A systematic review exploring the bidirectional relationship between puberty and autoimmune rheumatic diseases

Pediatric Rheumatology

Hannah Peckham¹  Anna Radziszewska¹  Meena Naja¹  Coziana Ciurtin¹  Nina M. de Gruijter²  Elizabeth C. Rosser²  Elizabeth C. Jury³  Gary E. Butler⁴  James Glenister⁵  Matthew Kinsella⁵ 

[1] Centre for Adolescent Rheumatology Versus Arthritis, Department of Medicine, University College London, Rayne Building, W1CE 6JF, London, UK;Centre for Adolescent Rheumatology Versus Arthritis, Department of Medicine, University College London, Rayne Building, W1CE 6JF, London, UK;Centre for Rheumatology Research, Division of Medicine, University College London, London, UK;Centre for Rheumatology Research, Division of Medicine, University College London, London, UK;Department of Paediatric & Adolescent Medicine and Endocrinology, University College London Hospital NHS Foundation Trust; University College London Great Ormond Street Institute of Child Health, London, UK;University College London Medical School, London, UK;

关键词: Autoimmune rheumatic diseases;    Puberty;    Adolescence;    Sex hormones;    Systemic lupus erythematosus;    Juvenile idiopathic arthritis;   

DOI  :  10.1186/s12969-021-00528-y

来源: Springer

【 摘 要 】

BackgroundAutoimmune rheumatic diseases (ARDs) are associated with a significant sex-bias, which becomes more evident post-puberty. This systematic review aims to elucidate the bidirectional relationship between puberty and ARD-related outcomes.MethodsStudies published in English until October 2019 were identified using a systematic search of endocrinology and rheumatology literature. Information was extracted on study design, sample size, demographics, puberty outcome measures, disease outcome measures, and main findings. The methodological quality of the studies included was analysed using the Newcastle-Ottawa Scale (NOS).ResultsSixteen non-randomised studies reporting on the impact of puberty on ARD outcomes (n = 7), ARD impact on puberty-related outcomes (n = 8), or both (n = 1) have been identified. The impact of puberty on ARD outcomes were investigated in patients with juvenile idiopathic arthritis (JIA)-associated uveitis (n = 1), juvenile systemic lupus erythematosus (JSLE) (n = 5) or in healthy controls who developed adult-onset SLE (n = 1) or had non-specific symptoms (n = 1). The impact of ARD on puberty outcomes was explored in JIA (n = 4) and JSLE (n = 3). Quality assessment of studies showed a small to moderate risk of bias overall (NOS 4–9/9). Due to large heterogeneity of the studies it was not possible to perform a meta-analysis. Multiple studies reported on delayed puberty in patients with JIA/JSLE, menstrual and hormonal abnormalities, and lower height and weight than controls. Earlier (pre-pubertal) onset of JSLE was correlated with more severe disease and more need for systemic treatment.ConclusionA bidirectional relationship exists between puberty and ARDs; however, more and better research is required to elucidate the complexity of this relationship. We propose puberty-related clinical assessments in patients with ARDs, which can improve patient outcomes and facilitate future research.

【 授权许可】

CC BY