Differences by race, sex and age in the clinical and immunologic features of recently diagnosed systemic lupus erythematosus patients in the southeastern United States
Differences by race, sex and age in the clinical and immunologic features of recently diagnosed systemic lupus erythematosus patients in the southeastern United States
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DOI：
10.1191/0961203302lu161oa
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发表时间：
2002-01-01
期刊：
影响因子：
2.6
通讯作者：
Dooley, MA
中科院分区：
文献类型：
--
作者：
Cooper, GS;Parks, CG;Dooley, MA
在一项对265名系统性红斑狼疮(SLE)患者的人群研究中，我们按种族、性别和年龄检查了SLE的临床和免疫学特征的患病率。患者符合美国风湿病学会的分类标准。从诊断到研究登记的中位数时间为13个月。临床和血液学数据仅限于诊断日期后6个月内发生的病例，如医疗记录所示。我们使用在研究登记时从244名患者(92%)收集的血清进行自身抗体的血清学测试。用Logistic回归分析SLE的临床和免疫学特征与年龄、性别和种族的关系。这些变量中的每一个变量的影响被检验调整了另外两个人口统计因素，非洲裔美国人和其他少数民族患者的平均确诊年龄比白人患者年轻6岁(P<；0.01)。盘状狼疮、蛋白尿、抗Sm和抗RNP自身抗体在非裔美国人患者中更常见，优势比高于3.0。在非裔美国人患者中，光敏和粘膜溃疡较少出现。蛋白尿、白细胞减少、淋巴细胞减少和血小板减少在男性中的发生率大约是女性的三倍。口腔或鼻部溃疡和抗DNA自身抗体的患病率随着年龄的增长而下降。我们观察到的差异在多大程度上反映了遗传或环境对疾病过程的影响，应该进行调查。
We examined the prevalence of clinical and immunologic features of systemic lupus erythematosus (SLE) by race, sex and age in a population-based study of 265 SLE patients. Patients fulfilled the American College of Rheumatology classification criteria. The median time between diagnosis and study enrollment was 13 months. The clinical and hematologic data were limited to occurrences up to 6 months after the diagnosis date, as documented in medical records. We used sera collected at study enrollment from 244 (92%) patients for serologic testing of autoantibodies. The associations between clinical and immunological features of SLE and age, sex and race were examined using logistic regression. The effect of each of these variables was examined adjusting for the other two demographic factors, Mean age at diagnosis was 6 years younger among African-Americans and other minorities compared with white patients (P < 0.01). Discoid lupus, proteinuria, anti-Sm and anti-RNP autoantibodies were more commonly seen in African-American patients, with odds ratios higher than 3.0. Photosensitivity and mucosal ulcers were noted less often in African-American patients. Proteinuria, leukopenia, lymphopenia and thrombocytopenia were approximately three times more common in men compared with women. The prevalence of oral or nasal ulcers and anti-DNA autoantibodies declined with age. The extent to which the differences we observed reflect genetic or environmental influences on the disease process should be investigated.