Effect of ethnicity on clinical presentation and risk of antiphospholipid syndrome in Roma and Caucasian patients with systemic lupus erythematosus: a multicenter cross‐sectional study

Manzano-Gamero, Victoria; Pardo‐Cabello, Alfredo J.; Vargas‐Hitos, José Antonio; Zamora-Pasadas, Mónica; Navarrete‐Navarrete, Nuria; Sabio, José Mario; Jáimez-Gámiz, Laura; Fernández, Raquel Ríos; Ortego‐Centeno, Norberto; Ayala-Gutiérrez, M Mar; Enrique, Rafael; Colodro‐Ruíz, Agustín; Micó-Giner, L.; Castillo-Palma, María Jesús; Robles‐Marhuenda, Ángel; Castillo, Juan De Dios Luna-Del; Jiménez-Alonso, J

doi:10.1111/1756-185x.13117

Cited by 9 publications

(10 citation statements)

References 27 publications

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“…[ 2 ] As stated in other studies, research concerning SLE in pregnant women have often been limited to a particular ethnic group, or most of the time to a specific region. [ 3 , 4 ] Therefore, to generalize this issue, Bundhun et al clearly demonstrated the impact of SLE on maternal and fetal outcomes through a meta-analysis including various studies from different parts of the globe and included studies which were published between the years 2001 and 2016. [ 5 ] The authors clearly showed the associated adverse events with this life threatening disease throughout pregnancy and stated that special care and treatment should be provided to those women to minimize the risk of unfavorable outcomes.…”

Section: Introductionmentioning

confidence: 99%

Maternal and fetal complications associated with systemic lupus erythematosus

Hua

2020

Medicine

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Background: Recent guidelines provide better treatment and management of pregnancy in women with systemic lupus erythematosus (SLE). In this analysis, we aimed to systematically assess the maternal and fetal complications associated with SLE using the most recent studies (2017–2019) to obtain an updated result of the present situation. Methods: http://www.clinicaltrials.gov , MEDLINE, Cochrane Central, Web of Science, EMBASE, and Google Scholar were searched for English based studies comparing maternal and fetal complications in pregnant women with versus without SLE. Maternal and fetal complications were the endpoints in this analysis. The RevMan software 5.3 (latest version) was the most suitable analytical software for this analysis. Data were represented by risk ratio (RR) with 95% confidence interval (CI). Results: A total number of eight million eight hundred and twelve thousand two hundred seventy-two (8,812,272) participants were included in this analysis, consisting of 9696 SLE-associated pregnancy. Based on an analysis of recently published studies (2017–2019), pre-eclampsia/eclampsia was significantly higher in pregnant women with SLE (RR: 3.38, 95% CI: 3.15–3.62; P = .00001). SLE was also associated with an increased risk of stillbirth (RR: 16.49, 95% CI: 2.95–92.13; P = .001) and fetal loss (RR: 7.55, 95% CI: 4.75–11.99; P = .00001). Abortion (RR: 4.70, 95% CI: 3.02–7.29; P = .00001) and the risk for cesarean section due to complications (RR: 1.38, 95% CI: 1.11–1.70; P = .003) were also significantly higher in pregnant women with SLE. In addition, fetal complications including preterm birth (RR: 2.33, 95% CI: 1.78–3.05; P = .00001), infants who were small for gestational age (RR: 2.50, 95% CI: 1.41–4.45; P = .002) and infants with low birth weight (RR: 4.78, 95% CI: 3.65–6.26; P = .00001) were also significantly higher in newborns from mothers with SLE. Moreover, the risk of newborns who were admitted to the neonatal intensive care unit (RR: 2.79, 95% CI: 2.31–3.37; P = .00001), newborns with an APGAR score <7 within 1 minute (RR: 2.47, 95% CI: 1.68–3.62; P = .00001) and 5 minutes (RR: 3.63, 95% CI: 2.04–6.45; P = .0001) respectively, were significantly highly associated with SLE. Conclusions: Based on the most recent studies, we could conclude that maternal and fetal complications were significantly higher in SLE-associated pregnancy. Therefore, SLE should still be considered a severe risk factor for pregnancy.

