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Instituto Nacional de Salud Pública

2002, Number 3

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salud publica mex 2002; 44 (3)

Risk factors associated with systemic lupus erythematosus in Mexican population.

Zonana-Nacach A, Rodríguez-Guzmán LM, Jiménez-Balderas FJ, Camargo-Coronel A, Escobedo-de la Peña J, Fraga A

Language: Spanish
References: 39
Page: 213-218
PDF size: 47.04 Kb.


ABSTRACT

Objective. To assess risk factors associated with systemic lupus erythematosus (SLE) in the Mexican population. Material and Methods. A case-control study was conducted on June 1996, at the Reumathology Clinic of Hospital de Especialidades del Centro Médico Nacional Siglo XXI (HE CMN), Instituto Mexicano del Seguro Social, in Mexico City. Cases were one hundred thirty subjects with four or more SLE criteria and disease evolution of ± 5 years. Controls were hospitalized patients with acute diseases but without autoimmune diseases. Cases and controls were matched 1:1 by age and gender; both groups were evaluated by direct interview through a structured questionnaire. The following risk factors were assessed: genetic family history of SLE and connective tissue disease; socioedemographic (ethnicity, geographic distribution, education, monthly income); hormonal (use of oral contraceptives, replacement therapy and gynecoobstetric background); environmental (use of hair products, living with dogs, bacterial/viral infections, and allergies). Statistical analysis consisted of odd ratios (OR) with 95% confidence intervals (CI ) and multivariate analysis using logistic regression. Results. The multivariate model showed association with family history of SLE (OR 4.2, CI 95% 1.17-15.2), family history of connective tissue disorder (OR 2.6, CI 95% 1.15-4.5), use of oral contraceptives for more than one year (OR 2.1, CI 95% 1.13-4.3), repetitive pharyngitis (OR 2.1, CI 95% 1.18-3.6), and use of medications (OR 5.0 IC 95% 1.62 - 21.6). No association was found with socieconomic status, hair dye products, asthma, or allergies. Conclusions. Genetic factors, such as family history of SLE and connective tissue disease in first-degree relatives, persist as important factors in the development of SLE. Other factors, such as use of some drugs, oral contraceptives, and repetitive pharyngitis, may also favor the onset of disease in genetically susceptible hosts.


REFERENCES

  1. Fessel WF. Epidemiology of systemic lupus erythematosus. Rheum Dis Clin North Am 1988;14:15-23.

  2. Deapen D, Escalante A, Weinrib L, Horwitz D, Bachman B, Roy-Burman P et al. A revised estimate of twin concordance in systemic lupus erythematosus. Arthritis Rheum 1992;35:311-318.

  3. Lawrence JS, Martins CL, Drake GL. A family survey of lupus erythematosus heritability. J Rheumatol 1987;14:913-921.

  4. Hochberg MC, Flosheim F, Scott J, Arnett J. Familial aggregation of systemic lupus erythematosus. Am J Epidemiol 1985;122:959-966.

  5. Alvaro-García JM, Humbría A, García-Vicuña R, Ariza A, García-Vadillo A, Laffón A. Systemic lupus erythematosus and tetrasomy-X. J Rheumatol 1989;16:1486-1488.

  6. Seuchter SA, Knapp M, Hartung K, Coldewey R, Kalden JR, Lakmek HJ et al. Testing the association in SLE families. Genet Epidemiol 1991;8: 409-416.

  7. Wakeland EK, Wandstrat AE, Liu K, Morel L. Genetic dissection of systemic lupus erythematosus. Curr Opin Immunol 1999;11:701-707.

  8. Sánchez-Guerrero J, Karlson EW, Liang MH, Hunter DJ, Speicer FE, Golditz GA. Past use of oral contraceptives and the risk of developing systemic lupus erythematosus. Arthritis Rheum 1997;40:804-808.

  9. Rood MJ, Van der Velde EA, Ten Cate R, Breedveld FC, Huizinga TW. Female sex hormones at the onset of systemic lupus erythematosus affect survival. Br J Rheumatol 1998;37:1008-1010.

  10. Liang MH, Karlson EW. Female hormone therapy and the risk factor of developing or exacerbating systemic lupus erythematosus or rheumatoid arthritis. Proc Assoc Am Physicians 1996;108:25-28.

  11. Mier CR, Sturkkenboom MC, Cohen AS, Jick H. Postmenopausal estrogen replacement therapy and the risk of developing systemic lupus erythematosus or discoid lupus. J Rheumatol 1998;25:1515-1519.

  12. Lahita RG. The role of sex hormones in systemic lupus erythematosus. Curr Opin Rheumatol 1999;11:352-356.

  13. Petri M, Allbritton J. Hair product use in systemic lupus erythematosus. A case-control study. Arthritis Rheum 1992;35:625-629.

  14. Love LA. New environmental agents associated with lupus-like disorders. Lupus 1994;3:467-471.

  15. Mayes MD. Epidemiologic studies of environmental agents and systemic autoimmune diseases. Environ Health Perspect 1999;107(Suppl 5):743-748.

