van Weelden Marlon, Queiroz Lígia B, Lourenço Daniela M R, Kozu Katia, Lourenço Benito, Silva Clovis A
Pediatric Rheumatology Unit, School of Medicine, Universidade de São Paulo, São Paulo, SP, Brazil; Medical Faculty, VU University, Amsterdam, Netherlands.
Adolescent Unit, School of Medicine, Universidade de São Paulo, São Paulo, SP, Brazil.
Rev Bras Reumatol Engl Ed. 2016 May-Jun;56(3):228-34. doi: 10.1016/j.rbre.2016.02.001. Epub 2016 Feb 28.
To evaluate alcohol, smoking and/or illicit drug use, and history of bullying in adolescent childhood-onset systemic lupus erythematosus and healthy controls.
174 adolescents with pediatric rheumatic diseases were selected. All of the 34 childhood-onset systemic lupus erythematosus patients and 35 healthy controls participated in this study. A cross-sectional study included demographic/anthropometric data and puberty markers assessments; structured questionnaire and CRAFFT screening interview.
McNemar tests indicated an excellent test-retest reliability of the structured questionnaire (p=1.0). The median current age was similar between childhood-onset systemic lupus erythematosus patients and controls [15 (12-18) vs. 15 (12-18) years, p=0.563]. The median of menarche age was significantly higher in childhood-onset systemic lupus erythematosus patients compared to controls [12 (10-15) vs. 11.5 (9-15) years, p=0.041], particularly in those that lupus had occurred before first menstruation [13 (12-15) vs. 11.5(9-15) years, p=0.007]. The other puberty marker and sexual function parameters were similar in both groups (p>0.05). Alcohol use was similar in both childhood-onset systemic lupus erythematosus patients and controls (38% vs. 46%, p=0.628). A trend of lower frequency of CRAFFT score ≥2 (high risk for substance abuse/dependence) was evidenced in childhood-onset systemic lupus erythematosus patients compared to controls (0% vs. 15%, p=0.053). Bullying was reported similarly for the two groups (43% vs. 44%, p=0.950). Further analysis in lupus patients regarding alcohol/smoking/illicit drug use showed no differences in demographic data, puberty markers, history of bullying, sexual function, contraceptive use, disease activity/damage scores, clinical/laboratorial features and treatments (p>0.05).
This study showed high frequencies of early alcohol use in lupus adolescents and healthy controls, despite of a possible low risk for substance abuse/dependence in childhood-onset systemic lupus erythematosus patients.
评估青少年期起病的系统性红斑狼疮患者及健康对照者的酒精、吸烟和/或非法药物使用情况，以及欺凌史。
选取174例患有儿科风湿性疾病的青少年。34例青少年期起病的系统性红斑狼疮患者和35例健康对照者均参与了本研究。一项横断面研究包括人口统计学/人体测量学数据及青春期指标评估；结构化问卷和CRAFFT筛查访谈。
McNemar检验表明结构化问卷具有出色的重测信度（p = 1.0）。青少年期起病的系统性红斑狼疮患者与对照组的当前年龄中位数相似[15（12 - 18）岁 vs. 15（12 - 18）岁，p = 0.563]。青少年期起病的系统性红斑狼疮患者的月经初潮年龄中位数显著高于对照组[12（10 - 15）岁 vs. 11.5（9 - 15）岁，p = 0.041]，尤其是那些狼疮在首次月经前发病的患者[13（12 - 15）岁 vs. 11.5（9 - 15）岁，p = 0.007]。两组的其他青春期指标和性功能参数相似（p > 0.05）。青少年期起病的系统性红斑狼疮患者与对照组的酒精使用情况相似（38% vs. 46%，p = 0.628）。与对照组相比，青少年期起病的系统性红斑狼疮患者中CRAFFT评分≥2（药物滥用/依赖高风险）的频率有降低趋势（0% vs. 15%，p = 0.053）。两组报告的欺凌情况相似（43% vs. 44%，p = 0.950）。对狼疮患者酒精/吸烟/非法药物使用的进一步分析显示，在人口统计学数据、青春期指标、欺凌史、性功能、避孕措施使用、疾病活动/损伤评分、临床/实验室特征及治疗方面无差异（p > 0.0５）。
本研究表明，狼疮青少年和健康对照者中早期酒精使用频率较高，尽管青少年期起病的系统性红斑狼疮患者药物滥用/依赖风险可能较低。
