Vilá L M, Alarcón G S, McGwin G, Friedman A W, Baethge B A, Bastian H M, Fessler B J, Reveille J D
Department of Internal Medicine, Division of Rheumatology, University of Puerto Rico, Medical Sciences Campus, PO Box 365067, San Juan, Puerto Rico 00936-5067, USA.
Rheumatology (Oxford). 2004 Mar;43(3):358-63. doi: 10.1093/rheumatology/keh048. Epub 2003 Nov 17.
To compare the baseline clinical manifestations, immunological features, disease activity and damage accrual in systemic lupus erythematosus (SLE) patients from two US Hispanic subgroups.
A total of 105 Hispanic SLE patients from Texas (a population of Mexican or Central American ancestry) and 81 from the island of Puerto Rico (all Puerto Ricans) participating in a longitudinal study of outcome were examined. The socio-economic/demographic, clinical and immunological variables were obtained at the time of enrollment (T(0)). Disease activity was determined with the Systemic Lupus Activity Measure (SLAM), and disease damage with the Systemic Lupus International Collaborating Clinics (SLICC) Damage Index (SDI). Disease activity was also determined at the time of diagnosis (T(D)).
At T(0) Hispanics from Texas were younger than those from Puerto Rico (33.1 +/- 12.0 vs 37.5 +/- 11.6 yr, P = 0.0125). Both groups were similar with regard to gender distribution (92.4 vs 95.1% females) and disease duration (1.4 +/- 1.4 vs 1.7 +/- 1.3 yr). Hispanics from Texas were more likely to have serositis (60.0 vs 8.6%, P < 0.0001), renal involvement (41.0 vs 13.6%, P < 0.0001), psychosis (5.7 vs 0.0%, P = 0.0365) and thrombocytopenia (21.0 vs 3.7%, P = 0.0006). On the other hand, Hispanics from Puerto Rico were more likely to have photosensitivity (81.5 vs 41.0%, P < 0.0001), malar rash (65.4 vs 45.7%, P = 0.0074) and discoid rash (13.6 vs 2.9%, P = 0.0060). At baseline, the presence of anti-dsDNA antibodies was higher in Hispanics from Texas (69.5% vs 46.9%, P = 0.0018) while anti-Ro antibodies were more frequent in Hispanics from Puerto Rico (24.7 vs 11.4%, P = 0.0175). Mean SLAM scores at T(D) (12.9 +/- 6.4 vs 9.1 +/- 4.6, P < 0.0001) and T(0) (10.9 +/- 6.3 vs 6.6 +/- 3.8, P < 0.0001) were significantly higher in Hispanics from Texas. Similarly, mean SDI scores at T(0) were higher in Hispanics from Texas (0.67 +/- 1.08 vs 0.26 +/- 0.54, P = 0.0026). By stepwise Poisson regression, SDI scores were associated with older age, disease activity and ethnicity (Hispanics from Texas).
Early in SLE, marked differences are observed between Hispanics from Texas and Puerto Rico. Higher disease activity, more major organ involvement, higher frequency of anti-dsDNA antibodies and more damage accrual occur in Hispanic lupus patients from Texas than in those from Puerto Rico.
比较来自美国两个西班牙裔亚组的系统性红斑狼疮（SLE）患者的基线临床表现、免疫特征、疾病活动度和损伤累积情况。
对参与一项结局纵向研究的105名来自得克萨斯州（墨西哥或中美洲血统人群）的西班牙裔SLE患者和81名来自波多黎各岛（均为波多黎各人）的患者进行了检查。在入组时（T(0)）获取社会经济/人口统计学、临床和免疫变量。用系统性狼疮活动度量表（SLAM）确定疾病活动度，用系统性狼疮国际协作临床中心（SLICC）损伤指数（SDI）确定疾病损伤情况。在诊断时（T(D)）也确定疾病活动度。
在T(0)时，来自得克萨斯州的西班牙裔患者比来自波多黎各的患者年轻（33.1±12.0岁对37.5±11.6岁，P = 0.0125）。两组在性别分布（92.
