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KMID : 1084220210280030150
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Journal of Rheumatic Diseases
2021 Volume.28 No. 3 p.150 ~ p.158
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Clinical and Genetic Risk Factors Associated With the Presence of Lupus Nephritis
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Shin Jung-Min
Kim Dam
Kwon Young-Chang
Ahn Ga-Young
Lee Ji-Young
Park Young-Ho
Lee Yeon-Kyung
Lee Tae-Han
Park Dae-Jin
Song Yeo-Jin
Ha Eun-Ji
Kim Kwang-Woo
Bang So-Young
Choi Chan-Bum
Lee Hye-Soon
Bae Sang-Cheol
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Abstract
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Objective: To elucidate whether clinical features and the weighted genetic risk score (wGRS) were associated with the presence of lupus nephritis (LN).
Methods: We retrospectively divided patients with systemic lupus erythematosus (SLE, n=1,078) into biopsy-proven LN (n=507) and non-LN groups (non-LN, n=571). Baseline clinical features, serologic markers, and the wGRS were collected. The wGRS was calculated from 112 non-human leukocyte antigen (non-HLA) loci and HLA-DRβ1 amino acid haplotypes for SLE. Associations among clinical features, wGRS, and the presence of LN were identified.
Results: In the multivariate analysis, patients with LN were younger at diagnosis (odds ratio [OR]=0.97, p<0.001), had more pleuritis (OR=2.44, p<0.001) and pericarditis (OR=1.62, p=0.029), had a higher detection rate of anti-double stranded deoxyribonucleic acid (anti-dsDNA antibodies, OR=2.22, p<0.001), anti-Smith antibodies (anti-Sm antibodies, OR=1.70, p=0.002), low level of complement (OR=1.37, p=0.043) and absence of antiphospholipid antibodies (aPL antibodies, OR=1.60, p=0.002), and had higher wGRS (OR=1.16, p=0.012). Mediation analysis suggested that anti-Sm antibodies and low complement could be mediators in the relationship between high wGRS and the presence of LN.
Conclusion: Onset age, pleuritis, pericarditis, several serologic markers, and wGRS were associated with the presence of LN. Anti-Sm antibodies and low complement appeared to mediate the indirect relationship between wGRS and the presence of LN.
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KEYWORD
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Systemic lupus erythematosus, Lupus nephritis, Genetic risk score, Associated factors
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