Systemic lupus erythematosus among male patients in Malaysia

how are we different from other geographical regions?

Syahrul Sazliyana Shaharir, W. D.Abdul Kadir, F. Nordin, F. Abu Bakar, M. W.H. Ting, Adawiyah Jamil, Rozita Mohd, Asrul Abdul Wahab

Research output: Contribution to journalArticle

Abstract

Background: Systemic lupus erythematosus (SLE) is an autoimmune disease which predominantly affects females. The disease characteristics in male SLE patients are reported to be distinct and may vary across ethnicities and geographical regions. Objective: To determine and compare the clinical phenotype and organ damage between male and female patients with SLE in Malaysia. Methodology: This was a cross-sectional study involving SLE patients from Universiti Kebangsaan Malaysia Medical Centre from June 2016 until June 2017. Information on their socio-demographics and disease characteristics were obtained from the clinical records. Disease damage was assessed using the Systemic Lupus International Collaborating Clinics/American College of Rheumatology (SLICC/ACR) damage index (SDI) scores. The disease characteristics, autoantibody profiles and organ damage were compared between male and female patients, and multivariable analysis using male sex as dependent variable was then performed. Results: A total of 418 patients were recruited and a total of 59 (14.1%) patients were male. Male patients presented with lower SLE ACR criteria at initial presentation but a significantly higher number of them had renal involvement (lupus nephritis) (78.0% versus 63.8%, p = 0.04). Male patients had less musculoskeletal involvement (45.8% versus 63.0%, p = 0.02) and tended to have lesser mucocutaneous involvement. Immunologic profile revealed that a lower number of male patients had positive anti-Ro antibody (22.7% versus 44.7%, p = 0.04) and they tended to have positive lupus anticoagulant antibody (27.6% versus 14.3%, p = 0.06). Presence of organ damage (SDI score ≥ 1) was significantly higher among males (55.9% versus 39.6%, p = 0.02) with higher renal damage (25.4% versus 9.2%, p = 0.004) and cardiovascular event of ischaemic heart disease or stroke (20.3% versus 7.0%, p = 0.004). They were also inclined to develop damage much earlier as compared to female patients, 3 (interquartile range (IQR) 7.5) versus 5 (IQR 7) years, p = 0.08. The occurrence of disease damage was independently associated with male gender with odds ratio of 1.9 (95% confidence interval 1.1–3.5), p = 0.02. Conclusion: Male patients with SLE have more severe disease with renal damage and cardiovascular event.

Original languageEnglish
Pages (from-to)137-144
Number of pages8
JournalLupus
Volume28
Issue number1
DOIs
Publication statusPublished - 1 Jan 2019

Fingerprint

Malaysia
Systemic Lupus Erythematosus
Kidney
Lupus Coagulation Inhibitor
Lupus Nephritis
Autoantibodies
Autoimmune Diseases
Myocardial Ischemia
Anti-Idiotypic Antibodies
Cross-Sectional Studies
Stroke
Odds Ratio
Demography
Confidence Intervals
Phenotype

Keywords

  • Cardiovascular
  • damage
  • male
  • systemic lupus erythematosus

ASJC Scopus subject areas

  • Rheumatology

Cite this

Systemic lupus erythematosus among male patients in Malaysia : how are we different from other geographical regions? / Shaharir, Syahrul Sazliyana; Kadir, W. D.Abdul; Nordin, F.; Bakar, F. Abu; Ting, M. W.H.; Jamil, Adawiyah; Mohd, Rozita; Abdul Wahab, Asrul.

In: Lupus, Vol. 28, No. 1, 01.01.2019, p. 137-144.

Research output: Contribution to journalArticle

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abstract = "Background: Systemic lupus erythematosus (SLE) is an autoimmune disease which predominantly affects females. The disease characteristics in male SLE patients are reported to be distinct and may vary across ethnicities and geographical regions. Objective: To determine and compare the clinical phenotype and organ damage between male and female patients with SLE in Malaysia. Methodology: This was a cross-sectional study involving SLE patients from Universiti Kebangsaan Malaysia Medical Centre from June 2016 until June 2017. Information on their socio-demographics and disease characteristics were obtained from the clinical records. Disease damage was assessed using the Systemic Lupus International Collaborating Clinics/American College of Rheumatology (SLICC/ACR) damage index (SDI) scores. The disease characteristics, autoantibody profiles and organ damage were compared between male and female patients, and multivariable analysis using male sex as dependent variable was then performed. Results: A total of 418 patients were recruited and a total of 59 (14.1{\%}) patients were male. Male patients presented with lower SLE ACR criteria at initial presentation but a significantly higher number of them had renal involvement (lupus nephritis) (78.0{\%} versus 63.8{\%}, p = 0.04). Male patients had less musculoskeletal involvement (45.8{\%} versus 63.0{\%}, p = 0.02) and tended to have lesser mucocutaneous involvement. Immunologic profile revealed that a lower number of male patients had positive anti-Ro antibody (22.7{\%} versus 44.7{\%}, p = 0.04) and they tended to have positive lupus anticoagulant antibody (27.6{\%} versus 14.3{\%}, p = 0.06). Presence of organ damage (SDI score ≥ 1) was significantly higher among males (55.9{\%} versus 39.6{\%}, p = 0.02) with higher renal damage (25.4{\%} versus 9.2{\%}, p = 0.004) and cardiovascular event of ischaemic heart disease or stroke (20.3{\%} versus 7.0{\%}, p = 0.004). They were also inclined to develop damage much earlier as compared to female patients, 3 (interquartile range (IQR) 7.5) versus 5 (IQR 7) years, p = 0.08. The occurrence of disease damage was independently associated with male gender with odds ratio of 1.9 (95{\%} confidence interval 1.1–3.5), p = 0.02. Conclusion: Male patients with SLE have more severe disease with renal damage and cardiovascular event.",
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AU - Shaharir, Syahrul Sazliyana

