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A systematic review exploring the bidirectional relationship between puberty and autoimmune rheumatic diseases
BACKGROUND: Autoimmune 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. METHODS: Studies published in English until October...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8008606/ https://www.ncbi.nlm.nih.gov/pubmed/33781271 http://dx.doi.org/10.1186/s12969-021-00528-y |
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author | de Gruijter, Nina M. Naja, Meena Peckham, Hannah Radziszewska, Anna Kinsella, Matthew Glenister, James Rosser, Elizabeth C. Butler, Gary E. Jury, Elizabeth C. Ciurtin, Coziana |
author_facet | de Gruijter, Nina M. Naja, Meena Peckham, Hannah Radziszewska, Anna Kinsella, Matthew Glenister, James Rosser, Elizabeth C. Butler, Gary E. Jury, Elizabeth C. Ciurtin, Coziana |
author_sort | de Gruijter, Nina M. |
collection | PubMed |
description | BACKGROUND: Autoimmune 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. METHODS: Studies 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). RESULTS: Sixteen 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. CONCLUSION: A 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. |
format | Online Article Text |
id | pubmed-8008606 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-80086062021-03-30 A systematic review exploring the bidirectional relationship between puberty and autoimmune rheumatic diseases de Gruijter, Nina M. Naja, Meena Peckham, Hannah Radziszewska, Anna Kinsella, Matthew Glenister, James Rosser, Elizabeth C. Butler, Gary E. Jury, Elizabeth C. Ciurtin, Coziana Pediatr Rheumatol Online J Research Article BACKGROUND: Autoimmune 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. METHODS: Studies 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). RESULTS: Sixteen 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. CONCLUSION: A 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. BioMed Central 2021-03-29 /pmc/articles/PMC8008606/ /pubmed/33781271 http://dx.doi.org/10.1186/s12969-021-00528-y Text en © The Author(s) 2021 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Article de Gruijter, Nina M. Naja, Meena Peckham, Hannah Radziszewska, Anna Kinsella, Matthew Glenister, James Rosser, Elizabeth C. Butler, Gary E. Jury, Elizabeth C. Ciurtin, Coziana A systematic review exploring the bidirectional relationship between puberty and autoimmune rheumatic diseases |
title | A systematic review exploring the bidirectional relationship between puberty and autoimmune rheumatic diseases |
title_full | A systematic review exploring the bidirectional relationship between puberty and autoimmune rheumatic diseases |
title_fullStr | A systematic review exploring the bidirectional relationship between puberty and autoimmune rheumatic diseases |
title_full_unstemmed | A systematic review exploring the bidirectional relationship between puberty and autoimmune rheumatic diseases |
title_short | A systematic review exploring the bidirectional relationship between puberty and autoimmune rheumatic diseases |
title_sort | systematic review exploring the bidirectional relationship between puberty and autoimmune rheumatic diseases |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8008606/ https://www.ncbi.nlm.nih.gov/pubmed/33781271 http://dx.doi.org/10.1186/s12969-021-00528-y |
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