Marri Luca, Vassallo Chiara, Esposito Pasquale, Bottaro Luca, De Palma Raffaele, Negrini Simone
Department of Internal Medicine University of Genova, Genova 16132, Italy.
Internal Medicine Clinical Immunology and Translational Medicine Unit IRCCS Ospedale Policlinico San Martino, Genova 16132, Italy.
Autoimmune Dis. 2024 Aug 27;2024:5593302. doi: 10.1155/2024/5593302. eCollection 2024.
Different studies report that systemic lupus erythematosus (SLE) tends to have a more aggressive course in Hispanic patients. In this study, we analysed epidemiologic, clinical, and laboratory characteristics in a cohort of Hispanic and Caucasian lupus patients in the context of Italian health service, which provides free access to care to all citizens, thus mitigating the impact of socioeconomic factors that negatively influence the course of the disease in ethnic minorities.
This single-center retrospective study was conducted at the San Martino Hospital "Lupus Clinic" in Genoa, Italy. Patients ≥18 years with a confirmed diagnosis of SLE and definite ethnicity (Hispanic or Caucasian) were recruited.
A total of 126 patients (90 Caucasians and 36 Hispanics) were enrolled. We compared epidemiologic characteristics, clinical features, autoantibodies profile, and treatment options without evidencing any statistically significant difference between the two groups, except for disease duration, which was higher in the Caucasian group (20.4 years versus 14.2 years in the Hispanic group, =0.002) and SLICC damage index, which was greater in Caucasian patients (2.11 versus 1.88 in Hispanics, =0.037), but this difference was no longer significant after correction for disease duration (=0.096).
In our cohort, Hispanic ethnicity is not associated with worse disease features and outcomes. Therefore, we speculated that socioeconomic factors, in particular, free access to healthcare, might be more relevant in influencing the course of the disease than genetic background.
不同研究报告称，系统性红斑狼疮（SLE）在西班牙裔患者中往往病程更为凶险。在本研究中，我们分析了意大利医疗服务背景下一组西班牙裔和白种人狼疮患者的流行病学、临床和实验室特征。意大利医疗服务为所有公民提供免费医疗服务，从而减轻了对少数族裔疾病病程产生负面影响的社会经济因素的影响。
这项单中心回顾性研究在意大利热那亚的圣马蒂诺医院“狼疮诊所”进行。招募了年龄≥18岁、确诊为SLE且种族明确（西班牙裔或白种人）的患者。
共纳入126例患者（90例白种人，36例西班牙裔）。我们比较了两组患者的流行病学特征、临床特征、自身抗体谱和治疗方案，未发现两组之间有任何统计学上的显著差异，但疾病持续时间除外，白种人组的疾病持续时间更长（20.4年，西班牙裔组为14.2年，P=0.002），系统性红斑狼疮国际协作临床（SLICC）损伤指数在白种人患者中更高（西班牙裔为1.88，白种人为2.11，P=0.037），但在校正疾病持续时间后，这种差异不再显著（P=0.096）。
在我们的队列中，西班牙裔种族与更差的疾病特征和结局无关。因此，我们推测社会经济因素，特别是免费医疗服务，可能比遗传背景在影响疾病病程方面更具相关性。
