title: Systemic lupus erythematosus in three ethnic groups: III. A comparison of characteristics early in the natural history of the LUMINA cohort. LUpus in MInority populations: NAture vs. Nurture.
abstract: OBJECTIVE
  To determine and contrast the socioeconomic-demographic and clinical features of patients with recent onset (< or =5 y) systemic lupus erythematosus (SLE) from three ethnic groups, Hispanic, African-American and Caucasian (H, AA, C).
  
  
  METHODS
  SLE cases (American College of Rheumatology criteria) (incident (n = 56), prevalent (n = 173)), were enrolled in a longitudinal study at The University of Alabama at Birmingham, The University of Texas-Houston Health Science Center and The University of Texas Medical Branch at Galveston. Socioeconomic-demographic, clinical, immunological, behavioral and psychological data were obtained using validated instruments and standard laboratory techniques, and compared.
  
  
  RESULTS
  70 H, 88 AA and 71 C SLE patients constitute this cohort. H and AA patients were younger and of lower socioeconomic-demographic status. They also had evidence of more frequent organ system involvement (renal, cardiovascular), more auto-antibodies, more active disease (after adjusting for discrepant socioeconomic-demographic features), lower levels of social support and more abnormal illness-related behaviors (more in H than in AA). H also were more likely to have an abrupt disease onset; C were more likely to be on antimalarials but less likely to be on corticosteroids. H, AA, and C used health care resources comparably. They had similar levels of pain and physical and mental functioning after adjusting for age, disease duration, income, education, social support, illness-related behaviors, and Systemic Lupus Activity Measure or SLAM scores.
  
  
  CONCLUSIONS
  H and AA patients have more active SLE, at an earlier age of onset, and a less favorable socioeconomic-demographic structure (worse among the H than AA) which predispose them to a less favorable natural history.
authors.affiliation: Department of Medicine, School of Medicine, The University of Alabama at Birmingham, 35294, USA. graciela.alarcon@ccc.uab.edu
authors.forename: G S
authors.initials: GS
authors.lastname: Alarcón
authors.forename: A W
authors.initials: AW
authors.lastname: Friedman
authors.forename: K V
authors.initials: KV
authors.lastname: Straaton
authors.forename: J M
authors.initials: JM
authors.lastname: Moulds
authors.forename: J
authors.initials: J
authors.lastname: Lisse
authors.forename: H M
authors.initials: HM
authors.lastname: Bastian
authors.forename: G
authors.initials: G
authors.lastname: McGwin
authors.forename: A A
authors.initials: AA
authors.lastname: Bartolucci
authors.forename: J M
authors.initials: JM
authors.lastname: Roseman
authors.forename: J D
authors.initials: JD
authors.lastname: Reveille
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American; D017668:Age of Onset; D000368:Aged; D015331:Cohort Studies; D005006:Ethnicity; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D044465:White People