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Section: Introductionmentioning

confidence: 99%

Maternal and fetal complications associated with systemic lupus erythematosus

Hua

2020

Medicine

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“…A limitation of our study is that SLE patients were, on average, older than controls (40 years vs. 34 years), which could have affected the prevalence of periodontitis; however, we think that the age group where it occurs the difference does not affect this frequency measurement. Another potential limitation is that the SLE group could not be representative of general SLE patients from a Caucasian population, due to a selection bias, but the demographic characteristics of this group are similar to the ones of other previously published studies with larger samples 6,37,38 …”

Section: Discussionmentioning

confidence: 99%

Periodontitis is associated with higher subclinical atherosclerosis in patients with systemic lupus erythematosus

Zamora-Pasadas

Marfil‐Álvarez

González‐Bustos

et al. 2022

J of Periodontal Research

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Aim: To determine periodontitis prevalence in patients with systemic lupus erythematosus (SLE) and to assess whether periodontitis in SLE patients is associated with a greater subclinical atherosclerosis. Methods: An observational case-control study was conducted in SLE (cases) and patients without any rheumatic diseases (controls), matched for sex. Sociodemographic and cardiometabolic variables were gathered, and SLE activity was assessed through several indexes. Periodontal examination registered probing pocket depth, clinical attachment level, bleeding on probing, plaque index, and tooth loss. Subclinical atherosclerosis was assessed by measuring the carotid-femoral pulse wave velocity (PWV) by Doppler velocimetry, homocysteine levels, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR). Bivariate analyses and logistic regression were used to assess the association of any of the studied variables with SLE.Results: Seventy-one cases and 72 controls were included in the study. Thirty-nine SLE patients (54.9%) were diagnosed with periodontitis, compared with 16 controls (22.2%). High levels of PWV (≥7.7 m/s, 75th percentile) were shown by 44.3% of the cases vs. 22.4% of the controls (p = .011). Among SLE patients, those with periodontitis showed higher PWV values (8.1 ± 1.52 vs. 7.16 ± 1.11 m/s, p = .006) and higher homeostasis model assessment index (indicative of insulin resistance) (1.7 ± 0.73 vs.2.92 ± 3.05, p = .028) compared to those with periodontal health. Logistic regression showed that waist circumference (OR 1.06, 95% CI 1.01-1.12, p = .015); ESR (OR 1.09, 95% CI 1.03-1.16, p = .003); and bleeding on probing (OR 1.1, 95% CI 1.01-1.19, p = .018) were associated with the risk of SLE. Conclusion:Systemic lupus erythematosus patients showed a higher periodontitis percentage than controls. Higher PWV values were found in SLE patients with periodontitis, indicating a higher prevalence of subclinical atherosclerosis. Patients with higher gingival bleeding showed a higher risk of SLE.

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“…Progress has been made in identifying the genes underlying JIA susceptibility, but only a few studies have shown the identification of environmental factors to be a trigger of the immunological abnormalities of JIA. Most of these studies discussed the connection between early life infection, maternal smoking, and autoimmune disease, but ethnicity was involved in only very few of them [23,24]. In 2018 Manzano-Gamero et al found a higher risk of antiphospholipid syndrome in Roma patients diagnosed with systemic lupus erythematodes [25].…”

Section: Discussionmentioning

confidence: 99%

Juvenile Idiopathic Arthritis: Roma Children Seem to Run More Risk than Non-Roma

Drobnakova

Gecková

Vargová

et al. 2020

IJERPH

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Background: Ethnic information regarding juvenile idiopathic arthritis (JIA) exists for various populations across the world but is fully lacking for Roma. We assessed the occurrence and clinical characteristics of JIA in Roma vs. non-Roma children. Methods: We obtained data on all outpatients (n = 142) from a paediatric rheumatology centre (age 3 to 18 years) in the eastern part of Slovakia (Kosice region). We assessed patients’ age, gender, disease type and related extra-articular conditions by ethnicity. We obtained population data from the 2011 census. Results: The share of Roma children was higher in the clinical JIA sample than in the overall population (24.6%, n = 35, Roma in the sample vs. 10.8%, n = 142, Roma in the population, p < 0.05). Moreover, Roma children had been diagnosed more frequently with extra-articular conditions but did not differ in other symptoms. Treatments also did not differ by ethnicity. Conclusion: Roma children had been diagnosed more with JIA than their non-Roma peers. This calls for further research on the causes of this increased disease burden in Roma children.

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Effect of ethnicity on clinical presentation and risk of antiphospholipid syndrome in Roma and Caucasian patients with systemic lupus erythematosus: a multicenter cross‐sectional study

Abstract: Prevalence and risk of APS were significantly higher in Roma SLE patients. Furthermore, Roma patients had a significantly higher prevalence of abortions and a non-significant higher prevalence of fetal deaths and thrombotic events.

Cited by 9 publications

References 27 publications

Maternal and fetal complications associated with systemic lupus erythematosus

Maternal and fetal complications associated with systemic lupus erythematosus

Periodontitis is associated with higher subclinical atherosclerosis in patients with systemic lupus erythematosus

Juvenile Idiopathic Arthritis: Roma Children Seem to Run More Risk than Non-Roma

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