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. 2025 Dec 15:82:15625.
doi: 10.3389/bjbs.2025.15625. eCollection 2025.

Epidemiological Analysis of Antinuclear Antibodies Positivity and Pattern Distribution in a Taiwanese Hospital-Based Cohort

Yu-Wei Tseng  1 , Cheng-Li Lin  2 , Si-Yu Chen  1 , Tze-Kiong Er  1   3   4
Affiliations

Epidemiological Analysis of Antinuclear Antibodies Positivity and Pattern Distribution in a Taiwanese Hospital-Based Cohort

Yu-Wei Tseng et al. Br J Biomed Sci. .

Abstract

Background: Autoimmune diseases pose an increasing global health burden. The detection of antinuclear antibodies (ANA) via indirect immunofluorescence (IIF) is central to diagnosing systemic autoimmune conditions. This study aimed to assess the prevalence and distribution of ANA patterns in a Taiwanese population.

Methods: We conducted a retrospective, cross-sectional study of 8,299 patients who underwent ANA testing at Asia University Hospital between January 2021 and December 2023. ANA patterns were classified based on fluorescence staining characteristics. Demographic variables, including age and gender, were analyzed.

Results: ANA positivity was observed in 35.3% of patients. The most frequent pattern was homogeneous (33.0%), followed by speckled (24.1%). Female patients had a significantly higher positivity rate (female-to-male ratio 2.7:1), and the ≥66-year age group accounted for 34.6% of ANA-positive cases. Mixed ANA patterns were identified in 22.8% of ANA-positive patients, with homogeneous-speckled being the most common combination (27.4%).

Conclusion: This large-scale study provides valuable epidemiological data on ANA prevalence and pattern distribution in Taiwan. The predominance of homogeneous and speckled patterns, particularly among older female patients, aligns with established trends in autoimmune diseases. The high proportion of mixed ANA patterns suggests the need for further investigation into their clinical significance and diagnostic value.

Keywords: ANA patterns; antinuclear antibodies; autoimmune diseases; indirect immunofluorescence; prevalence.

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Conflict of interest statement

The author(s) declared that this work was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Age-specific distribution of ANA positivity by gender. This figure presents the percentage of ANA-positive individuals across five age groups for both males and females. Female participants showed consistently higher ANA positivity at all age intervals, with a clear increasing trend with age observed in both genders. Positivity rates rose markedly after age 50, reaching the highest levels in the ≥66-year group.
FIGURE 2
FIGURE 2
Distribution of ANA patterns among ANA-positive individuals. This figure illustrates the frequency of nuclear and cytoplasmic ANA patterns identified in the cohort. Homogeneous and speckled patterns were the most prevalent, followed by cytoplasmic and mixed patterns. ANA patterns with a frequency below 0.5% were grouped under the “Other” category for clarity; this includes centrioles, discrete dots, and other rare patterns.
FIGURE 3
FIGURE 3
Representative ANA indirect immunofluorescence (IIF) patterns observed in this study. (A) Homogeneous pattern. (B) Speckled pattern. (C) Mixed pattern (homogeneous–cytoplasmic). (D) Cytoplasmic dense fine speckled pattern.
FIGURE 4
FIGURE 4
Distribution of mixed ANA patterns among ANA-positive individuals. This figure displays the distribution of mixed ANA patterns identified among ANA-positive patients. The most common combinations include homogeneous-speckled, homogeneous-cytoplasmic, and speckled-cytoplasmic patterns, emphasizing the diversity of mixed patterns observed in the study.
FIGURE 5
FIGURE 5
Age and gender distribution among individuals with mixed ANA patterns. This figure illustrates the percentage of individuals with mixed ANA patterns across five age groups, stratified by gender. Female patients consistently demonstrated higher frequencies of mixed ANA patterns compared with males at all ages. A clear age-related increase was observed in both sexes, with the highest proportion occurring in individuals aged ≥66 years.
See this image and copyright information in PMC

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