{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T14:50:12Z","timestamp":1782312612762,"version":"3.54.5"},"reference-count":77,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T00:00:00Z","timestamp":1761696000000},"content-version":"unspecified","delay-in-days":120,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Guangdong Provincial Basic and Applied Basic Research Fund Project","award":["2024A1515012734"],"award-info":[{"award-number":["2024A1515012734"]}]},{"name":"2024 Basic and Applied Basic Research","award":["2024A04J9909"],"award-info":[{"award-number":["2024A04J9909"]}]},{"name":"National Natural Science Foundation of China Youth Fund","award":["82201998"],"award-info":[{"award-number":["82201998"]}]},{"name":"Third Affiliated Hospital of Sun Yat-Sen University Second Major Talent Development Program"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Lupus Sci Med"],"accepted":{"date-parts":[[2025,10,13]]},"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Anti-C1q autoantibodies can disrupt normal complement function, contributing to the formation of pathogenic immune complexes and end-organ damage. Although their role in SLE is well-established, their detection rate and clinical relevance across a broader spectrum of diseases remain insufficiently characterised. This study aimed to investigate the distribution of abnormal anti-C1q levels in the population and examine their associations with age, sex and specific clinical subtypes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective study included patients who underwent anti-C1q testing at our hospital between September 2020 and September 2023. The primary outcome was the detection rate of abnormal anti-C1q levels (&gt;10\u2009U\/mL) categorised by patient sex, age and disease diagnosis. One-way and two-way fixed-effect models were used to assess associations between odds of abnormal antibody levels and demographic factors. Multivariate logistic regression was performed to identify disease-specific correlates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 15\u2009363 patients (median (IQR) age, 38 (28\u201353) years; 79.02% female; 52.19% aged &lt;40 years) representing 67 distinct diagnoses, 7.88% showed abnormal anti-C1q levels. Female sex and younger age showed higher median anti-C1q levels and a greater proportion of abnormal results. SLE subtypes showed the highest detection rate of abnormal anti-C1q levels, with SLE without severe complications (853 of 3760, 22.69%) and lupus nephritis (88 of 294, 29.93%) being the most obvious. Lupus haematological and encephalopathic manifestations were associated with elevated antibody levels. Additionally, autoimmune cirrhosis (7 of 59, 11.86%) and systemic sclerosis (19 of 165, 11.52%) also showed high detection rates of abnormal anti-C1q levels. Both univariate and multivariate analyses indicated that male sex and younger age were significantly associated with increased odds of abnormal anti-C1q levels.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Elevations in anti-C1q levels extend beyond SLE and are influenced by both demographic factors and specific disease phenotypes. Male sex and younger age emerged as significant predictors of abnormal anti-C1q status. Our findings underscore the potential utility of anti-C1q testing for improving diagnostic precision and risk stratification across a wide range of clinical conditions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/lupus-2025-001701","type":"journal-article","created":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T07:50:12Z","timestamp":1761810612000},"page":"e001701","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Detection rate, demographic associations and clinical implications of anti-C1q antibody elevations across diverse disease states"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-1602-2296","authenticated-orcid":false,"given":"Siwei","family":"Xie","sequence":"first","affiliation":[{"name":"Department of Rheumatology and Immunology, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China"},{"name":"Johns Hopkins School of Medicine, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yao","family":"Liang","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Immunology, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China"},{"name":"Department of Rheumatology and Immunology, Guangxi Hospital Division of The First Affiliated Hospital of Sun Yat-sen University, Nanning, Guangxi Zhuang Autonomous Region, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weihang","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Immunology, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinlei","family":"Jia","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Immunology, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiujing","family":"Wei","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Immunology, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenying","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chenyang","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Immunology, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yutong","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Immunology, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,10,29]]},"reference":[{"key":"2026010700555230000_12.2.e001701.1","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1016\/j.molimm.2021.10.010","article-title":"Circulating C1q levels in health and disease, more than just a biomarker","volume":"140","author":"van de Bovenkamp","year":"2021","journal-title":"Mol Immunol"},{"key":"2026010700555230000_12.2.e001701.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2008.06.006"},{"key":"2026010700555230000_12.2.e001701.3","first-page":"873","article-title":"Anti-C1q in systemic lupus erythematosus","volume":"25","author":"Stojan","year":"2016","journal-title":"Lupus (Los Angel)"},{"key":"2026010700555230000_12.2.e001701.4","doi-asserted-by":"crossref","DOI":"10.3389\/fimmu.2024.1410032","article-title":"Anti-C1q antibodies: a biomarker for diagnosis and management of lupus nephritis. 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