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Wang Q, Lu X, Xu L, Liang H. Gender variations in the impact of hyperuricemia on thyroid disorders. Endocr Res 2023; 48:77-84. [PMID: 37382510 DOI: 10.1080/07435800.2023.2231092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 06/23/2023] [Indexed: 06/30/2023]
Abstract
This study aimed to examine the impact of hyperuricemia on various thyroid disorders with emphasized focus on differences resulting from different genders. 16094 adults aged ≥18 years were enrolled in this cross-sectional study using a randomized stratified sampling strategy. Clinical data including thyroid function and antibodies, uric acid, and anthropometric measurements were measured. Multivariable logistic regression was used to determine the association between hyperuricemia and thyroid disorders. Women who have hyperuricemia are at a significantly increased risk of developing hyperthyroidism. Women's risk of overt hyperthyroidism and Graves' disease may be markedly increased by hyperuricemia. Men with hyperuricemia did not differ significantly in their chance of acquiring any thyroid disorders.
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Affiliation(s)
- Qiang Wang
- Medical Education Administrate Office, People's Hospital of Ningxia Hui Autonomous Region, Yinchuan, China
| | - Xixuan Lu
- Department of Endocrinology, Cardiovascular and Cerebrovascular Disease Hospital, General Hospital of Ningxia Medical University, Yinchuan, China
| | - Li Xu
- Department of Radiology, The 942th Hospital of the People's Liberation Army Joint Logistics Support Force, Yinchuan, China
| | - Haiyan Liang
- Department of Endocrinology, Cardiovascular and Cerebrovascular Disease Hospital, General Hospital of Ningxia Medical University, Yinchuan, China
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2
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Ceccarelli F, Perricone C, Natalucci F, Picciariello L, Olivieri G, Cafaro G, Bartoloni E, Roberto G, Conti F. Organ damage in Systemic Lupus Erythematosus patients: A multifactorial phenomenon. Autoimmun Rev 2023:103374. [PMID: 37301273 DOI: 10.1016/j.autrev.2023.103374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 06/04/2023] [Indexed: 06/12/2023]
Abstract
The prevention of chronic damage, especially in early disease phases, remains an unmet need in the management of Systemic Lupus Erythematous (SLE) patients, despite the application of a so-called treat-to-target strategy. The high proportion of SLE patients developing chronic damage suggests a multifactorial aetiology. Thus, besides disease activity, other factors may contribute to the development of damage. The revision of data published so far underlines that, next to disease activity, it is possible to identify other factors playing a relevant role in damage development and progression. In summary, the presence of antiphospholipid antibodies and drugs used to treat SLE patients, in particular glucocorticoids, is strongly associated with SLE-related damage. Furthermore, recent data suggests the possible role of genetic background in determining the development of specific organ damage, in particular renal and neurological. Nonetheless, demographic factors, such as age, sex and disease duration could exert a role along with the presence of comorbidities. The contribution of different factors in determining damage development suggests the need for new outcomes to assess a comprehensive disease control including not only the assessment of disease activity, but also the evaluation of chronic damage development.
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Affiliation(s)
- Fulvia Ceccarelli
- Lupus Clinic, Division of Rheumatology, Department of Internal Clinical Sciences, Anaesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Carlo Perricone
- Rheumatology Unit, Department of Medicine and Surgery, University of Perugia, Perugia, Italy.