  16. Cooper GS, Dooley MA, Treadwell EL, St. Clair EW, Parks CG, Gilkeson GS. Hormonal, environmental, and infections risk factors for developing systemic lupus erythematosus. Arthritis Rheum 1998;41:1714-1724.

  17. Kardestuncer T, Frumkin H. Systemic lupus erythematous in relation to environmental pollution in an African-American community in North Georgia. Arch Environ Health1997;52:85-90.

  18. Granholm NA, Cavallo T. Autoimmunity, polyclonal B-cell activation and infection. Lupus 1992;2:163-174.

  19. Granholmy NA, Cavallo T. Enhancement of renal disease in BXSB lipus prone mice after prior exposure to bacterial lipopolysaccharide. Lupus 1995; 4:339-347.

  20. Acha-Orbea H. Bacterial and viral superantigens: Role in autoimmunity? Ann Rheum Dis 1993; 52(Suppl 1):S6-S16.

  21. Hess EV. Role of drugs and environmental agents in lupus syndromes. Curr Opin Rheumatol 1992;4:688-692.

  22. Salazar-Páramo M, Rubín RL, García de la Torre J. Systemic lupus erythematosus induced by isoniazid. Ann Rheum Dis 1992;51:1085-1087.

  23. Fritzler MJ. Drug recently associated with lupus syndromes. Lupus 1994;3:455-459.

  24. Montoya-Cabrera MA, Sauceda-García JM, Escalante-Galindo P, López- Morales E. Thallium poisoning wich stimulated systemic lupus erythematosus in a child. Gac Med Mex 1991;127:333-336.

  25. Strom BL, Reidenberg MM, West S, Sim ES, Freundlich B, Stolley PD. Shingles, allergies, family history, oral contraceptives, and other potential risk factors for systemic lupus erythematosus. Am J Epidemiol 1994;140: 632-642.

  26. Freni-Titulaer LW, Kelley DB, Grow AG, McKinley TW, Arnett FC, Hochberg MC. Connective tissue disease in Southeastern Georgia: A case-control study of etiologic factors. Am J Epidemiol 1989;130:404-409.

  27. Hardy CJ, Plamer BP, Muir KR, Sutton AJ, Powell RJ. Smoking history, alcohol consumption, and systemic lupus erythematosus: A case-control study. Ann Rheum Dis 1998;57:451-455.

  28. Benoni C, Nilson Å, Nived O. Smoking and inflammatory bowel disease: Comparison with systemic lupus erythematosus: A case-control study. Scand J Gastroenterol 1990;25:751-755.

  29. Nagata C, Fujita S, Iwata H, Kurosowa Y, Kobayashi K, Kobayashi M et al. Systemic lupus erythematous: A case-control epidemiologic study in Japan. Int J Dermatol 1995;34:333-337.

  30. Minami Y, Sasaki T, Komatsu S, Nishikori M, Fukao A, Yoshinaga K et al. Female systemic lupus erythematosus in Miyagi Prefecture, Japan: A casecontrol study of dietary and reproductive factors. Tohoku J Exp Med 1993;169:245-252.

  31. Grimes DA, LeBolt SA, Grimes KR, Wingo PA. Systemic lupus erythematosus and reproductive function: A case control study. Am J Obstet Gynecol 1985;153:179-186.

  32. Tan EM, Cohen AS, Fries JF, Masi AT, McShane DJ, Rothfield NF et al. The 1982 revised criteria for the classification of systemic lupus erythematosus (SLE). Arthritis Rheum 1982;25:1271-1277.

  33. Arden Nk, Lloyd M, Spector TD, Hughes GRV. Safety of hormone replacement therapy (ERT) in systemic lupus erythematosus. Lupus 1994;3: 11-13.

  34. Sánchez-Guerrero J, Karlson EW, Colditz GA, Hunter DJ, Speizer FE, Liang MH. Hair due products and the risk of developing systemis lupus erythematosus. Arthritis Rheum 1996;39:657-662.

  35. Cavallo T, Granholm NA. Bacterial lipopolysaccharide transform mesangial into proliferative lupus nephritis without interfering with processing of pathogenic immune complexes in NZB/W mice. Am J Pathol 1990; 971-978.

  36. Bisno AL. Acute pharingitis. N Engl J Med 2001;344:205-211.

  37. Nagata C, Yoshida H, Fujita S, Komura Y, Inaba R, Iwata H et al. A casecontro study of SLE based on patients receiving finnacial aid for tretament. Recent progress of epidemiologic study of intractable diseases in Japan. Tokio: Ministery of Health and Welfare of Japan, 1992:113-116.

  38. Kilburn KH, Warshaw RH. Prevalence of symptoms of systemic lupus erythematosus (SLE) and of fluorescent antinuclear antibodies associated with chronic exposure to trichloroethylene and other chemicals in well water. Environ Res 1992;57:1-9.

  39. Lüthke K, Conrad K, Mehlhorn J, Dörmer T, Frank KH. Systemic lupus erythematosus after heavy exposure to quartz dust in uranium mines: Clinical and serological characteristics. Lupus 1996;6:62-69.




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