Geographical distribution, a risk factor for the incidence of lupus nephritis in China

Abstract

BackgroundGeographical variation in lupus nephritis epidemiology may indicate important environmental factors contributions to the etiology of lupus nephritis. This paper first describes the epidemiology of biopsy-proven lupus nephritis in China by performing a systematic literature review and the possible social-environmental influential factors.MethodsThe keywords “lupus nephritis”, “renal biopsy” and “systemic lupus erythematous” were searched in the three largest Chinese electronic databases and Medline/PubMed. The data of the patients with biopsy-proven lupus nephritis were extracted. The possible environmental influential factors including the population density, ethnic group populations, the ratio of females to males, the average sunshine per year, annual average temperature and annual relative humidity, in different regions of China were analyzed.ResultsForty-one study centers with 34574 renal disease patients, and 3699 lupus nephritis patients met the inclusion criteria. Lupus nephritis accounts for 2.37% to 25% of all renal disease and 27.2% to 80.65% of renal disease associated with secondary glomerular diseases. The male-to-female ratio is approximately 1:5 in lupus nephritis patients. The included period is predominantly from 1995 to 2010. The proportion ratio of biopsy-proven lupus nephritis in all renal disease or in secondary glomerular disease significantly increased with decreasing latitude from the north to the south part of China. The population is predominantly Han Chinese.ConclusionsGeographical distribution appears to be a risk factor for the incidence of biopsy-proven LN in China.

Chinese SLE Treatment and Research Group (CSTAR) registry:VIII. Influence of socioeconomic and geographical variables on disease phenotype and activity in Chinese patients with SLE

“…Some studies have even indicated subtle genetic differences in the Chinese Han population between these two regions . In a systemic meta‐analysis, the proportion ratio of biopsy‐proven lupus nephritis among all renal diseases was found to increase from the northern to southern part of China . The present study revealed the phenotype differences in SLE patients between southern and northern China for the first time in a Chinese population.…”

“…The division of China into southern and northern China was mainly based on China's distinct climate features. The annual average temperature and humidity decrease gradually from south to north . The seasonal sunshine patterns vary considerably by region, but overall, the north is sunnier than the south of China .…”

Assessment of Renal Pathological Changes in Lupus Nephritis Using Diffusion Weighted Imaging: A Multiple Correspondence Analysis

“…Lupus nephritis (LN) is one of the most common forms of secondary glomerulonephritis in China. An epidemiological investigation by Pan et al, reported that LN was found in approximately 2.37% to 25% of all biopsy-confirmed renal diseases and in approximately 27.2% to 80.65% of renal disease biopsies performed for secondary causes of glomerular disease [3]. Clinically, renal biopsy is a useful assessment method in patients with LN.…”

Evaluation of Micro-RNA199 in systemic lupus erythematosus patients with and without lupus nephritis

“…In general, increased self-production and deposition of antibodies and altered immune responses increase inflammation and fibrosis and may lead to LN (Sun et al, 2018). LN differs greatly between races and ethnicities and genetic factors appear to play a role in the risk of different clinical manifestations (Pan et al, 2014).…”