| | - Francesco Natalucci
- Lupus Clinic, Division of Rheumatology, Department of Internal Clinical Sciences, Anaesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Licia Picciariello
- Lupus Clinic, Division of Rheumatology, Department of Internal Clinical Sciences, Anaesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Giulio Olivieri
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy; Research Unit of Clinical Immunology and Vaccinology, Bambino Gesù Children's Hospital, Rome, Italy
| | - Giacomo Cafaro
- Rheumatology Unit, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Elena Bartoloni
- Rheumatology Unit, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Gerli Roberto
- Rheumatology Unit, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Fabrizio Conti
- Lupus Clinic, Division of Rheumatology, Department of Internal Clinical Sciences, Anaesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
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3
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Campos-López B, Meza-Meza MR, Pesqueda-Cendejas K, Ruiz-Ballesteros AI, Rivera-Escoto M, Vargas-Morales JM, Parra-Rojas I, Mora-García PE, Vizmanos B, Montoya-Buelna M, Cerpa-Cruz S, De la Cruz-Mosso U. Nutritional, biochemical, and clinical determinants of hyperuricemia in systemic lupus erythematosus patients: Relationship with clinical and renal disease activity. Lupus 2023; 32:270-283. [PMID: 36562214 DOI: 10.1177/09612033221146923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Systemic lupus erythematosus (SLE) is the prototypical autoimmune disease considered as an independent risk factor for mortality by cardiovascular disease. Currently, uric acid is described as a novel biomarker associated with cardiometabolic risk. However, nutritional and serum determinants that influence hyperuricemia development in autoimmune diseases have not been fully elucidated. This study aimed to assess the nutritional, biochemical, and cardiometabolic determinants of hyperuricemia and its relationship with clinical variables in SLE patients. A cross-sectional study was conducted in 167 SLE patients and 195 control subjects (CS). Nutrient intake, anthropometry, biochemical, and cardiometabolic indexes were evaluated. In SLE patients, adequate protein (OR = 0.4; p = 0.04) and carbohydrate (OR = 0.2; p = 0.01) intakes were associated with a lower risk of hyperuricemia. SLE patients with hyperuricemia presented a higher risk of clinical (OR = 2.2; p = 0.03) and renal activity (OR = 3.4; p < 0.01), as well as triglycerides ≥150 mg/dL (OR = 3.6; p < 0.01), hs-CRP ≥1 mg/L (OR = 3.1; p < 0.01), Kannel score ≥3 (OR = 2.5; p = 0.02), and BMI ≥25 kg/m2 (OR = 2.2; p = 0.02). Oppositely, serum levels of HDL-C ≥40 mg/dL (OR = 0.2; p < 0.01) were associated with a lower risk of hyperuricemia. According to the pharmacotherapy administered, prednisone treatment was associated with a high risk of hyperuricemia (OR = 4.7; p < 0.001). In contrast, the hydroxychloroquine treatment was associated with a lower risk of hyperuricemia (OR = 0.4; p = 0.02). In conclusion, SLE patients with hyperuricemia presented a high risk of clinical and renal activity as well as worse cardiometabolic status. Notably, an adequate intake of protein, carbohydrates, healthy HDL-C serum levels, and hydroxychloroquine treatment could be determinants of lower risk of hyperuricemia.
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Affiliation(s)
- Bertha Campos-López
- Red de Inmunonutrición y Genómica Nutricional en las Enfermedades Autoinmunes, Centro Universitario de Ciencias de la Salud, 27802Universidad de Guadalajara, Guadalajara, Mexico.,Instituto de Neurociencias Traslacionales, Departamento de Neurociencias, Centro Universitario de Ciencias de la Salud, 27802Universidad de Guadalajara, Guadalajara, Mexico
| | - Mónica R Meza-Meza
- Red de Inmunonutrición y Genómica Nutricional en las Enfermedades Autoinmunes, Centro Universitario de Ciencias de la Salud, 27802Universidad de Guadalajara, Guadalajara, Mexico.,Instituto de Neurociencias Traslacionales, Departamento de Neurociencias, Centro Universitario de Ciencias de la Salud, 27802Universidad de Guadalajara, Guadalajara, Mexico
| | - Karen Pesqueda-Cendejas
- Red de Inmunonutrición y Genómica Nutricional en las Enfermedades Autoinmunes, Centro Universitario de Ciencias de la Salud, 27802Universidad de Guadalajara, Guadalajara, Mexico.,Instituto de Neurociencias Traslacionales, Departamento de Neurociencias, Centro Universitario de Ciencias de la Salud, 27802Universidad de Guadalajara, Guadalajara, Mexico
| | - Adolfo I Ruiz-Ballesteros
- Red de Inmunonutrición y Genómica Nutricional en las Enfermedades Autoinmunes, Centro Universitario de Ciencias de la Salud, 27802Universidad de Guadalajara, Guadalajara, Mexico.,Instituto de Neurociencias Traslacionales, Departamento de Neurociencias, Centro Universitario de Ciencias de la Salud, 27802Universidad de Guadalajara, Guadalajara, Mexico
