Journal
JOURNAL OF RHEUMATOLOGY
Volume 37, Issue 8, Pages 1667-1672Publisher
J RHEUMATOL PUBL CO
DOI: 10.3899/jrheum.091028
Keywords
ALBUMIN; BIOMARKER; LUPUS NEPHRITIS; SYSTEMIC LUPUS ERYTHEMATOSUS
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Funding
- Canadian Institutes of Health Research [QNT 78341, MOP-64336]
- Arthritis Centre of Excellence, University of Toronto
- Lupus Canada
- Lupus Ontario
- Lupus Foundation of Ontario
- BC Lupus as well as the Arthritis and Autoimmune Research Centre Foundation
- Smythe Foundation
- Dance for the Cure
- Flare for Fashion
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Objective. To determine whether serum albumin reflects disease activity in patients with systemic lupus erythematosus (SLE) with and without nephritis (LN, LNN), and whether scrum 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 scrum 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. (First Release June 1 2010; J Rheumatol 2010;37:1667-72; doi:10.3899/jrheum.091028)
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