Hernández-Ledesma Ana Laura, Martínez Domingo, Fajardo-Brigido Elizabeth, Román-López Talía V, Nuñez-Reza Karen J, Tapia-Atilano Andrea Y, Vera Del Valle Sandra V, Domínguez-Zúñiga Donají, Tinajero-Nieto Lizbet, Peña-Ayala Angélica, Torres-Valdez Estefania, Frontana-Vázquez Gabriel, Gutiérrez-Arcelus María, Rosetti Florencia, Alcauter Sarael, Rentería Miguel E, Ruiz-Contreras Alejandra E, Alpízar-Rodríguez Deshiré, Medina-Rivera Alejandra
Laboratorio Internacional de Investigación sobre el Genoma Humano, Universidad Nacional Autónoma de México, Campus Juriquilla, Blvd Juriquilla 3001, 76230 Santiago de Querétaro, México.
Instituto de Biotecnología, Universidad Nacional Autónoma de México, Cuernavaca, Morelos, México.
PLOS Digit Health. 2025 Jan 23;4(1):e0000706. doi: 10.1371/journal.pdig.0000706. eCollection 2025 Jan.
Higher prevalence and worst outcome have been reported among people with systemic lupus erythematosus with non-European ancestries, with both genetic and socioeconomic variables as contributing factors. In Mexico, studies assessing the inequities related to quality of life for Systemic Lupus Erythematosus patients remain sparse. This study aims to assess the inequities related to quality of life in a cohort of Mexican people with SLE. This study included 942 individuals with SLE from the Mexican Lupus Registry (LupusRGMX) and two healthy control groups. Self-answered surveys were collected via the Research Electronic Data Capture platform between May 2021 and January 2023. Data was analyzed as a cross-sectional study. A random forest model was implemented to assess potential predictive variables. Permutation tests were performed to analyze the effect health providers had on diagnosis lag and quality of life's differences among socioeconomic levels. Partial correlation analysis between the number of patients and rheumatologists registered was also performed. Systemic Lupus Erythematosus participants had significantly lower quality of life than healthy people (p-values < 0.0001). Socioeconomic status, delay in diagnosis, and corticosteroid consumption were the factors that influenced QoL the most (RMSE = 9.53 with the importance variable validated); lower quality of life was associated with lower socioeconomic status (p-value < 0.0001). Disparities in health services were reflected in longer diagnosis time among people with public health providers (p-value = 0.0419). A significant association between diagnosed patients and available rheumatologists by geographical state was observed (ρ = 0.4, p-value = 0.0259), which can be translated into restricted access to specialists. Since most of our cohort exhibited low socioeconomic status, it is important to consider them as a vulnerable population; this study settles the necessity to deepen the effects of the socioeconomic disparities, allowing to design public policies and strategies aimed to reduce Systemic Lupus Erythematosus disparities, therefore improving quality of life of Mexican people with Systemic Lupus Erythematosus.
据报道，非欧洲血统的系统性红斑狼疮患者的患病率更高，预后更差，遗传和社会经济变量都是促成因素。在墨西哥，评估系统性红斑狼疮患者生活质量不平等问题的研究仍然很少。本研究旨在评估一组墨西哥系统性红斑狼疮患者生活质量方面的不平等问题。本研究纳入了来自墨西哥狼疮登记处（LupusRGMX）的942名系统性红斑狼疮患者和两个健康对照组。2021年5月至2023年1月期间，通过研究电子数据采集平台收集了自我回答的调查问卷。数据作为横断面研究进行分析。实施了随机森林模型来评估潜在的预测变量。进行了排列检验，以分析医疗服务提供者对诊断延迟和社会经济水平之间生活质量差异的影响。还对登记的患者数量和风湿病学家数量进行了偏相关分析。系统性红斑狼疮参与者的生活质量明显低于健康人（p值<0.0001）。社会经济地位、诊断延迟和皮质类固醇的使用是对生活质量影响最大的因素（验证重要变量后均方根误差=9.53）；生活质量较低与社会经济地位较低相关（p值<0.0001）。公共卫生服务提供者的患者诊断时间更长，这反映了卫生服务方面的差异（p值=0.0419）。观察到按地理区域划分的确诊患者与现有风湿病学家之间存在显著关联（ρ=0.4，p值=0.0259），这可能意味着获得专科医生服务的机会有限。由于我们的大多数队列显示社会经济地位较低，因此将他们视为弱势群体很重要；本研究确定有必要深入研究社会经济差异的影响，以便制定旨在减少系统性红斑狼疮差异的公共政策和战略，从而改善墨西哥系统性红斑狼疮患者的生活质量。