| | - Melissa Rivera-Escoto
- Red de Inmunonutrición y Genómica Nutricional en las Enfermedades Autoinmunes, Centro Universitario de Ciencias de la Salud, 27802Universidad de Guadalajara, Guadalajara, Mexico.,Instituto de Neurociencias Traslacionales, Departamento de Neurociencias, Centro Universitario de Ciencias de la Salud, 27802Universidad de Guadalajara, Guadalajara, Mexico
| | - Juan M Vargas-Morales
- Red de Inmunonutrición y Genómica Nutricional en las Enfermedades Autoinmunes, Centro Universitario de Ciencias de la Salud, 27802Universidad de Guadalajara, Guadalajara, Mexico.,Facultad de Ciencias Químicas, Universidad Autónoma de San Luis Potosí, San Luis Potosí, Mexico
| | - Isela Parra-Rojas
- Red de Inmunonutrición y Genómica Nutricional en las Enfermedades Autoinmunes, Centro Universitario de Ciencias de la Salud, 27802Universidad de Guadalajara, Guadalajara, Mexico.,Laboratorio de Investigación en Obesidad y Diabetes, Facultad de Ciencias Químico-Biológicas, Universidad Autónoma de Guerrero, Chilpancingo de los Bravo, Mexico
| | - Paulina E Mora-García
- Red de Inmunonutrición y Genómica Nutricional en las Enfermedades Autoinmunes, Centro Universitario de Ciencias de la Salud, 27802Universidad de Guadalajara, Guadalajara, Mexico.,Instituto de Neurociencias Traslacionales, Departamento de Neurociencias, Centro Universitario de Ciencias de la Salud, 27802Universidad de Guadalajara, Guadalajara, Mexico
| | - Barbara Vizmanos
- Red de Inmunonutrición y Genómica Nutricional en las Enfermedades Autoinmunes, Centro Universitario de Ciencias de la Salud, 27802Universidad de Guadalajara, Guadalajara, Mexico
| | - Margarita Montoya-Buelna
- Red de Inmunonutrición y Genómica Nutricional en las Enfermedades Autoinmunes, Centro Universitario de Ciencias de la Salud, 27802Universidad de Guadalajara, Guadalajara, Mexico.,Laboratorio de Inmunología, Departamento de Fisiología, Centro Universitario de Ciencias de la Salud, 27802Universidad de Guadalajara, Guadalajara, Mexico
| | - Sergio Cerpa-Cruz
- Departamento de Reumatología, O. P. D. Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara, Mexico
| | - Ulises De la Cruz-Mosso
- Red de Inmunonutrición y Genómica Nutricional en las Enfermedades Autoinmunes, Centro Universitario de Ciencias de la Salud, 27802Universidad de Guadalajara, Guadalajara, Mexico.,Instituto de Neurociencias Traslacionales, Departamento de Neurociencias, Centro Universitario de Ciencias de la Salud, 27802Universidad de Guadalajara, Guadalajara, Mexico
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Han Y, Lu X, Xiao S, Qin J, Zheng L, Feng Y, Cai Y, Qiu R, Huang Q, Yang M. Association between serum uric acid level and systemic lupus erythematosus kidney outcome: An observational study in Southern Chinese population and a meta-analysis. Lupus 2023; 32:83-93. [PMID: 36396610 DOI: 10.1177/09612033221140267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The study aimed to explore the effect of serum uric acid (SUA) level on the progression of kidney function in systemic lupus erythematosus (SLE) patients. METHODS A total of 123 biopsy-proven lupus nephritis (LN) patients were included in this retrospective observational study. Cox proportional hazard regression analyses as well as restricted cubic spline analyses were performed to identify predictors of renal outcome in LN patients. We also performed a systematic review and meta-analysis for SUA and overall kidney outcomes in SLE patients. RESULTS Based on the laboratory tests at renal biopsy, 72 (58.5%) of the 123 patients had hyperuricemia. The median (IQR) follow-up duration was 3.67 years (1.79-6.63 years), and a total of 110 (89.4%) patients experienced progression of LN. Increased serum uric acid level, whether analyzed as continuous or categorical variable, was associated with higher risk of LN progression in Cox proportional hazard regression model (hazard ratio [HR]: 1.003, 95% confidence interval [CI]: 1.001-1.005; HR: 1.780, 95% CI: 1.201-2.639, respectively). This relationship maintained in women (HR: 1.947, 95% CI: 1.234-3.074) but not men (HR: 2.189, 95% CI: 0.802-5.977). The meta-analysis showed a similar result that both continuous and categorical SUA were positively associated with the risk of kidney function progression in LN (weighted mean difference [WMD]: 1.73, 95% CI: 0.97-2.49; odds ratio [OR]: 1.55, 95% CI: 1.20-2.01, respectively). CONCLUSIONS Our study found overall and especially in women that higher SUA in LN patients were associated with increased risk of renal progression. Meta-analysis yielded consistent results. Future studies are required to establish if uric acid can be used as a biomarker for risk assessment and/or as a novel therapeutic target in SLE.
