Park Su Jin, Ahn Moon Bae, Jeong Dae Chul
Division of Endocrinology, Department of Pediatrics, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Division of Rheumatology, Department of Pediatrics, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Front Med (Lausanne). 2025 Feb 6;12:1429337. doi: 10.3389/fmed.2025.1429337. eCollection 2025.
Juvenile-onset systemic lupus erythematosus (JSLE) is a chronic autoimmune disease affecting individuals under 18, causing multi-system impairment. Patients with JSLE exhibit more severe disease when compared to patients with adult-onset SLE. This study aimed to evaluate the prevalence of endocrine and metabolic comorbidities in patients with JSLE, and analyze the factors associated with each comorbidity.
Anthropometric, clinical, laboratory data, and the details of glucocorticoids and disease-modifying anti-rheumatic drugs use were collected.
A total of 57 patients with JSLE (48 girls and 9 boys) were included in this study. Endocrine and metabolic comorbidities were observed in 64.9% of the patients. The most prevalent comorbidities were dyslipidemia (40.4%), being overweight or obese (26.3%), subclinical hypothyroidism (24.6%), autoimmune thyroid disease (AITD) (21.1%), and low bone mass (20.9%). The risk of dyslipidemia and AITD increased in patients who were overweight or obese. The risk of being overweight or obese was associated with skin involvement at diagnosis and rheumatoid factor positivity. Younger age at diagnosis and longer duration of glucocorticoid exposure increased the risk of low bone mass. The overall prevalence of endocrine and metabolic comorbidities was associated with short stature at diagnosis, being overweight or obese at follow-up, skin involvement at diagnosis, and rheumatoid factor positivity.
Patients with JSLE have higher burdens of endocrine and metabolic comorbidities and should be routinely monitored. Prevention of obesity may be helpful in lowering the risk of comorbidities.
青少年起病的系统性红斑狼疮（JSLE）是一种影响18岁以下个体的慢性自身免疫性疾病，可导致多系统损害。与成人起病的系统性红斑狼疮（SLE）患者相比，JSLE患者的病情更为严重。本研究旨在评估JSLE患者内分泌和代谢合并症的患病率，并分析与每种合并症相关的因素。
收集人体测量学、临床、实验室数据以及糖皮质激素和改善病情抗风湿药物的使用细节。
本研究共纳入57例JSLE患者（48例女孩和9例男孩）。64.9%的患者存在内分泌和代谢合并症。最常见的合并症为血脂异常（40.4%）、超重或肥胖（26.3%）、亚临床甲状腺功能减退（24.6%）、自身免疫性甲状腺疾病（AITD）（21.1%）和低骨量（20.9%）。超重或肥胖患者发生血脂异常和AITD的风险增加。超重或肥胖的风险与诊断时的皮肤受累及类风湿因子阳性有关。诊断时年龄较小和糖皮质激素暴露时间较长会增加低骨量的风险。内分泌和代谢合并症的总体患病率与诊断时身材矮小、随访时超重或肥胖、诊断时皮肤受累及类风湿因子阳性有关。
JSLE患者的内分泌和代谢合并症负担较重，应进行常规监测。预防肥胖可能有助于降低合并症的风险。
