Prevalence and characteristics of thyroid diseases in patients with systemic lupus erythematosus
10.3760/cma.j.issn.1007-7480.2014.07.004
- VernacularTitle:系统性红斑狼疮患者伴发甲状腺疾病的患病率及临床分析
- Author:
Hui GAO
;
Chun LI
;
Lijun CHEN
;
Zhanguo LI
- Publication Type:Journal Article
- Keywords:
Lupus erythematosus,systemic;
Lupus nephritis;
Hypothyroidism;
Thyroid diseases
- From:
Chinese Journal of Rheumatology
2014;18(7):449-454
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the prevalence of thyroid diseases in systemic lupus erythematosus (SLE) patients and to analyze the prevalence of subclinical hypothyroidism (SCH) with lupus nephritis (LN).Methods A total of 813 hospitalized SLE patients were retrospectively analyzed.The demographic,clinical and biochemical data were collected.The prevalence of different thyroid diseases was calculated.Among all patients,83 patients with SCH and 562 patients without any thyroid diseases were recruited according to thyroid hormone,thyroid stimulating hormone (TSH) and anti-thyroid antibodies levels.Case control study was performed to explore the potential risk factors for SCH in SLE.T test,Mann-Whitney U test,x2 test and Logistic regression analysis were used for statistical analysis.Results Among the 813 patients,13 (1.6％) had clinical hypothyroidism,83(10.2％) had SCH,13 (1.6％) had central hypothyroidism,27(3.3％) had autoimmunethyroid disease (AITD),10 (1.2％) had hyperthyroidism,95 (11.7％) had euthyroid sick syndrome (ESS) and 11 (1.4％) had nodules.SCH was more frequent in patients with LN (13.7％,50/366) than those without LN [7.4％(33/447),x2=8.654,P＜0.01].Meanwhile,prevalence of LN was also significantly higher in SCH group in case control study [60.2％(50/83) vs 42.9％(241/562),x2=8.800,P＜0.01].Besides,SLE patients with SCH had more severe proteinuria,hypoalbuminemia,and hyperlipidemia,which were complications of LN.In addition,the SCH group presented significantly higher anti-dsDNA antibody positive rate [50.6％(42/83) vs 33.7％(212/562),x2=5.026,P＜0.01].In Logistic regression models,24-hour urine protein and serum creatinine was retained as independent correlated factors with SCH after adjusted for demographic variables,risk factors,and other potential confounders.The presence of SCH was associated with increased 24-hour urine protein levels,occurring in 10.4％ of subjects with 24-hour urine protein ≤ 150 mg,11.9％ with 24-hour urine protein 150.1-1 500 mg,17.2％ with 24-hour urine protein 1 500.1-3 500 mg,and d24.4％ with 24-hour urine protein ＞3 500 mg (P＜0.05 for trend).In addition,when eGFR ≥30 ml·min-1· 1.73 m-2,the prevalence of SCH was increased as eGFR decreased:occurring in 12.8％ with eGFR ≥90 ml·min-1· 1.73 m-2,12.6％ with eGFR 60-89.9 ml·min-1· 1.73 m-2 and 20.0％ with eGFR 30-59.9 ml ·min-1· 1.73 m-2.Conclusion Thyroid diseases are common in SLE patients,and SCH is closely related with LN and disease activity.
