Bridges John, Chung Kara W, Martz Connor D, Smitherman Emily A, Drenkard Cristina, Wu Calvin, Lin Jue, Lim S Sam, Chae David H
Division of Pediatric Rheumatology, University of Alabama at Birmingham, Birmingham, USA.
Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, USA.
ACR Open Rheumatol. 2022 May;4(5):426-431. doi: 10.1002/acr2.11411. Epub 2022 Feb 17.
The study objective was to compare leukocyte telomere length (LTL) among patients with systemic lupus erythematosus (SLE) diagnosed in childhood versus adulthood.
Data are from the Black Women's Experiences Living with Lupus (BeWELL) study. Multivariable linear regression analyses that examined childhood diagnosis of SLE (diagnosed before 18 years of age), age, and their interaction in relationship to LTL were conducted, adjusting for a range of demographic, socioeconomic, and health-related covariates.
The total analytic sample size was 415. Forty participants (9.6%) were diagnosed in childhood. There was no main effect of childhood diagnosis on LTL (b = 0.007; 95% confidence interval [CI]: -0.089 to 0.103). However, the interaction between age and childhood diagnosis was significant (b = -0.008; 95% CI: -0.016 to -0.001), indicating a steeper inverse association between age and LTL among those diagnosed in childhood compared with those diagnosed in adulthood. This interaction remained statistically significant (P = 0.024) after controlling for disease duration measured dichotomously (less than 10 years vs. 10 years or more); it was marginally significant (P = 0.083) when controlling for disease duration measured continuously.
This cross-sectional analysis suggests that Black women with childhood-onset SLE may undergo accelerated LTL shortening compared with their adult-onset counterparts. This relationship persisted even after controlling for differences in SLE damage and disease duration. These findings inform research on immunosenescence mechanisms of SLE.
本研究的目的是比较儿童期与成年期诊断的系统性红斑狼疮(SLE)患者的白细胞端粒长度(LTL)。
数据来自狼疮患者黑人女性经历(BeWELL)研究。进行了多变量线性回归分析,研究儿童期SLE诊断(18岁之前诊断)、年龄及其与LTL的相互作用,并对一系列人口统计学、社会经济和健康相关协变量进行了调整。
总分析样本量为415。40名参与者(9.6%)在儿童期被诊断。儿童期诊断对LTL没有主要影响(b = 0.007;95%置信区间[CI]:-0.089至0.103)。然而,年龄与儿童期诊断之间的相互作用具有显著性(b = -0.008;95%CI:-0.016至-0.001),表明与成年期诊断的患者相比,儿童期诊断的患者年龄与LTL之间的负相关关系更陡峭。在二分法测量疾病持续时间(小于10年与10年或更长时间)后,这种相互作用仍具有统计学显著性(P = 0.024);在连续测量疾病持续时间时,其具有边缘显著性(P = 0.083)。
这项横断面分析表明,与成年期发病的黑人女性SLE患者相比,儿童期发病的患者可能会经历更快的LTL缩短。即使在控制了SLE损伤和疾病持续时间的差异后,这种关系仍然存在。这些发现为SLE免疫衰老机制的研究提供了信息。