Population-Based Incidence and Prevalence of Systemic Lupus Erythematosus
Published Date:Feb 2014
Source:Arthritis Rheumatol. 2014; 66(2):369-378.
Pubmed Central ID:PMC4198147
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
To estimate the incidence and prevalence of systemic lupus erythematosus (SLE) in a sociodemographically diverse southeastern Michigan source population of 2.4 million people.
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.
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).
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.
image/gif image/jpeg image/gif image/jpeg image/gif image/jpeg image/gif image/jpeg application/octet-stream application/pdf
You May Also Like: