Duarte-García Alí, Hocaoglu Mehmet, Valenzuela-Almada Maria, Osei-Onomah Shirley-Ann, Dabit Jesse Y, Sanchez-Rodriguez Alain, Duong Stephanie Q, Giblon Rachel E, Langenfeld Hannah E, Alarcón Graciela S, Helmick Charles G, Crowson Cynthia S
Division of Rheumatology, Mayo Clinic, Rochester, Minnesota, USA
Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota, USA.
Ann Rheum Dis. 2022 Aug 11;81(9):1260-1266. doi: 10.1136/annrheumdis-2022-222276.
To determine the trends in incidence, prevalence and mortality of systemic lupus erythematosus (SLE) in a US population over four decades.
We identified all the patients with SLE in Olmsted County, Minnesota who fulfilled the European Alliance of Associations for Rheumatology (EULAR)/American College of Rheumatology (ACR) criteria for SLE during 1976-2018. Age-specific and sex-specific incidence and prevalence rates were adjusted to the standard 2000 projected US population. The EULAR/ACR score was used as a proxy for disease severity. Standardised mortality ratio (SMR) was estimated.
There were 188 incident SLE cases in 1976-2018 (mean age 46.3±SD 16.9; 83% women). Overall age-adjusted and sex-adjusted annual SLE incidence per 100 000 population was 4.77 (95% CI 4.09 to 5.46). Incidence was higher in women (7.58) than men (1.89). The incidence rate increased from 3.32 during 1976-1988 to 6.44 during 2009-2018. Incidence rates were higher among the racial and ethnic minority populations than non-Hispanic whites. The EULAR/ACR score did not change significantly over time. Overall prevalence increased from 30.6 in 1985 to 97.4 in 2015. During the study period, there was no improvement in SMR over time (p=0.31).
The incidence and prevalence of SLE are increasing in this US population. The increase in incidence may be at least partially explained by the rising ethnic/racial diversity of the population. There was no evidence that the severity of SLE has changed over time. The survival gap between SLE and the general population remains unchanged. As the US population grows more diverse, we might continue to see an increase in the incidence of SLE.
确定四十年来美国人群中系统性红斑狼疮（SLE）的发病率、患病率和死亡率趋势。
我们识别了明尼苏达州奥尔姆斯特德县所有在1976 - 2018年期间符合欧洲抗风湿病联盟（EULAR）/美国风湿病学会（ACR）SLE标准的患者。将年龄和性别特异性发病率及患病率调整至2000年美国标准预测人口。使用EULAR/ACR评分作为疾病严重程度的替代指标。估计标准化死亡率（SMR）。
1976 - 2018年有188例SLE新发病例（平均年龄46.3±标准差16.9；83%为女性）。总体年龄和性别调整后的每10万人口年SLE发病率为4.77（95%置信区间4.09至5.46）。女性发病率（7.58）高于男性（1.89）。发病率从1976 - 1988年的3.32增至2009 - 2018年的6.44。种族和少数民族人群的发病率高于非西班牙裔白人。EULAR/ACR评分随时间无显著变化。总体患病率从1985年的30.6增至2015年的97.4。研究期间，SMR随时间无改善（p = 0.31）。
该美国人群中SLE的发病率和患病率正在上升。发病率增加可能至少部分归因于人口中种族/民族多样性的增加。没有证据表明SLE的严重程度随时间发生了变化。SLE与一般人群之间的生存差距保持不变。随着美国人口日益多样化，我们可能会继续看到SLE发病率上升。
