MODIFIABLE RISK FACTORS FOR ADVERSE OUTCOMES IN SLE

本研究的目的是前瞻性地确认先前检查的系统性红斑狼疮（SLE）不良结局的危险因素。可改变的危险因素已被证明对SLE的疾病活动性（由SLAM测量）和SF 36评估的健康状况都有影响。我们的目的是确认潜在的可改变的风险因素，如自我效能感和社会支持确实影响疾病活动性（SLAM）和健康状况（SF36）。心血管疾病导致年轻女性SLE患者的高发病率和死亡率。我们计划研究SLE患者心血管危险因素管理的变化（根据已发表的指南进行危险因素检测和适当性管理）。我们还计划研究心血管危险因素管理、特殊睡眠障碍因素、社会人口统计学和社会心理因素之间的关系，以及：a)包括吸烟、高血压、高脂血症、久坐生活方式、肥胖和糖尿病在内的中间结果；B)心血管事件，包括心绞痛、心肌梗死、充血性心力衰竭或中风。该研究的基本设计是对1989年至1994年间首次评估的40名患者进行前瞻性随访。每位患者将被要求通过邮件填写一份调查问卷。在此之后，受试者将来到诊所接受医师疾病活动评估（SLAM）。6个月后用SA-SLAM量表测量疾病活动，用SF36量表测量身心健康。这将通过邮件填写，并通过电话或家访对未答复者进行随访。受试者将被要求提供自诊断为狼疮以来所有提供者和医院的所有医疗记录，以及诊断前的相关问题。将审查记录中的心血管危险因素。

The objective of this investigation is to prospectively confirm previously examined risk factors for adverse outcomes in Systemic Lupus Erythematosus (SLE). Modifiable risk factors have been shown to impact on both the disease activity, as measured by the SLAM as well as health status assessed by SF 36 in SLE. We aim to confirm that potentially modifiable risk factors such as self-efficacy and social support do effect disease activity (SLAM) and health status (SF36). Cardiovascular disease results in excess morbidity and mortality in young women with SLE. We plan to study the variation in cardiovascular risk factor management (risk factor detection and appropriateness of management according to published guidelines) in patients with SLE. We also plan to look at the association between cardiovascular risk factor management, SLE-specific factors, socio-demographic and psychosocial factors and: a) intermediate outcomes including smoking, hypertension, hyperlipidemia, sedentary lifestyle, obesity and diabetes; b) cardiovascular events including angina, myocardial infarction, congestive heart failure or stroke. The basic design of the proposed study is a prospective followup of 40 patients who were first evaluated between 1989 and 1994. Each patient will be asked to fill out a questionnaire by mail. After this, subjects will come to the clinic for a physician assessment of disease activity (SLAM). Disease activity will be measured 6 months later using the SA-SLAM and physical and mental health will be measured by the SF36. This will be filled out by mail with telephone or home visit followup for nonrespondents. Subjects will be asked to release all medical records regarding their care from all providers and hospitals since their diagnosis of lupus, and for relevant problems prior to diagnosis. The records will be reviewed for cardiovascular risk factors.