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Serum Albumin as a Marker for Disease Activity in Patients with Systemic Lupus Erythematosus

医学 狼疮性肾炎 蛋白尿 内科学 白蛋白 肾炎 胃肠病学 全身性疾病 肾活检 血清白蛋白 系统性红斑狼疮 红斑狼疮 免疫学 活检 疾病 抗体
作者
Jonathan Yip,Elaheh Aghdassi,Jiandong Su,Wendy Lou,Heather N. Reich,Joanne M. Bargman,James W. Scholey,Dafna D. Gladman,Murray B. Urowitz,Paul R. Fortin
出处
期刊:The Journal of Rheumatology [The Journal of Rheumatology Publishing Company Limited]
卷期号:37 (8): 1667-1672 被引量:48
标识
DOI:10.3899/jrheum.091028
摘要

Objective. To determine whether serum albumin reflects disease activity in patients with systemic lupus erythematosus (SLE) with and without nephritis (LN, LNN), and whether serum albumin could be a surrogate marker of SLE disease activity overall. There is currently no clinical “gold standard” in the assessment of disease activity in SLE. Methods. Patients with ≥ 3 clinic visits within a maximum followup period of 10 years were selected from the University of Toronto Lupus Clinic database. Subjects were divided into 3 groups: LN-B, those with nephritis defined by histological findings on renal biopsies; LN-L, those with nephritis defined by laboratory abnormalities in the absence of biopsy; and LNN, those without nephritis. In a subanalysis, the renal groups were further stratified by proteinuria status. The associations of SLE-Disease Activity Index (SLEDAI-2K) with serum albumin and dsDNA were examined using the mixed model regression analysis. Results. A total of 1078 patients were studied: 89.1% female, 71.5% white, mean age 33.6 (SD 12.6) years, and with median baseline SLEDAI-2K of 8. Serum albumin was more significantly associated with SLEDAI in LN-B and LN-L. The association was also present but weaker in the LNN group. In all LN, the associations between serum albumin and SLEDAI-2K were stronger in those with proteinuria. Conclusion. In patients with SLE, higher SLEDAI was associated with lower serum albumin levels.
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