title: Chinese SLE Treatment and Research group (CSTAR) registry: V. gender impact on Chinese patients with systemic lupus erythematosus.
abstract: BACKGROUND
  Many studies have shown that differences were observed between male and female lupus patients. Although systemic lupus erythematosus (SLE) affects mostly females (female:male ratio 9:1), male SLE patients show higher mortality due to kidney and neurological disease. Currently there are limited epidemiological data concerning lupus in the Chinese population. As such, the Chinese SLE Treatment and Research group (CSTAR) developed the first online registry of Chinese lupus patients in 2009, and represents a multicenter observational study that attempts to describe and compile the major clinical characteristics of lupus in Chinese patients.
  
  
  OBJECTIVE
  To investigate the effect of gender on the phenotypes of Chinese SLE patients.
  
  
  METHODS
  Data for 2104 SLE patients were prospectively collected and included in the CSTAR registry. Patients fulfilled the 1997 American College of Rheumatology (ACR) SLE classification criteria. We conducted a cross-sectional case-control study to analyze patient clinical and laboratory data at onset and at enrollment. SLE disease activity scores (SLEDAI) were also measured at enrollment.
  
  
  RESULTS
  This study included 1914 women and 190 men. Males and females showed no differences in mean ages at onset, delay of diagnosis and disease duration. Males presented more frequently with fever (p = 0.003), while musculoskeletal involvement (p = 0.001) and cytopenia (p = 0.017) was more common in females as the initial manifestation at onset of SLE. For manifestations at enrollment, males presented more frequently with fever (p = 0.005), renal disease (p = 0.019), vasculitis (p = 0.032) and neuropsychiatric lupus (p = 0.007). For cumulative manifestations at enrollment, males presented more frequently with discoid rash (p < 0.001) and neuropsychiatric lupus (p = 0.036), while less frequently with arthritis (p = 0.011). However, the laboratory data showed no significant differences between the two groups at enrollment. Males also had higher SLEDAI scores at enrollment (p = 0.002).
  
  
  CONCLUSIONS
  Renal disease, vasculitis and neuropsychiatric lupus are more common in male SLE patients with higher SLEDAI scores compared to female SLE patients in China.
authors.affiliation: Department of Rheumatology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China.
authors.forename: S
authors.initials: S
authors.lastname: Zhang
authors.affiliation: Department of Rheumatology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China.
authors.forename: J
authors.initials: J
authors.lastname: Su
authors.affiliation: Department of Rheumatology, the Second Hospital of Shanxi Medical University, Shanxi, China.
authors.forename: X
authors.initials: X
authors.lastname: Li
authors.affiliation: Department of Rheumatology, Guangdong Provincial People's Hospital, Guangzhou, China.
authors.forename: X
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Department of Rheumatology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
authors.forename: S
authors.initials: S
authors.lastname: Liu
authors.affiliation: Department of Rheumatology, the People's Hospital of Xinjiang Autonomous, Urumqi, China.
authors.forename: L
authors.initials: L
authors.lastname: Wu
authors.affiliation: Department of Rheumatology, China-Japan Friendship Hospital Affiliated to the Ministry of Health of PRC, Beijing, China.
authors.forename: L
authors.initials: L
authors.lastname: Ma
authors.affiliation: Department of Rheumatology, Sino-Japanese Friendship Hospital of Jilin University, Changchun, China.
authors.forename: L
authors.initials: L
authors.lastname: Bi
authors.affiliation: Department of Rheumatology, Xiangya Hospital, Central South University, Changsha, China.
authors.forename: X
authors.initials: X
authors.lastname: Zuo
authors.affiliation: Department of Rheumatology, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China.
authors.forename: L
authors.initials: L
authors.lastname: Sun
authors.affiliation: Department of Rheumatology, Beijing Hospital Affiliated to the Ministry of Health of PRC, Beijing, China.
authors.forename: C
authors.initials: C
authors.lastname: Huang
authors.affiliation: Department of Rheumatology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China.
authors.forename: J
authors.initials: J
authors.lastname: Zhao
authors.affiliation: Department of Rheumatology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China.
authors.forename: M
authors.initials: M
authors.lastname: Li
authors.affiliation: Department of Rheumatology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China zengxfpumc@163.com.
authors.forename: X
authors.initials: X
authors.lastname: Zeng
mesh_terms: D000293:Adolescent; D000328:Adult; D044466:Asian People; D016022:Case-Control Studies; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000453:epidemiology*; D008180:Lupus Erythematosus, Systemic / Q000453:epidemiology*; D020945:Lupus Vasculitis, Central Nervous System / Q000453:epidemiology*; D008297:Male; D012042:Registries; D012720:Severity of Illness Index; D017678:Sex Distribution; D012737:Sex Factors; D055815:Young Adult
keywords: SLEDAI; Systemic lupus erythematosus (SLE); gender