OBJECTIVE: The objective of this paper is to examine the role of place of residency in the expression and outcomes of systemic lupus erythematosus (SLE) in a multi-ethnic Latin American cohort. PATIENTS AND METHODS: SLE patients (< two years of diagnosis) from 34 centers constitute this cohort. Residency was dichotomized into rural and urban, cut-off: 10,000 inhabitants. Socio-demographic, clinical/laboratory and mortality rates were compared between them using descriptive tests. The influence of place of residency on disease activity at diagnosis and renal disease was examined by multivariable regression analyses. RESULTS: Of 1426 patients, 122 (8.6%) were rural residents. Their median ages (onset, diagnosis) were 23.5 and 25.5 years; 85 (69.7%) patients were Mestizos, 28 (22.9%) Caucasians and 9 (7.4%) were African-Latin Americans. Rural residents were more frequently younger at diagnosis, Mestizo and uninsured; they also had fewer years of education and lower socioeconomic status, exhibited hypertension and renal disease more frequently, and had higher levels of disease activity at diagnosis; they used methotrexate, cyclophosphamide pulses and hemodialysis more frequently than urban patients. Disease activity over time, renal damage, overall damage and the proportion of deceased patients were comparable in rural and urban patients. In multivariable analyses, rural residency was associated with high levels of disease activity at diagnosis (OR 1.65, 95% CI 1.06-2.57) and renal disease occurrence (OR 1.77, 95% CI 1.00-3.11). CONCLUSIONS: Rural residency associates with Mestizo ethnicity, lower socioeconomic status and renal disease occurrence. It also plays a role in disease activity at diagnosis and kidney involvement but not on the other end-points examined.
OBJECTIVE: The objective of this paper is to examine the role of place of residency in the expression and outcomes of systemic lupus erythematosus (SLE) in a multi-ethnic Latin American cohort. PATIENTS AND METHODS: SLEpatients (< two years of diagnosis) from 34 centers constitute this cohort. Residency was dichotomized into rural and urban, cut-off: 10,000 inhabitants. Socio-demographic, clinical/laboratory and mortality rates were compared between them using descriptive tests. The influence of place of residency on disease activity at diagnosis and renal disease was examined by multivariable regression analyses. RESULTS: Of 1426 patients, 122 (8.6%) were rural residents. Their median ages (onset, diagnosis) were 23.5 and 25.5 years; 85 (69.7%) patients were Mestizos, 28 (22.9%) Caucasians and 9 (7.4%) were African-Latin Americans. Rural residents were more frequently younger at diagnosis, Mestizo and uninsured; they also had fewer years of education and lower socioeconomic status, exhibited hypertension and renal disease more frequently, and had higher levels of disease activity at diagnosis; they used methotrexate, cyclophosphamide pulses and hemodialysis more frequently than urban patients. Disease activity over time, renal damage, overall damage and the proportion of deceased patients were comparable in rural and urban patients. In multivariable analyses, rural residency was associated with high levels of disease activity at diagnosis (OR 1.65, 95% CI 1.06-2.57) and renal disease occurrence (OR 1.77, 95% CI 1.00-3.11). CONCLUSIONS: Rural residency associates with Mestizo ethnicity, lower socioeconomic status and renal disease occurrence. It also plays a role in disease activity at diagnosis and kidney involvement but not on the other end-points examined.
Authors: G S Alarcón; G McGwin; A A Bartolucci; J Roseman; J Lisse; B J Fessler; H M Bastian; A W Friedman; J D Reveille Journal: Arthritis Rheum Date: 2001-12
Authors: E M Tan; A S Cohen; J F Fries; A T Masi; D J McShane; N F Rothfield; J G Schaller; N Talal; R J Winchester Journal: Arthritis Rheum Date: 1982-11
Authors: Bernardo A Pons-Estel; Luis J Catoggio; Mario H Cardiel; Enrique R Soriano; Silvana Gentiletti; Antonio R Villa; Isaac Abadi; Francisco Caeiro; Alejandro Alvarellos; Donato Alarcón-Segovia Journal: Medicine (Baltimore) Date: 2004-01 Impact factor: 1.889
Authors: Yves Jackson; Drenusha Vieira de Mello Pula; Axel Finckh; Carlo Chizzolini; François Chappuis Journal: Mem Inst Oswaldo Cruz Date: 2018-02-05 Impact factor: 2.743
Authors: Bernardo A Pons-Estel; Eloisa Bonfa; Enrique R Soriano; Mario H Cardiel; Ariel Izcovich; Federico Popoff; Juan M Criniti; Gloria Vásquez; Loreto Massardo; Margarita Duarte; Leonor A Barile-Fabris; Mercedes A García; Mary-Carmen Amigo; Graciela Espada; Luis J Catoggio; Emilia Inoue Sato; Roger A Levy; Eduardo M Acevedo Vásquez; Rosa Chacón-Díaz; Claudio M Galarza-Maldonado; Antonio J Iglesias Gamarra; José Fernando Molina; Oscar Neira; Clóvis A Silva; Andrea Vargas Peña; José A Gómez-Puerta; Marina Scolnik; Guillermo J Pons-Estel; Michelle R Ugolini-Lopes; Verónica Savio; Cristina Drenkard; Alejandro J Alvarellos; Manuel F Ugarte-Gil; Alejandra Babini; André Cavalcanti; Fernanda Athayde Cardoso Linhares; Maria Jezabel Haye Salinas; Yurilis J Fuentes-Silva; Ana Carolina Montandon de Oliveira E Silva; Ruth M Eraso Garnica; Sebastián Herrera Uribe; Diana Gómez-Martín; Ricardo Robaina Sevrini; Rosana M Quintana; Sergio Gordon; Hilda Fragoso-Loyo; Violeta Rosario; Verónica Saurit; Simone Appenzeller; Edgard Torres Dos Reis Neto; Jorge Cieza; Luis A González Naranjo; Yelitza C González Bello; María Victoria Collado; Judith Sarano; Soledad Retamozo; María E Sattler; Rocio V Gamboa-Cárdenas; Ernesto Cairoli; Silvana M Conti; Luis M Amezcua-Guerra; Luis H Silveira; Eduardo F Borba; Mariana A Pera; Paula B Alba Moreyra; Valeria Arturi; Guillermo A Berbotto; Cristian Gerling; Carla A Gobbi; Viviana L Gervasoni; Hugo R Scherbarth; João C Tavares Brenol; Fernando Cavalcanti; Lilian T Lavras Costallat; Nilzio A Da Silva; Odirlei A Monticielo; Luciana Parente Costa Seguro; Ricardo M Xavier; Carolina Llanos; Rubén A Montúfar Guardado; Ignacio Garcia de la Torre; Carlos Pineda; Margarita Portela Hernández; Alvaro Danza; Marlene Guibert-Toledano; Gil Llerena Reyes; Maria Isabel Acosta Colman; Alicia M Aquino; Claudia S Mora-Trujillo; Roberto Muñoz-Louis; Ignacio García Valladares; María Celeste Orozco; Paula I Burgos; Graciela V Betancur; Graciela S Alarcón Journal: Ann Rheum Dis Date: 2018-07-25 Impact factor: 19.103