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Affiliation(s)
- Yipeng Han
- Department of Rheumatology and Immunology, Nanfang Hospital, 198153Southern Medical University, Guangzhou, China
| | - Xiaoxi Lu
- Department of Rheumatology and Immunology, Nanfang Hospital, 198153Southern Medical University, Guangzhou, China
| | - Shibai Xiao
- Department of Rheumatology and Immunology, Nanfang Hospital, 198153Southern Medical University, Guangzhou, China
| | - Jiayu Qin
- Department of Rheumatology and Immunology, Nanfang Hospital, 198153Southern Medical University, Guangzhou, China
| | - Lijuan Zheng
- Department of Rheumatology and Immunology, Nanfang Hospital, 198153Southern Medical University, Guangzhou, China
| | - Yi Feng
- Department of Rheumatology and Immunology, Nanfang Hospital, 198153Southern Medical University, Guangzhou, China
| | - Yujie Cai
- Department of Rheumatology and Immunology, Nanfang Hospital, 198153Southern Medical University, Guangzhou, China
| | - Rong Qiu
- Department of Rheumatology and Immunology, Nanfang Hospital, 198153Southern Medical University, Guangzhou, China
| | - Qin Huang
- Department of Rheumatology and Immunology, Nanfang Hospital, 198153Southern Medical University, Guangzhou, China
| | - Min Yang
- Department of Rheumatology and Immunology, Nanfang Hospital, 198153Southern Medical University, Guangzhou, China
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Wen Q, Tang X, Zhou Q, Chen W, Yu X. Clinicopathological Patterns and Outcomes in Patients with Lupus Nephritis and Hyperuricemia. J Clin Med 2022; 11:jcm11113075. [PMID: 35683463 PMCID: PMC9181739 DOI: 10.3390/jcm11113075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 05/21/2022] [Indexed: 12/04/2022] Open
Abstract
A limited number of large cohort studies have reported the clinicopathological characteristics and prognosis of patients with lupus nephritis (LN) and hyperuricemia (HUA). In this retrospective cohort study, 1297 LN patients were enrolled from January 1996 to December 2011 in the First Affiliated Hospital of Sun Yat-Sen University, and HUA occurred in 649 (50.04%) of these 1297 LN patients. Compared to patients without HUA, those with HUA presented with higher blood pressure and triglyceride levels, lower hemoglobin and serum albumin levels, worse renal function, more severe hematuria and proteinuria, higher lupus activity, and more positive antiphospholipid antibody. Pathologically, HUA cases presented more crescents, a higher degree of mesangial matrix, endothelial cell proliferation, and inflammatory cell infiltration. During the 52-month follow-up, the 5-year and 10-year incidence rates of renal endpoint events were 11.1% and 19.5% in the HUA group, and 8.3% and 13.8% in the non-HUA group, respectively (p = 0.073). In addition, the 5-year and 10-year mortality rates did not differ significantly between the HUA (12.0% and 18.2%) and non-HUA (12.2% and 17.5%) groups, respectively. This study verified that HUA was not an independent risk for poor clinical outcomes, and steroids that delay the deterioration of renal function did not affect the survival of these patients.
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Affiliation(s)
- Qiong Wen
- Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China; (Q.W.); (X.T.); (X.Y.)
- NHC Key Laboratory of Clinical Nephrology (Sun Yat-sen University), Guangzhou 510080, China
- Guangdong Provincial Key Laboratory of Nephrology, Guangzhou 510080, China
| | - Xueqing Tang
- Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China; (Q.W.); (X.T.); (X.Y.)
- NHC Key Laboratory of Clinical Nephrology (Sun Yat-sen University), Guangzhou 510080, China
- Guangdong Provincial Key Laboratory of Nephrology, Guangzhou 510080, China
- Department of Nephrology, The First Affiliated Hospital of Shandong First Medical University (Shandong Provincial Qianfoshan Hospital), Jinan 250014, China
| | - Qian Zhou
- Clinical Trials Unit, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China;
| | - Wei Chen
- Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China; (Q.W.); (X.T.); (X.Y.)
- NHC Key Laboratory of Clinical Nephrology (Sun Yat-sen University), Guangzhou 510080, China
- Guangdong Provincial Key Laboratory of Nephrology, Guangzhou 510080, China
- Correspondence: ; Tel./Fax: +86-020-87769673
| | - Xueqing Yu
- Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China; (Q.W.); (X.T.); (X.Y.)
- NHC Key Laboratory of Clinical Nephrology (Sun Yat-sen University), Guangzhou 510080, China
- Guangdong Provincial Key Laboratory of Nephrology, Guangzhou 510080, China
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