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Population-Based Incidence and Prevalence of Systemic Lupus Erythematosus
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Details:
  • Pubmed ID:
    24504809
  • Pubmed Central ID:
    PMC4198147
  • Description:
    Objective

    To estimate the incidence and prevalence of systemic lupus erythematosus (SLE) in a sociodemographically diverse southeastern Michigan source population of 2.4 million people.

    Methods

    SLE cases fulfilling the American College of Rheumatology classification criteria (primary case definition) or meeting rheumatologist-judged SLE criteria (secondary definition) and residing in Wayne or Washtenaw Counties during 2002–2004 were included. Case finding was performed from 6 source types, including hospitals and private specialists. Age-standardized rates were computed, and capture–recapture was performed to estimate underascertainment of cases.

    Results

    The overall age-adjusted incidence and prevalence (ACR definition) per 100,000 persons were 5.5 (95% confidence interval [95% CI] 5.0–6.1) and 72.8 (95% CI 70.8–74.8). Among females, the incidence was 9.3 per 100,000 persons and the prevalence was 128.7 per 100,000 persons. Only 7 cases were estimated to have been missed by capture–recapture, adjustment for which did not materially affect the rates. SLE prevalence was 2.3-fold higher in black persons than in white persons, and 10-fold higher in females than in males. Among incident cases, the mean ± SD age at diagnosis was 39.3 ± 16.6 years. Black SLE patients had a higher proportion of renal disease and end-stage renal disease (ESRD) (40.5% and 15.3%, respectively) as compared to white SLE patients (18.8% and 4.5%, respectively). Black patients with renal disease were diagnosed as having SLE at younger age than white patients with renal disease (mean ± SD 34.4 ± 14.9 years versus 41.9 ± 21.3 years; P = 0.05).

    Conclusion

    SLE prevalence was higher than has been described in most other population-based studies and reached 1 in 537 among black female persons. There were substantial racial disparities in the burden of SLE, with black patients experiencing earlier age at diagnosis, >2-fold increases in SLE incidence and prevalence, and increased proportions of renal disease and progression to ESRD as compared to white patients.

  • Document Type:
  • Collection(s):
  • Funding:
    K01 ES019909/ES/NIEHS NIH HHS/United States
    K01-ES-019909/ES/NIEHS NIH HHS/United States
    K12 HD001438/HD/NICHD NIH HHS/United States
    K12-HD-001438/HD/NICHD NIH HHS/United States
    U58/DP001441/DP/NCCDPHP CDC HHS/United States
    UL1 RR024986/RR/NCRR NIH HHS/United States
    UL1-RR-024986/RR/NCRR NIH HHS/United States
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