Background Systemic lupus erythematosus (SLE) is regarded as a prototype autoimmune disease because it can serve as a means for studying differences between ethnic minorities and sex. Traditionally, all Hispanics have been bracketed within the same ethnic group, but there are differences between Hispanics from Spain and those from Latin America, not to mention other Spanish-speaking populations. Objectives This study aimed to determine the demographic and clinical characteristics, severity, activity, damage, mortality and co-morbidity of SLE in Hispanics belonging to the two ethnic groups resident in Spain, and to identify any differences. Methods This was an observational, multi-centre, retrospective study. The demographic and clinical variables of patients with SLE from 45 rheumatology units were collected. The study was conducted in accordance with Good Clinical Practice guidelines. Hispanic patients from the registry were divided into two groups: Spaniards or European Caucasians (EC) and Latin American mestizos (LAM). Comparative univariate and multivariate statistical analyses were carried out. Results A total of 3490 SLE patients were included, 90% of whom were female; 3305 (92%) EC and 185 (5%) LAM. LAM patients experienced their first lupus symptoms four years earlier than EC patients and were diagnosed and included in the registry younger, and their SLE was of a shorter duration. The time in months from the first SLE symptoms to diagnosis was longer in EC patients, as were the follow-up periods. LAM patients exhibited higher prevalence rates of myositis, haemolytic anaemia and nephritis, but there were no differences in histological type or serositis. Anti-Sm, anti-Ro and anti-RNP antibodies were more frequently found in LAM patients. LAM patients also had higher levels of disease activity, severity and hospital admissions. However, there were no differences in damage index, mortality or co-morbidity index. In the multivariate analysis, after adjusting for confounders, in several models the odds ratio (95% confidence interval) for a Katz severity index >3 in LAM patients was 1.45 (1.038–2.026; p = 0.02). This difference did not extend to activity levels (i.e. SLEDAI >3; 0.98 (0.30–1.66)). Conclusion SLE in Hispanic EC patients showed clinical differences compared to Hispanic LAM patients. The latter more frequently suffered nephritis and higher severity indices. This study shows that where lupus is concerned, not all Hispanics are equal.
The aim of the European Journal of Rheumatology is to cover various aspects of rheumatology for its readers, encompassing the spectrum of diseases with arthritis, musculoskeletal conditions, autoinflammatory diseases, connective tissue disorders, osteoporosis, translational research, the latest therapies and treatment programs. European Journal of Rheumatology publishes original articles, invited reviews, case based reviews, letters to the editor and images in rheumatology. The publication language of the journal is English.
Objetive: To evaluate, over a 79.2-month follow-up period, the behavior of bone mineral density (BMD) determined by Computerized Axial Densitometry (DXA), volumetric bone mineral density (BMDvol) and its relationship with anthropometric data, together with the parameters related to bone metabolism (calcium, phosphorus, alkaline phosphatase, parathormone (PTH) and vitamin D (25-OH-D3)) in a child population with Type 1 Diabetes Mellitus (DM1) without microvascular complications and a control group of reference with similar characteristics. Material and methods: Initially, a cross-sectional study was carried out in 40 diabetic children (mean age 9.4±2.8 years) and 108 controls (9.3±1.5 years) to assess the possible differences between the two populations. 26 patients from the initial diabetic group were reassessed after 79.2 months of follow-up. Results: It was observed that, at baseline, bone mass was similar in diabetics and controls. After follow-up, the BMD of the diabetic children was much lower than that expected in the non-diabetic child population. Weight, height, and Body Mass Index (BMI) followed the same pattern as BMD. The values of calcium, phosphorus, alkaline phosphatase, PTH and vitamin D, although within the normal range, were lower than in the controls. Alkaline phosphatase did not increase in the pubertal period. Conclusions: The present study demonstrates that children and adolescents with a recent diagnosis of DM1 have a normal BMD. However, over time, and especially during adolescence, they show less bone mass gain and changes in bone turnover parameters.
BackgroundIntroduction: Women with breast cancer have a higher risk of osteoporotic fractures than the rest of the population of the same sex and age. This problem is due to multiple factors among which are the treatments to which they are subjected. Among them, chemical castration, chemo and/or radiotherapy, corticosteroids, surgery, monoclonal antibodies against HER-2 and aromatase inhibitors are related to increased bone resorption.ObjectivesObjectives: To assess the prevalence of and factors associated with fragility fractures in women with breast adenocarcinoma.MethodsPatients and methods: Prospective, cross-sectional study in progress. In a multidisciplinary consultation of OP and Oncology of two third-level centres in Seville, women diagnosed with breast cancer are treated. The factors associated with the presence of vertebral and peripheral fragility fractures in these patients at the time of the first evaluation were analysed.ResultsResults: 409 women were included in this analysis, evaluated between September 2014 and December 2017. The median age (Q1-Q3) was 63 55–68 years. 38 (9%) fragility fractures were observed, 22 (5.4%) vertebral and 18 (4.4%) peripheral. Three patients presented peripheral and vertebral fractures. Factors such as smoking, family history, menopause age, exercise, sun exposure, milk consumption or BMI were not associated with fragility fractures. The t-score in the femoral neck or spine was also not associated with fragility fractures. Of the 88 patients treated with tamoxifen, 6 (6.8%) had fragility fractures compared to 32/320 (10%) of those who did not receive tamoxifen (p=0.367). They presented fragility fractures 22/215 (10%) women with letrozole compared to 16/194 (8%) that were not treated with letrozole (p=0.490). At the time of the first evaluation, the mean (SD) of the FRAX was 6.1 (5.3) in women without fractures and 11.7 (7.7) in those with fragility fractures (p<0.001). In the logistic regression, the only variable associated independently was the FRAX [FRAX >10, adjusted OR 8.9 (3.9–20.4), p<0.001]. The best logistic regression model explained 12% of fragility fracturesConclusionsConclusion: In women with breast cancer, FRAX is the only clinical variable associated independently with the presence of fragility fractures in ourDisclosure of InterestNone declared
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