater propensity to exhibit DLE compared to ACLE. Moreover, the presence of rapid response photodermatitis (i.e., self-reported photosensitivity) was associated with a lower rate of systemic involvement."

基金机构："CAMS Innovation Fund for Medical Sciences (CIFMS) [2021-I2M-1059]; Non-profit Central Research Institute Fund of Chinese Academy of Medical Sciences [2020-RC320-003]; National Natural Science Foundation of China [81830097, 32141004]; Special Program of National Natural Science Foundation of China [81874253]; 15th medium-term special grant of postdoctoral Science Foundation of China [2022T150742]; Excellent postdoctoral innovative talents of Hunan province [2020RC2014]; Natural Science Foundation of Hunan Province China [2021JJ40837]"

基金资助正文："This work was funded by CAMS Innovation Fund for Medical Sciences (CIFMS) No.2021-I2M-1-059, the Non-profit Central Research Institute Fund of Chinese Academy of Medical Sciences (2020-RC320-003) to QL, the National Natural Science Foundation of China (No.81830097) (https:// www. nsfc. gov. cn/) to QL, and the Special Program of National Natural Science Foundation of China (No. 32141004) to QL. The National Natural Science Foundation of China (No. 81874253) (https:// www. nsfc. gov. cn/), the 15th medium-term special grant of postdoctoral Science Foundation of China (2022T150742) (https:// jj. china postd octor. org. cn/ websi te/ index. html), Excellent postdoctoral innovative talents of Hunan province in 2020 (No. 2020RC2014) (http:// kjt. hunan. gov. cn/), and Natural Science Foundation of Hunan Province China (No. 2021JJ40837) (http:// kjt.hunan. gov. cn/) granted funding to HJ."