Chinese Systemic Lupus Erythematosus Treatment and Research Group Registry VI: Effect of Cigarette Smoking on the Clinical Phenotype of Chinese Patients with Systemic Lupus Erythematosus.
OBJECTIVE
Our study aimed to investigate the effect of cigarette smoking on the clinical phenotype of patients registered in the Chinese Systemic Lupus Erythematosus (SLE) Treatment and Research (CSTAR) group registry database, the first online registry of Chinese patients with SLE.


METHODS
A prospective cross-sectional study of Chinese SLE patients was conducted using the CSTAR. Our case-control analysis was performed on age- and gender-matched subjects to explore the potential effect of cigarette smoking on the clinical manifestation of SLE.


RESULTS
Smokers comprised 8.9% (65/730) of patients, and the ratio of females/males was 19/46. Thirty-nine patients were current smokers, and 26 were ex-smokers. Data showed significant differences between smokers and nonsmokers in the following areas: nephropathy (58.5% vs. 39.2%; p = 0.003), microscopic hematuria (30.8% vs. 19.1%; p = 0.025), proteinuria (53.8% vs. 34.4%; p = 0.002), and SLE Disease Activity Index(DAI) scores (12.38±8.95 vs. 9.83±6.81; p = 0.028). After adjusting for age and gender, significant differences between smokers and nonsmokers were found with photosensitivity (35.9% vs. 18%; p = 0.006), nephropathy (59.4% vs. 39.8%; p = 0.011), and proteinuria (54.7% vs. 35.2%). Although smokers tended to have greater disease severity compared with nonsmokers (SLEDAI scores: 12.58±8.89 vs.10.5±7.09), the difference was not significant (p = 0.081).


CONCLUSIONS
Cigarette smoking triggers the development and exacerbation of SLE, especially with respect to renal involvement. Chinese smokers with SLE should be advised to discontinue cigarette use.
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; No.1 Shuaifuyuan, Beijing, 100730, China.
Dong
D
Xu
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; No.1 Shuaifuyuan, Beijing, 100730, China.
Xin
X
You
Department of Rheumatology, Beijing Tongren Hospital Affiliated to Capital Medical University, NO 1, Dong Jiao Min Xiang, Eastern District, Beijing, 100730, China.
Zhengang
Z
Wang
Department of Rheumatology, the First Affiliated Hospital of Shantou University Medical College, No.57 ChangPingLu, Shantou, 515041, China.
Qingyu
Q
Zeng
Department of Rheumatology, the First Affiliated Hospital of Anhui Medical University, No.218 JiXiLu, Hefei, 230022, China.
Jianhua
J
Xu
Department of Rheumatology, Zhongshan Hospital Affiliated to Fudan University, No.180 FengLinLu, Shanghai, 200032, China.
Lindi
L
Jiang
Department of Rheumatology, the General Hospital of Tianjing Medical University, No.154 AnShanDao, Tianjing, 300052, China.
Lu
L
Gong
Department of Rheumatology, Capital Institute of Pediatrics, No.2 YaBaoLu, Beijing, 100020, China.
Fengqi
F
Wu
Department of Rheumatology, the Third Affiliated Hospital of Sun Yat-sen University, No.600 TianHeLu, Guangzhou, 510630, China.
Jieruo
J
Gu
Department of Rheumatology, the Second Affiliated Hospital of Guangzhou Medical College, No.107 YanJiangXiLu, Guangzhou, 510120, China.
Yi
Y
Tao
Department of Rheumatology, the Second Xiangya Hospital of Central South University, No.139 RenMinZhongLu, Changsha, 410011, China.
Jinwei
J
Chen
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; No.1 Shuaifuyuan, Beijing, 100730, China.
Jiuliang
J
Zhao
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; No.1 Shuaifuyuan, Beijing, 100730, China.
Mengtao
M
Li
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; No.1 Shuaifuyuan, Beijing, 100730, China.
Yan
Y
Zhao
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; No.1 Shuaifuyuan, Beijing, 100730, China.
Xiaofeng
X
Zeng
D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006417:Hematuria / Q000453:epidemiology / Q000473:pathology; D006801:Humans; D007668:Kidney / Q000473:pathology*; D008180:Lupus Erythematosus, Systemic / Q000473:pathology*; D008297:Male; D010787:Photosensitivity Disorders / Q000453:epidemiology / Q000473:pathology; D011446:Prospective Studies; D011507:Proteinuria / Q000453:epidemiology / Q000473:pathology; D012042:Registries; D012907:Smoking / Q000009:adverse effects* / Q000453:epidemiology*