Prevalence of Systemic Lupus Erythematosus and Associated Comorbidities in Puerto Rico

Abstract

Objective-To determine the prevalence of systemic lupus erythematosus (SLE) and its associated comorbidities in patients from Puerto Rico using a database from a health insurance company.Methods-The insurance claims submitted by physicians in 2003 to a health insurance company of Puerto Rico were examined. Of 552,733 insured people, 877 had a diagnosis of SLE (code 710.0) per the International Classification of Diseases, Ninth Revision (ICD-9). Demographic parameters and selected comorbidities were determined. The diagnosis of comorbities was ascertained using the ICD-9 code, the Current Procedural Terminology-4 (CPT-4) code (for disease specific procedures) and/or the Medi-Span Therapeutic Classification System (for disease specific pharmacologic treatment). Fisher exact test and Chi-square were used to evaluate differences between SLE patients groups.Results-The mean age was 42.0 ± 13 and the female to male ratio was 12.5:1. The overall prevalence of SLE was 159 per 100,000 individuals. The prevalence for females was 277 per 100,000 women and for males it was 25 per 100,000 men. The most common comorbidities were high blood pressure (33.7%), osteopenia/osteoporosis (22.2%), hypothyroidism (19.0%), diabetes mellitus (11.6%) and hypercholesterolemia (11.6%). Overall, high blood pressure, diabetes mellitus, hypercholesterolemia, and coronary artery disease were more prevalent in SLE patients older than 54 years. Osteopenia/osteoporosis was more prevalent in women than in men.Conclusions-The prevalence of SLE in Puerto Rico is very high. High blood pressure, diabetes mellitus, hypercholesterolemia, hypothyroidism and osteopenia/osteoporosis are common comorbidities in these patients. Identification and management of these comorbidities are critical for optimal medical care to this population. Key indexing termsSystemic lupus erythematosus; prevalence; comorbidities; Puerto Rico Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by a wide spectrum of clinical and immunological abnormalities (1). Epidemiological studies on the prevalence of SLE show a broad range among different ethnic populations (21.7 to 124 per 100,000 population), possibly related to variability in genetic and environment factors (2-9).

C-Reactive Protein is Linked to Lower Cognitive Performance in Overweight and Obese Women

“…We found that CRP levels were higher in females than in males, which is consistent with other studies [16,56]. Of interest, women are more prone to autoimmune diseases such as Lupus and Rheumatoid Arthritis [57,58], which are characterized by inflammation, elevated CRP [59,60], and accelerated rates of microvascular disease and atherosclerosis [61,62]. Elevated CRP in these women is also associated with cognitive impairments.…”

Drugs used in incident systemic lupus erythematosus – results from the Finnish nationwide register 2000–2007

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A Hot Spot for Systemic Lupus Erythematosus, but Not for Psoriatic Arthritis, Identified by Spatial Analysis Suggests an Interaction Between Ethnicity and Place of Residence

“…Unlike previous studies that assigned a single incidence rate to all patients (1,(22)(23)(24)(25), this method assigned different rates for various age and sex categories by census tract, therefore adjusting for these variables. In the process of constructing this map, a systematic methodology for converting patient residential history from paper charts to an electronic database and subsequently to a map was also demonstrated.…”