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1988年至2017年美国女性系统性红斑狼疮死亡率的黑白差异长期趋势中的年龄差异

Age differences in secular trends in black-white disparities in mortality from systemic lupus erythematosus among women in the United States from 1988 to 2017.

作者信息

Guo Qianyu, Liang Meie, Duan Jiaoniu, Zhang Liyun, Kawachi Ichiro, Lu Tsung-Hsueh

机构信息

Department of Rheumatology, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Shanxi Medical University, Shanxi, China.

Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA, USA.

出版信息

Lupus. 2021 Apr;30(5):715-724. doi: 10.1177/0961203321988936. Epub 2021 Feb 3.

Abstract

OBJECTIVE

To examine the age differences in secular trends in black-white disparities in mortality from systemic lupus erythematosus (SLE) among women in the United States from 1988 to 2017.

METHODS

We used mortality data to calculate age-specific SLE and all-causes (as reference) mortality rates and black/white mortality rates ratios among women from 1988 to 2017. Annual percent change was estimated using joinpoint regression analysis.

RESULTS

We identified 10,793 and 4,165,613 black women and 19,455 and 31,129,528 white women who died between 1988 and 2017 from SLE and all-causes, respectively. The black/white SLE mortality rate ratio according joinpoint regression model was 6.6, 7.2, 4.4, and 1.4 for decedents aged 0-24, 25-44, 45-64, and 65+ years in 1988 and was 7.2, 5.9, 4.1, and 1.9, respectively in 2017. No significant decline trend was noted and the annual percent change was 0.3%, -0.7%, -0.2%, and 1.0%, respectively. On the contrast, the black/white all-causes mortality rate ratio was 2.0, 2.5, 1.8, and 1.0, respectively in 1988 and was 1.7, 1.3, 1.5, and 0.9, respectively in 2017, a significant decline trend was noted in each age group.

CONCLUSIONS

Black adults, youths and adolescents had four to seven times higher SLE mortality rates than their white counterparts and the black-white disparities persisted during the past three decades. On the contrast, black women had less than two times higher all-causes mortality rates than their white counterparts and black-white disparities significantly diminish during the past three decades.

摘要

目的

研究1988年至2017年美国女性系统性红斑狼疮(SLE)死亡率的黑白差异的长期趋势中的年龄差异。

方法

我们使用死亡率数据计算了1988年至2017年女性中特定年龄的SLE死亡率和全因死亡率(作为参考)以及黑白死亡率之比。使用连接点回归分析估计年度百分比变化。

结果

我们确定了1988年至2017年期间分别因SLE和全因死亡的10793名黑人女性和4165613名白人女性,以及19455名黑人女性和31129528名白人女性。根据连接点回归模型,1988年0至24岁、25至44岁、45至64岁和65岁及以上死者的黑白SLE死亡率之比分别为6.6、7.2、4.4和1.4,2017年分别为7.2、5.9、4.1和1.9。未观察到显著下降趋势,年度百分比变化分别为0.3%、-0.7%、-0.2%和1.0%。相比之下,1988年的黑白全因死亡率之比分别为2.0、2.5、1.8和1.0,2017年分别为1.7、1.3、1.5和0.9,每个年龄组均观察到显著下降趋势。

结论

黑人成年人、青年人和青少年的SLE死亡率比白人同龄人高四至七倍,并且在过去三十年中黑白差异持续存在。相比之下,黑人女性的全因死亡率比白人同龄人高不到两倍,并且在过去三十年中黑白差异显著缩小。

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