{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T21:12:18Z","timestamp":1777929138142,"version":"3.51.4"},"reference-count":42,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T00:00:00Z","timestamp":1763337600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"National Natural Science Foundation of China Youth Fund","award":["82201998"],"award-info":[{"award-number":["82201998"]}]},{"name":"Basic and Applied Basic Research of Guangzhou Basic Research Program","award":["2024A04J9909"],"award-info":[{"award-number":["2024A04J9909"]}]},{"name":"Guangzhou Science and Technology Plan Key Research and Development Project","award":["2023B03J1244"],"award-info":[{"award-number":["2023B03J1244"]}]},{"name":"Third Affiliated Hospital of Sun Yat-Sen University Second Major Talent Development Program."},{"name":"Guangdong Provincial Basic and Applied Basic Research Fund Project","award":["2024A1515012734"],"award-info":[{"award-number":["2024A1515012734"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Lupus"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Systemic Lupus Erythematosus (SLE) exhibits marked sex-based difference. Understanding these sex-specific variations in clinical manifestations and autoantibody profiles, particularly within diverse ethnic cohorts like Chinese populations, is crucial for advancing personalized management strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed data from 1029 SLE patients (121 males, 908 females). Comprehensive immunological profiles, including complement C3, C4, CH50, antinuclear antibodies (ANA) titers and patterns, and antiphospholipid (aPL) antibodies, were assessed. Statistical analyses were performed to identify sex-specific prevalence and correlation patterns between autoantibodies and clinical indicators.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Distinct autoantibody patterns emerged by sex. The speckled ANA pattern was more prevalent in males (84.1% vs 53.5%) and anti-Smith (Sm) antibodies were significantly higher in females (34.4% vs 19.8% in males;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .001). No sex differences were found in ANA titers or aPL antibodies. Females had significantly lower complement levels and higher mean SLEDAI-2K scores (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001), while males showed more cardiovascular (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .039) and pulmonary involvement (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .026). Sex-specific correlations were evident: males displayed positive autoantibody-autoantibody correlations (e.g., anti-Sm vs anti-RNP), whereas females showed broader correlations, particularly between complement components and disease activity, serum creatinine, and anti-double-stranded DNA (dsDNA) antibodies, reflecting established markers of disease activity and renal involvement. Anti-Sm positivity linked to lower complement in both sexes. Notably, females with anti-Sm had increased anti-dsDNA positivity and elevated SLEDAI-2K, while males with anti-Sm showed higher 24-h urinary protein (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .02), directly linking anti-Sm to renal involvement in males, a key aspect of male SLE severity.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study highlights significant sex-based variations in autoantibody patterns and their clinical associations in a Chinese SLE cohort. The distinct prevalence of ANA patterns and anti-Sm antibodies, coupled with sex-specific immunological correlation networks, underscores the complex interplay of immune factors.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/09612033251399718","type":"journal-article","created":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T00:08:51Z","timestamp":1763424531000},"page":"5-16","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Distinct autoantibody patterns and clinical phenotypes by sex in Chinese systemic lupus erythematosus: A cross-sectional study"],"prefix":"10.1177","volume":"35","author":[{"given":"Shuiming","family":"Xu","sequence":"first","affiliation":[{"name":"Department of Rheumatology and Immunology, Guangdong Provincial People's Hospital Ganzhou Hospital, Ganzhou Municipal Hospital, Ganzhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhihua","family":"Tu","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Immunology, PanYu Hospital GuangZhou University of Chinese Medicine, Guangzhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanli","family":"Zhang","sequence":"additional","affiliation":[{"name":"Third Affiliated Hospital of Sun Yat-sen University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Siwei","family":"Xie","sequence":"additional","affiliation":[{"name":"Johns Hopkins University School of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shaopeng","family":"Cai","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Immunology, PanYu Hospital GuangZhou University of Chinese Medicine, Guangzhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xinyuan","family":"Xu","sequence":"additional","affiliation":[{"name":"Third Affiliated Hospital of Sun Yat-sen University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhengquan","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Immunology, PanYu Hospital GuangZhou University of Chinese Medicine, Guangzhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhiming","family":"Lin","sequence":"additional","affiliation":[{"name":"Third Affiliated Hospital of Sun Yat-sen University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kefei","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Immunology, Guangdong Provincial People's Hospital Ganzhou Hospital, Ganzhou Municipal Hospital, Ganzhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6558-4201","authenticated-orcid":false,"given":"Yutong","family":"Jiang","sequence":"additional","affiliation":[{"name":"Third Affiliated Hospital of Sun Yat-sen University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Weifeng","family":"Ni","sequence":"additional","affiliation":[{"name":"Second Affiliated Hospital of Shantou University Medical College"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,11,17]]},"reference":[{"key":"e_1_3_6_2_2","first-page":"397","article-title":"Systemic lupus erythematosus: one year in review 2025","volume":"43","author":"Elia A","year":"2025","unstructured":"Elia A, Zucchi D, Silvagni E, et al. 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