Clinical Analysis Of Patients With Systemic Lupus Erythematosus Combined With Abnormal Thyroid Function

Objective: A retrospective analysis of the differences in clinical characteristics between patients with SLE combined with hyperthyroidism or hypothyroidism and those with normal thyroid function in SLE was performed in order to identify risk factors associated with abnormal thyroid function in SLE in a timely manner.Methods: Retrospective analysis of 974 patients who were diagnosed and admitted to the Second Affiliated Hospital of Kunming Medical University from June2013 to June 2021 and discharged with the main diagnosis of systemic lupus erythematosus,lupus encephalitis,lupus nephritis and thyroid function examination.According to the normal thyroid function,patients were divided into SLE combined with hyperthyroidism or hypothyroidism group(hereinafter referred to as comorbidities group)and SLE normal thyroid function group(hereinafter referred to as monopathy group).General data,morbidity,systemic involvement,major laboratory examinations,major therapeutic drugs and disease outcomes of patients were statistically analyzed.Results: 1.A total of 974 patients met the inclusion and exclusion criteria,including 301 patients in the comorbiditis group,including 32 males(10.6%)and 269females(89.4%),with a male-to-female ratio of 1:8.40.There were 673 cases in the single disease group,including 86 males(12.8%)and 587 females(87.2%),with a male to female ratio of 1:6.81.There was no significant difference in gender composition between the two groups,and the age of onset of disease(P=0.010)and the age of seeking medical treatment(P=0.040)in the comorbidity group were significantly higher than those in the single disease group.In the 301 comorbidities group,45 cases(4.62%)of hyperthyroidism(including subclinical hyperthyroidism)and 256 cases(26.28%)of hypothyroidism(including subclinical hypothyroidism)were found.2.The incidence of respiratory system involvement in the comorbidity group was significantly higher than that in the single disease group(P=0.049),and the incidence of light sensitivity,thrombosis,kidney involvement,blood system involvement and joint muscle symptoms in the comorbidity group was higher than that in the single disease group,but the difference was not statistically significant.3.The red blood cell count in the comorbidities group was significantly lower than that in the single disease group(P=0.027).The levels of glutamic oxalacetic transaminase,lactate dehydrogenase,creatine kinase,creatinine,uric acid,triglyceride,anti-thyroglobulin antibody(TGAB),thyrotropin receptor antibody(TRAB),thyroid peroxidase antibody(ATPO)and free triiodothyronine(FT3)in comorbidity group were significantly higher than those in single disease group,with P <0.05.The difference was statistically significant.4.The use rate of immunosuppressant in the comorbidities group was significantly lower than that in the single disease group(P=0.020),and there were no significant differences in the use of glucocorticoid,maximum daily hormone dosage(all converted to prednisone dose)and hydroxychloroquine sulfate tablets between the two groups.5.Logistic regression analysis suggested that anti-thyroglobulin antibody,thyrotropin receptor antibody,thyroid peroxidase antibody and free triiodothyronine were independent risk factors for SLE complicated with hyperthyroidism or hypothyroidism,and immunosuppressive drugs were protective factors for SLE complicated with hyperthyroidism or hypothyroidism.Conclusions:Older SLE patients are more likely to be combined with hyperthyroidism or hypothyroidism;SLE combined with hyperthyroidism or hypothyroidism are more likely to have respiratory system involvement;SLE patients should have routine thyroid function tests to facilitate early diagnosis and timely treatment;timely use of immunosuppressants in SLE patients can help reduce the occurrence of thyroid function abnormalities.