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Association of African-American ethnicity and smoking status with total and individual damage index in systemic lupus erythematosus

Clinical rheumatology, 2020-02, Vol.39 (2), p.365-373 [Peer Reviewed Journal]

International League of Associations for Rheumatology (ILAR) 2019 ;Clinical Rheumatology is a copyright of Springer, (2019). All Rights Reserved. ;ISSN: 0770-3198 ;EISSN: 1434-9949 ;DOI: 10.1007/s10067-019-04800-1 ;PMID: 31705325

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Title:
Association of African-American ethnicity and smoking status with total and individual damage index in systemic lupus erythematosus
Author: Kallas, Romy ; Li, Jessica ; Petri, Michelle
Subjects: Adult ; African Americans ; African Americans - statistics & numerical data ; Alopecia - epidemiology ; Alopecia - ethnology ; Arteriosclerosis ; Arthritis ; Arthritis - epidemiology ; Arthritis - ethnology ; Atherosclerosis - epidemiology ; Atherosclerosis - ethnology ; Atrophy ; Avascular necrosis ; Cardiomyopathies - epidemiology ; Cardiomyopathies - ethnology ; Cardiomyopathy ; Cardiovascular diseases ; Cardiovascular Diseases - epidemiology ; Cardiovascular Diseases - ethnology ; Cataract - epidemiology ; Cataract - ethnology ; Cicatrix - epidemiology ; Cicatrix - ethnology ; Cigarette Smoking - epidemiology ; Cohort Studies ; Diabetes ; Diabetes mellitus ; Diabetes Mellitus - epidemiology ; Diabetes Mellitus - ethnology ; Ethnicity ; Ex-Smokers ; Female ; Humans ; Hypertension ; Hypertension, Pulmonary - epidemiology ; Hypertension, Pulmonary - ethnology ; Kidney Failure, Chronic - epidemiology ; Kidney Failure, Chronic - ethnology ; Longitudinal Studies ; Lupus ; Lupus Erythematosus, Cutaneous - epidemiology ; Lupus Erythematosus, Cutaneous - ethnology ; Lupus Erythematosus, Systemic - epidemiology ; Lupus Erythematosus, Systemic - ethnology ; Lupus Nephritis - epidemiology ; Lupus Nephritis - ethnology ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Minority & ethnic groups ; Muscular Atrophy - epidemiology ; Muscular Atrophy - ethnology ; Non-Smokers ; Original Article ; Osteonecrosis - epidemiology ; Osteonecrosis - ethnology ; Proportional Hazards Models ; Pulmonary hypertension ; Rheumatology ; Skin ; Smokers ; Smoking ; Systemic lupus erythematosus ; Time ; United States - epidemiology ; White people ; Whites - statistics & numerical data
Is Part Of: Clinical rheumatology, 2020-02, Vol.39 (2), p.365-373
Description: Introduction Smoking has been associated with increased incidence, severity of cutaneous lupus, and lupus activity. We looked at the association of both smoking and ethnicity with the individual damage items from the SLICC/ACR Damage Index. Methods Poisson regression was used to model the total SLICC/ACR Damage Index score against ever smoking. Cox regression was used to assess the relationship between time to individual damage items and ever smoking. Furthermore, we compared SLICC/ACR Damage Index items among African-American and Caucasian ever smokers. Results The study included 2629 patients, 52.6% Caucasian and 39.3% African-American. The prevalence of ever smokers was 35.8%. There was no significant difference in total SLICC/ACR Damage Index score between ever smokers and never smokers after adjustment for ethnicity, gender, age at diagnosis, and years of education. Ever smokers had more atherosclerotic cardiovascular damage and skin damage compared to non-smokers. Caucasian SLE patients who ever smoked were more likely to have muscle atrophy and atherosclerosis compared to Caucasian non-smokers. African-American patients who ever smoked were more likely to have skin damage compared to African-American non-smokers. African-Americans who smoked were more likely to have many more damage items (cataract, renal damage, pulmonary hypertension, cardiomyopathy, deforming or erosive arthritis, avascular necrosis, skin damage, and diabetes) compared to Caucasians who smoked. Conclusion Our analysis proved the major effect of smoking on cardiovascular and cutaneous damage. Surprisingly, cardiovascular damage items had higher hazard ratios in Caucasian smokers than non-smokers while skin damage items hazard ratios were higher in African-American smokers compared to non-smokers. Key Points • This study is the largest cohort study to date evaluating the effect of smoking on the cumulative SLICC/ACR Damage Index and its individual damage items. • It is the only study that examined the effect of smoking on individual items of the SLICC/ACR Damage Index in terms of Caucasians vs. African-American ethnicity. • Our analysis proved the major effect of smoking on cardiovascular and cutaneous damage. Compared to non-smokers, Caucasian smokers had higher risk of cardiovascular damage while African-American smokers had more skin damage. • African-Americans who smoked were more likely to have many more damage items (cataract, renal damage, pulmonary hypertension, cardiomyopathy, deforming or erosive arthritis, avascular necrosis, skin damage, and diabetes) compared to Caucasians who smoked.
Publisher: London: Springer London
Language: English
Identifier: ISSN: 0770-3198
EISSN: 1434-9949
DOI: 10.1007/s10067-019-04800-1
PMID: 31705325
Source: MEDLINE
ProQuest Central

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Association of African-American ethnicity and smoking status with total and individual damage index in systemic lupus erythematosus

International League of Associations for Rheumatology (ILAR) 2019 ;Clinical Rheumatology is a copyright of Springer, (2019). All Rights Reserved. ;ISSN: 0770-3198 ;EISSN: 1434-9949 ;DOI: 10.1007/s10067-019-04800-1 ;PMID: 31705325

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