Comparison of Estradiol Levels in Female Adolescents with and Without Systemic Lupus Erythematosus

Abstract

Systemic lupus erythematosus (SLE) often affects females during adolescence. Evidence on circulating estradiol and disease activity in adolescent females with SLE is inconsistent. This cross-sectional study included 44 female adolescents aged 8–18 years: 22 with SLE and 22 without SLE. Participants were recruited at a tertiary hospital in Makassar, Indonesia, from January to April 2026. Serum estradiol was measured using enzyme-linked immunosorbent assay. Demographic, nutritional, and menstrual-cycle characteristics were recorded, and SLE activity was assessed using SLEDAI. ANCOVA adjusted for age and menstrual-cycle phase. Estradiol concentrations were higher in the SLE group than in the non-SLE group, but not significantly (p=0.105). Median concentrations were 64.67 pg/mL (50.10–107.80) and 56.37 pg/mL (36.50–95.20), respectively. After adjustment, estimated marginal means were 63.35 pg/mL and 59.71 pg/mL, with no significant difference (F=0.370, p=0.547, partial η²=0.010). Estradiol did not differ by nutritional status, menstrual-cycle phase, or disease-activity categories, and correlated neither with SLEDAI nor with age or %BW/H. Circulating estradiol alone was not associated with SLE status or disease activity. Larger studies warranted.