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The Effect of Race on Disease Activity in Systemic Lupus Erythematosus
NAJEEB O. GHAUSSY, WILMER L. SIBBITT Jr, ARTHUR D. BANKHURST, and CLIFFORD R. QUALLS
ABSTRACT. Methods. Socioeconomic-demographic and clinical data were collected from 125 SLE patients by an interview-administered questionnaire. The Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) was used to assess disease activity. Results. Seventy-four Hispanics (H) and 40 Caucasians (C) were compared. Demographics including age, gender, disease duration, marital status, and cigarette smoking were similar between the 2 groups. However, education and income were higher in the Caucasian group compared to the Hispanic group. There was no significant difference between the 2 groups in overall disease activity as measured by the SLEDAI. However, when individual components of the SLEDAI were compared, Hispanics had an increased prevalence of arthritis (77% vs 51%, p = 0.01) and depressed complement levels (40% vs 18%, p = 0.02). Moreover, corticosteroid use was higher among the Hispanics compared to the Caucasian population (p = 0.03). Conclusion. We found similar levels of overall disease activity in Hispanic and Caucasian patients with SLE. However, Hispanics used more corticosteroids, had a greater prevalence of arthritis, and had depressed complement levels indicating increased SLE disease activity highly restricted to specific domains. It remains to be determined whether these restricted but discrete differences are genetic in origin, or are related cultural or environmental factors. (J Rheumatol 2004;31:915-9) Key Indexing Terms:
SYSTEMIC LUPUS ERYTHEMATOSUS
From the Departments of Internal Medicine, Neurology, Mathematics and Statistics, and Epidemiology, and the Clinical and Magnetic Research Center, The University of New Mexico Health Sciences Center, Albuquerque, New Mexico, USA. Supported in part by the National Institutes of Health RO1 NS 35708 (to Dr. Sibbitt). N.O. Ghaussy, MD, Physician, Department of Internal Medicine; W.L. Sibbitt Jr., MD, Professor, Departments of Internal Medicine and Neurology; A.D. Bankhurst, MD, Professor, Head of Rheumatology; C.R. Qualls, PhD, Professor of Mathematics and Statistics and Epidemiology, Departments of Mathematics and Statistics, and Epidemiology, Staff Statistician Clinical Research Center. Address reprint requests to Dr. W.L. Sibbitt Jr., Departments of Internal Medicine and Neurology, 5th Floor ACC, University of New Mexico Health Sciences Center, Albuquerque, NM 87131, USA. Submitted June 12, 2003; revision accepted November 24, 2003. |