AU - Kadir, W. D.Abdul

AU - Nordin, F.

AU - Bakar, F. Abu

AU - Ting, M. W.H.

AU - Jamil, Adawiyah

AU - Mohd, Rozita

AU - Abdul Wahab, Asrul

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N2 - Background: Systemic lupus erythematosus (SLE) is an autoimmune disease which predominantly affects females. The disease characteristics in male SLE patients are reported to be distinct and may vary across ethnicities and geographical regions. Objective: To determine and compare the clinical phenotype and organ damage between male and female patients with SLE in Malaysia. Methodology: This was a cross-sectional study involving SLE patients from Universiti Kebangsaan Malaysia Medical Centre from June 2016 until June 2017. Information on their socio-demographics and disease characteristics were obtained from the clinical records. Disease damage was assessed using the Systemic Lupus International Collaborating Clinics/American College of Rheumatology (SLICC/ACR) damage index (SDI) scores. The disease characteristics, autoantibody profiles and organ damage were compared between male and female patients, and multivariable analysis using male sex as dependent variable was then performed. Results: A total of 418 patients were recruited and a total of 59 (14.1%) patients were male. Male patients presented with lower SLE ACR criteria at initial presentation but a significantly higher number of them had renal involvement (lupus nephritis) (78.0% versus 63.8%, p = 0.04). Male patients had less musculoskeletal involvement (45.8% versus 63.0%, p = 0.02) and tended to have lesser mucocutaneous involvement. Immunologic profile revealed that a lower number of male patients had positive anti-Ro antibody (22.7% versus 44.7%, p = 0.04) and they tended to have positive lupus anticoagulant antibody (27.6% versus 14.3%, p = 0.06). Presence of organ damage (SDI score ≥ 1) was significantly higher among males (55.9% versus 39.6%, p = 0.02) with higher renal damage (25.4% versus 9.2%, p = 0.004) and cardiovascular event of ischaemic heart disease or stroke (20.3% versus 7.0%, p = 0.004). They were also inclined to develop damage much earlier as compared to female patients, 3 (interquartile range (IQR) 7.5) versus 5 (IQR 7) years, p = 0.08. The occurrence of disease damage was independently associated with male gender with odds ratio of 1.9 (95% confidence interval 1.1–3.5), p = 0.02. Conclusion: Male patients with SLE have more severe disease with renal damage and cardiovascular event.

AB - Background: Systemic lupus erythematosus (SLE) is an autoimmune disease which predominantly affects females. The disease characteristics in male SLE patients are reported to be distinct and may vary across ethnicities and geographical regions. Objective: To determine and compare the clinical phenotype and organ damage between male and female patients with SLE in Malaysia. Methodology: This was a cross-sectional study involving SLE patients from Universiti Kebangsaan Malaysia Medical Centre from June 2016 until June 2017. Information on their socio-demographics and disease characteristics were obtained from the clinical records. Disease damage was assessed using the Systemic Lupus International Collaborating Clinics/American College of Rheumatology (SLICC/ACR) damage index (SDI) scores. The disease characteristics, autoantibody profiles and organ damage were compared between male and female patients, and multivariable analysis using male sex as dependent variable was then performed. Results: A total of 418 patients were recruited and a total of 59 (14.1%) patients were male. Male patients presented with lower SLE ACR criteria at initial presentation but a significantly higher number of them had renal involvement (lupus nephritis) (78.0% versus 63.8%, p = 0.04). Male patients had less musculoskeletal involvement (45.8% versus 63.0%, p = 0.02) and tended to have lesser mucocutaneous involvement. Immunologic profile revealed that a lower number of male patients had positive anti-Ro antibody (22.7% versus 44.7%, p = 0.04) and they tended to have positive lupus anticoagulant antibody (27.6% versus 14.3%, p = 0.06). Presence of organ damage (SDI score ≥ 1) was significantly higher among males (55.9% versus 39.6%, p = 0.02) with higher renal damage (25.4% versus 9.2%, p = 0.004) and cardiovascular event of ischaemic heart disease or stroke (20.3% versus 7.0%, p = 0.004). They were also inclined to develop damage much earlier as compared to female patients, 3 (interquartile range (IQR) 7.5) versus 5 (IQR 7) years, p = 0.08. The occurrence of disease damage was independently associated with male gender with odds ratio of 1.9 (95% confidence interval 1.1–3.5), p = 0.02. Conclusion: Male patients with SLE have more severe disease with renal damage and cardiovascular event.

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